Blood, fangs, garlic: Vampire myths might be based on very real blood disorders

Centuries ago, physicians began documenting people coming down with a mystery illness that tainted their urine with a reddish hue, cursed them with extreme sensitivity to the sun and transformed their teeth into fang-like shapes that appear to glow in the dark.

Although it sounds like the genesis of the world’s first clan of blood-sucking vampires, it was actually the beginning of the acknowledgment of a more logical explanation among the medical community — one that some historians believe birthed much of the vampire folklore that continues to inspire Halloween movies and costumes today.

The illness is now known as porphyria, a group of eight genetic blood disorders that cause people to produce less heme. Heme is an important component of hemoglobin, the protein that carries oxygen in the blood.

This malfunction causes an abnormal buildup of natural chemicals called porphyrins that can lead to symptoms such as sensitivity to sunlight, hallucinations, facial disfigurement, seizures and reddish-purple urine, according to the American Porphyria Foundation.

Many historians believe this disease is what debilitated King George III of England and led to his dethronement in the early 1800s.

However, symptoms and treatments vary greatly depending on the kind of porphyria someone has, which is based on the specific type of porphyrin that accumulates in the body.

The diseases are considered rare, affecting fewer than 200,000 people in the U.S.

Some may inherit the genes that cause porphyria, but not all people will show symptoms; the genes may lay dormant without ever becoming active. Environmental factors such as smoking, alcohol use and taking certain medications can trigger the disease in some people.

Why is porphyria connected to vampires?

Although people with porphyria do not burst into ashes or glitter while under the sun like traditional vampires, they do develop painful skin blisters that can permanently scar and disfigure their skin, including their face.

For some types of porphyria, this disfigurement worsens over time, which likely caused some patients to avoid mirrors, similar to folk tales that describe vampires’ inability to see their reflection, according to Michael Hefferon, assistant professor of pediatrics at Queen’s University in Canada and author of “Of Plagues and Vampires: Believable Myths and Unbelievable Facts from Medical Practice.”

Erythropoietic protoporphyria (EPP) is the most common kind of childhood porphyria, and is mostly characterized by sun sensitivity. People with this disease “are chronically anemic, which makes them feel very tired and look very pale,” Dr. Barry Paw, who was a principal investigator of the Dana-Farber/Boston Children’s Cancer and Blood Disorders Center in Massachusetts, said in a 2017 news release.

Staying indoors during the day and receiving blood transfusions are some ways patients can alleviate their symptoms, but early on this was likened to vampires’ desire for blood and dark hideouts.

Before medical advancements, some doctors recommended people with porphyria drink animal blood to remedy their pain, which fueled vampiric legends. People also thought those with porphyria drank blood because of the reddish-purple color of their urine caused by chemical buildup.

Some types of the disease can also lead to gum recession and cause teeth to glow in the dark, thanks to the porphyrins that make them fluorescent. This oral transformation has been compared to vampire fangs.

And according to Hefferon, some people with porphyria may be sensitive to sulfur concentrations in garlic and fear the crucifix, too.

“During the Spanish Inquisition (1478-1834), 600 ‘vampires’ were reportedly burned at the stake. Some of these accused vampires were innocent sufferers of porphyria,” Hefferon wrote. “Porphyria patients had good reason to fear the Christian faith and Christian symbols.”

A group of researchers in Florida published a “notable note” in the journal JAMA Dermatology in 2016 that said the blood disorders’ “notoriety can be attributed to a poor understanding of the dermatologic manifestations of the disease.”

“While the connection to vampiric myth is largely based on conjecture and misinformation, there may be little harm in keeping alive a time-old tale of mystery and intrigue as long as its connection to the debilitating disease of porphyria is severed,” the researchers wrote. “As the pale stranger in your office can attest, life with porphyria is difficult enough without everyone thinking you are Dracula.”