Low iron? Anemic? Try this!

Do you have low iron?

Nothing is more exhausting than Iron Deficient Anemia! In today’s post i’d like to cover some helpful information on how to deal with this frustrating condition!


So, what is iron? What does it do?

“Iron is an essential mineral.

Iron is an important component of hemoglobin, the substance in red blood cells that carries oxygen from your lungs to transport it throughout your body. Hemoglobin represents about two-thirds of the body’s iron. If you don’t have enough iron, your body can’t make enough healthy oxygen-carrying red blood cells. A lack of red blood cells is called iron deficiency anemia.

Without healthy red blood cells, your body can’t get enough oxygen. Iron causes fatigue and can affect everything from your brain function to your immune system‘s ability to fight off infections. If you’re pregnant, severe iron deficiency may increase your baby’s risk of being born too early, or smaller than normal.

Iron has other important functions, too including maintaining healthy cells, skin, hair, and nails.”¹


How do we get iron? How much do we need?

We get iron in the foods we consume. Iron requirements vary by age, sex, and activity level. According to the National Academy of Sciences and the U.S. Department of Health and Human Services Office of Disease Prevention and Health Promotion² the recommended dietary allowance for iron can be seen below.

 

Table 1: Recommended Dietary Allowances (RDAs) for Iron [²]
Age Male Female Pregnancy Lactation
Birth to 6 months 0.27 mg* 0.27 mg*
7–12 months 11 mg 11 mg
1–3 years 7 mg 7 mg
4–8 years 10 mg 10 mg
9–13 years 8 mg 8 mg
14–18 years 11 mg 15 mg 27 mg 10 mg
19–50 years 8 mg 18 mg 27 mg 9 mg
51+ years 8 mg 8 mg

* Adequate Intake (AI)

Note: If you have a deficiency, heavy periods, digestive disorders, have recently donated blood, or have a Malabsorption syndrome your requirements for iron intake will be higher than the general recommended amount. Please see your physician for a specific guideline on how much iron you should aim to consume each day.


How can I reach my goal?

protein

The following foods are good sources of heme iron (from animal sources):³

  • Beef
  • Lamb
  • Ham
  • Turkey
  • Chicken
  • Veal
  • Pork
  • Dried beef
  • Liver
  • Liverwurst
  • Eggs (any style)
  • Shrimp
  • Clams
  • Scallops
  • Oysters
  • Tuna
  • Sardines
  • Haddock
  • Mackerel

 

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The following foods are good sources of non-heme iron (from plants):³

  • White bread (enriched)
  • Whole wheat bread
  • Enriched pasta
  • Wheat products
  • Bran cereals
  • Corn meal
  • Oat cereal
  • Cream of Wheat
  • Rye bread
  • Enriched rice
  • Strawberries
  • Watermelon
  • Raisins
  • Dates
  • Figs
  • Prunes
  • Prune juice
  • Dried apricots
  • Dried peaches
  • Tofu
  • Beans (kidney, garbanzo, or white, canned)
  • Tomato products (e.g., paste)
  • Dried peas
  • Dried beans
  • Lentils
  • Instant breakfast
  • Corn syrup
  • Maple syrup
  • Molasses
  • Spinach
  • Sweet  potatoes
  • Peas
  • Broccoli
  • String beans
  • Beet greens
  • Dandelion greens
  • Collards
  • Kale
  • Chard

What else do I need to know?

Iron deficiency is the most common nutritional deficiency in the world. Sources of non-heme iron are significantly less bioavailable and abundant than heme-iron sources.

 

Careful planning must be taken to ensure that the iron we consume is actually absorbed. When consuming iron it’s best to avoid:

  • Medications that reduce the amount of acid in the stomach such as antacids or proton pump inhibitors.
  • Calcium (like iron) is an essential mineral, which means the body gets this nutrient from diet. Calcium is found in foods such as milk, yogurt, cheese, sardines, canned salmon, tofu, broccoli, almonds, figs, turnip greens and rhubarb and is the only known substance to inhibit absorption of both non-heme and heme iron.
  • Eggs contain a compound that impairs absorption of iron.  Phosphoprotein called phosvitin is a protein with a iron binding capacity that may be responsible for the low bioavailability of iron from eggs. This  iron inhibiting characteristic of eggs is called the “egg factor”. The egg factor has been observed in several separate studies. One boiled egg can reduce absorption of iron in a meal by as much as 28%.
  • Oxalates impair the absorption of nonheme iron. Oxalates are compounds derived from oxalic acid and found in foods such as spinach, kale, beets, nuts, chocolate, tea, wheat bran, rhubarb, strawberries and herbs such as oregano, basil, and parsley. The presence of oxalates in spinach explains why the iron in spinach is not absorbed. In fact, it is reported that the iron from spinach that does get absorbed is probably from the minute particles of sand or dirt clinging to the plant rather than the iron contained in the plant.
  • Polyphenols are major inhibitors of iron absorption. Polyphenols or phenolic compounds include chlorogenic acid found in cocoa, coffee and some herbs. Phenolic acid found in apples, peppermint and some herbal teas, and tannins found in black teas, coffee, cocoa, spices, walnuts, fruits such as apples, blackberries, raspberries and blueberries all have the ability to inhibit iron absorption. Coffee is high in tannin and chlorogenic acid; one cup of certain types of coffee can inhibit iron absorption by as much as 60%.  
  • Phytate is a compound contained in soy protein and fiber. Even low levels of phytate (about 5 percent of the amounts in cereal whole flours) have a strong inhibitory effect on iron bioavailability. Phytate is found in walnuts, almonds, sesame, dried beans, lentils and peas, and cereals and whole grains. Phytate compounds can reduce iron absorption by 50% to 65 %

 

As you can see, most of the “non-heme” sources of iron are compounded with inhibitors. Avoiding the above for a minimum of 2 hours before you consume iron is best for the highest rate of absorption.

 

On the contrary there are some things which can boost the effectiveness of iron absorption including:

  • Vitamin C or ascorbic acid occurs naturally in vegetables and fruits, especially citrus. Ascorbic acid can also be synthesized for use in supplements.  In studies about effects of ascorbic acid on iron absorption, 100 milligrams of ascorbic acid increased iron absorption from a specific meal by 4.14 times.
  • Alcohol Although alcohol can enhance the absorption of iron, no one is encouraged to drink alcohol as a means of improving iron status.  Moderate consumption of alcohol has known health benefits but heavy or abusive drinking, especially when in combination with high body iron levels increases the risk for liver damage, liver cancer and blood cell production.
  • Beta-Carotene is one of more than 100 carotenoids that occur naturally in plants and animals. Carotenoids are yellow to red pigments that are contained in foods such as apricots, beets and beet greens, carrots, collard greens, corn, red grapes, oranges, peaches, prunes, red peppers, spinach, sweet potatoes, tomatoes, turnip greens and yellow squash. Beta-carotene enables the body to produce vitamin A. Moreover, in the presence of phytates or tannic acid, beta-carotene generally overcame the inhibitory effects of both compounds depending on their concentrations.
  • Additive iron such as EDTA+fe and Ferrochel are additive iron compounds and are emerging as candidates for fortification by major food manufacturers. Both additives were found to exceed absorption capabilities of the commonly used fortificant ferrous sulfate.
  • Hydrochloric acid (HCI) present in the stomach, frees nutrients from foods so that they can be absorbed.
  • Meat Especially red meat increases the absorption of nonheme iron. Beef, lamb and venison contain the highest amounts of heme as compared to pork or chicken which contains low amounts of heme. It has been calculated that one gram of meat (about 20 percent protein) has an enhancing effect on nonheme iron absorption equivalent to that of 1 milligram of ascorbic acid.
  • Sugar As part of the Framingham Heart Study, a National Institutes of Health project, investigators looked at the factors that increased iron stores such as diet and iron supplementation. Participants included more than six hundred elderly patients. Those who took supplemental iron along with fruit had higher iron stores, some as much as three times. No one is encouraged to consume sugar to improve iron absorption. Too much sugar can lead to other health problems, such as obesity and diabetes. Refined white sugar has no nutritional value except calories. However, eating fruits or adding honey or black-strap molasses to foods such as cereals can boost iron absorption and add nutrients that are lacking in refined sugar.

 

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In addition to eating foods higher in iron, eating foods which boost iron absorption, and avoiding iron inhibitors, it’s important to note that you may use cast-iron as a simple way to add more iron to foods. Cast iron may release more iron into food when used to cook acidic foods that have a higher moisture content, such as applesauce and spaghetti sauce, absorb the most iron. For example, one study published in the July 1986 issue of the Journal of the American Dietetic Association found that the iron content in 100 grams of spaghetti sauce jumped from 0.6 mg to 5.7 mg after being cooked in a cast iron pot.


 

Pills and Supplements:

Taking an iron supplement should be done at the instruction of your physician. Due to the possible negative side-effects of iron supplements, we suggest increasing the iron in your diet through foods FIRST (unless you have a serious deficiency, speak to your doctor about this!).

“Iron is LIKELY SAFE for most people when it is taken by mouth in appropriate amounts. However, it can cause side effects including stomach upset and pain, constipation or diarrhea, nausea, and vomiting. Taking iron supplements with food seems to reduce some of these side effects. However, food can also reduce how well the body absorbed iron. Iron should be taken on an empty stomach if possible. If it causes too many side effects, it can be taken with food. Try to avoid taking it with foods containing dairy products, coffee, tea, or cereals.

There are many forms of iron products such as ferrous sulfate, ferrous gluconate, ferrous fumarate, and others. Some products, such as those containing polysaccharide-iron complex (Niferex-150, etc), claim to cause fewer side effects than others. But there is no reliable evidence to support this claim.

Some enteric coated or controlled release iron products might reduce nausea for some people; however, these products also have less absorption by the body.

Liquid iron supplements may blacken teeth.

 

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Anecdotally my favorite iron supplement is Spatone iron-enriched water (And no, i’m not being paid to say that!). This supplement has a high absorption rate, is incredibly gentle on the stomach, and can be taken relatively pain-free with a glass of OJ in the morning. Having tried many many other supplements (including prescription) this is the only supplement i’ve tried which doesn’t cause the slew of stomach problems!

 


What’s the Takeaway?

If you have low iron and wish to increase your iron levels it may be advisable to:

  • Take Iron alone about 2 hours before/after eating a meal
  • Eat more sources of Heme-Iron (animal sourced)
  • Avoid eating iron with iron inhibitors
  • Take your iron with an iron boosting substance
  • Taking an iron supplement when needed, try a gentler source of iron such as Spatone
  • See your physician for more information about RDA

 


Want more information? Check out our sources!

  1. Feature, S. W. (n.d.). Iron: What You Need to Know. Retrieved October 11, 2016, from http://www.webmd.com/vitamins-and-supplements/features/iron-supplements
  2. 1994–1996, B. I. (n.d.). Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Retrieved October 11, 2016, from https://www.nap.edu/read/10026/chapter/1#ii
  3. Iron-Rich Foods. (n.d.). Retrieved October 11, 2016, from http://www.redcrossblood.org/learn-about-blood/health-and-wellness/iron-rich-foods
  4. Achieving Iron Balance with Diet. (n.d.). Retrieved October 11, 2016, from http://www.irondisorders.org/diet/
  5. Food prepared in iron cooking pots as an intervention for reducing iron deficiency anaemia in developing countries: A systematic review. (n.d.). Retrieved October 11, 2016, from https://www.ncbi.nlm.nih.gov/pubmed/12859709
  6. IRON: Uses, Side Effects, Interactions and Warnings – WebMD. (n.d.). Retrieved October 11, 2016, from http://www.webmd.com/vitamins-supplements/ingredientmono-912-iron.aspx?activeingredientid=912