Amyloidosis is a condition characterized by the buildup of abnormal protein deposits, known as amyloid fibrils, within the body’s organs and tissues. These deposits interfere with normal organ function. While the disease involves misfolded proteins made by the body, dietary protein does not directly cause the deposits to form. However, complications arising from organ damage, particularly to the heart and kidneys, often require specific dietary restrictions to manage symptoms and support overall health. Dietary modification is a supportive measure, not a cure, and any changes should only be made after consulting with a physician or a registered dietitian.
Restricting Sodium and Fluid Intake
Damage to the heart and kidneys is common in amyloidosis, often necessitating the restriction of sodium and fluid intake. Limiting sodium helps prevent the body from retaining excess water, which can lead to swelling (edema) and increase blood pressure. Excess fluid retention forces the heart to work harder and can cause congestion in the lungs.
A common recommendation is to limit daily sodium intake to less than 2,000 milligrams, which is about 2 grams, though some patients may require stricter limits. Foods to strictly avoid include highly processed items such as canned soups, fast food, frozen dinners, and cured or smoked meats. Condiments like soy sauce, ketchup, and pickled items are also sources of high sodium content that should be avoided.
Checking nutrition labels for sodium content is a practical way to manage intake, focusing on products labeled as “low-sodium” or “very-low-sodium.” When cooking at home, salt should be avoided entirely, using herbs, spices, or lemon juice to add flavor instead. Fluid intake may also be restricted, typically to between 1.5 to 2 liters per day, including all liquids and foods with high water content. Monitoring fluid intake helps reduce strain on the heart and kidneys and prevents complications like pulmonary congestion.
Managing Protein and Electrolyte Levels
When amyloidosis affects the kidneys, the organs may struggle to filter waste products, requiring careful management of certain nutrients. While protein is a building block for the body, damaged kidneys may have difficulty removing the waste generated from protein metabolism. This may necessitate restricting overall protein consumption to prevent waste buildup in the blood, but the specific amount must be determined by a healthcare provider.
Patients are advised to avoid excessive protein intake, such as very large portions of meat or certain protein supplements, and to choose leaner protein sources. Kidney involvement also requires careful monitoring of electrolytes like potassium and phosphorus. High levels of potassium (hyperkalemia) can lead to dangerous heart rhythm issues.
High-potassium foods that may need to be limited include bananas, oranges, potatoes, tomatoes, and dried fruits. High phosphorus levels can cause the body to pull calcium from the bones, leading to brittle bones over time. Foods high in phosphorus to limit include dairy products, nuts, bran cereals, and dark-colored colas, which often contain easily absorbed phosphate additives.
Dietary Adjustments for Gastrointestinal Symptoms
Amyloid deposits can affect the digestive tract, leading to symptoms like malabsorption, diarrhea, or motility issues. Patients experiencing diarrhea or malabsorption, where the body struggles to absorb nutrients, should limit high-fat foods. Unabsorbed fat can pass through the digestive system and worsen diarrhea.
During periods of active gastrointestinal symptoms, foods with high fiber or excessive residue may need to be temporarily reduced to manage diarrhea and abdominal discomfort. Foods known to increase gas production, such as beans, certain cruciferous vegetables, or carbonated drinks, should also be avoided to minimize bloating.
If the disease has caused motility issues, such as gastroparesis, focusing on softer, easier-to-digest foods is recommended. Hard, tough, or sharp-edged foods can be difficult to move through a digestive system with impaired function. Eating smaller, more frequent meals can also help the stomach empty more efficiently and reduce symptoms like nausea and vomiting.
Supplements and Unregulated Products to Avoid
Individuals with amyloidosis should avoid taking high-dose vitamins, herbal remedies, or unverified dietary supplements unless explicitly approved by the medical team. Many of these unregulated products can add undue strain on compromised organs, particularly the liver and kidneys. The primary danger is the potential for drug-nutrient interactions with standard amyloidosis treatments.
Certain herbal supplements and common items like green tea may interfere with the effectiveness of chemotherapy drugs used to treat the condition. Patients taking specific medications, such as bortezomib, must completely avoid certain supplements, including Vitamin C and green tea, as they can inhibit the drug’s action. All over-the-counter supplements and vitamins should be reviewed with a physician to ensure they do not compromise the treatment plan or place a burden on affected organs.