A Note About Iron

Many people (women in particular) experience iron deficiency anemia at some point in their lives. If you are told you have low iron it is important to figure out why. Is it a dietary deficiency? Is it intestinal parasites (which can feed off of your iron stores)? Are you a vegetarian/vegan, pregnant, an endurance athlete, someone who experiences heavy menstruation, or in a period of adolescent growth? Do you have a B12 deficiency (pernicious anemia) masking itself as iron deficiency anemia? Managing iron levels can be tricky and definitely requires the assistance of a health care provider (ideally a holistic one!).

However, I thought I’d share some of the basics about why we need iron and factors affecting iron absorption. 

  • Iron is found in every cell of the body, almost all of it combined with protein
  • The hemoglobin molecule, essential for carrying oxygen throughout the body contains 60-70% of the body’s iron
  • If we lack iron, we produce less hemoglobin and therefore supply less oxygen to our tissues


Common Signs of Iron Deficiency:

  • in children, hyperactivity, short attention span and reduced IQ
  • in adults, lack of energy, lack of concentration and fatigue
  • finger nails flat or concave (spoon-shaped)
  • thin, fragile, brittle nails; vertical ridges on nails
  • lack of endurance or stamina
  • More iron is required during growth (e.g. infancy, adolescence, pregnancy)
  • Iron absorption occurs in the intestinal tract and poor absorption is one of the main reasons for deficiency, along with low-iron diets
  • The ability of the body to absorb iron (aka bioavailability) depends on a number of factors
  • Individuals who are iron deficient absorb iron less easily than those who have sufficient stores
  • There are two forms of iron: heme and non-heme
  • Heme iron is the most bioavailable form and is found in animal products (red meat, fish, poultry and shellfish)
  • Non-heme iron is less readily absorbed and is found in plant foods as well as eggs, milk and meat
  • Many plant sources of iron also contain phytates which bind to iron and carry it through the digestive tract unabsorbed
  • Other inhibitors of iron absorption include phytic acid in grains, legumes, and certain plants, tannins in tea, coffee, cocoa, fiber, egg protein
  • Calcium, Zinc, Magnesium and Copper compete with iron absorption
  • It is not necessary (or in every case healthy) to avoid these foods but rather to enhance absorption with the addition of vitamin C or  a heme iron source (e.g. serve spinach with lemon juice)
  • When taking iron supplements try to avoid taking Ca, Mg or Zn within 2 hours of iron supplementation
  • Low stomach acid can also lead to poor iron absorption (foods aren’t broken down properly and the digestive cascade including bile production compromises intestinal absorption)
  • Commonly prescribed ferrous sulfate, fumarate and gluconate can be difficult to absorb and are often associated with digestive upset and/or constipation
  • Many drug forms of iron also contain harmful additives
  • There are other forms of iron available for supplementation such as chelated iron and ferrous succinate which may be more easily absorbed and cause fewer side effects
  • Consult your physician before making any changes to iron supplementation

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