Iron Deficiency Anemia: what, why, and fix it now!


It’s not only females who are at risk of low iron: think athletes (i.e. endurance runners), restrictive diets, vegetarians/vegans, gastrointestinal disorders, the elderly…the list goes on and on.

Difficulty concentrating, fatigue, weight gain, irritability, amenorrhea, and loss of libido are only a few of the signs you may be low in iron.

Working with women, I come across this often. Why? Our red blood cells bind iron. Women lose blood monthly due to menstruation. Ta-dah!

Women the ages of 19-50 years (not including those pregnant or breastfeeding) require 18 milligrams (mg) iron daily, compared to our equal-aged male counterparts requiring only 8 mg. And for those of you pregnant, you require a whopping 27 mg, which lowers to 9 mg once breastfeeding. Click here for more information on specific requirements based on age and gender.

Who is at risk?

In general, it’s not solely women that are at risk of low iron. The following are at list of others who may need to pay special attention to their dietary intake of iron:

  • Those on low calorie and/or restrictive diets: the less you eat overall increases your risk for nutrient deficiencies
  • Athletes, especially runners: pounding pavement literally destroys red blood cells
  • Vegetarians: women the ages of 19-50 years require 33 mg; pregnant women require 49 mg; and men 14 mg
  • Vegetarian athletes
  • Those who give blood frequently
  • Those over the age of 50 years
  • Those with kidney failure
  • Gastrointestinal disorders: resections, celiac disease, inflammatory bowel disease, pernicious anemia, atrophic gastritis, etc.
  • Taking high doses of antacids

Being diagnosed with iron deficiency anemia:

If you have been diagnosed as low by your doctor, treatment by supplementation is the guided practice. Your doctor will likely prescribe pills called FeraMax, ferrous sulphate, ferrous fumarate, or ferrous gluconate.

The best way to take these pills is on an empty stomach. Just don’t take with a multivitamin, antacid, or calcium supplement (or else the iron becomes trapped and will not be absorbed). Once you’re back in the normal range, iron supplements should be discontinued. Why? Very little iron is removed from the body, so if your levels become too high there is the risk of toxicity.

One downfall of iron supplements: they tend to constipate people. Ensure to drink extra water!

Iron and the diet:

Once your levels have returned to normal, eating strategically is key, especially as you were previously deficient. If you were to return to the same way as eating, a future deficiency is likely.

Consider these:

  • Iron from animal foods (i.e. “heme”) is more readily taken up by our bodies. Choose lean meats (skinless, loin, lean, removal of the white fat) like chicken, pork, turkey, and beef or turn to the ocean for shrimp, tuna, oysters, and mussels.
  • Iron from plant foods (i.e. “non-heme”) is NOT as available to the body,mainly due to binding from other components within the plant as well as being lower in iron compared to animal sources. That being said, they still contribute to your overall daily iron intake. These items include black strap molasses, spinach, beans and legumes, and pumpkin seeds. Click here for more ideas.
  • Mix your servings of heme with non-heme sources: think a tuna sandwich with hummus, salmon with a side of potatoes, or toss chicken into your spinach salad.
  • Add a splash of vitamin C: this enhances the absorption of iron into the body. Ever wonder why spinach salads tend to have mandarin oranges on them? Other vitamin C options include red and green bell peppers, grapefruits, kiwi, strawberries, Brussels sprouts, cantaloupe, and papaya. Click here for more ideas.
  • Refrain from drinking coffee or tea an hour before or after eating foods containing iron.
  • Use a cast iron skillet: when cooking, iron will leach out from the pan into your food.
  • Opt for foods that are iron-fortified: the breakfast aisle is a dream world for this.
  • Though dairy, whole grains, and legumes do contain substances that may lower your ability to absorb iron, making a greater effort to replace low iron with high iron foods should be the first effort.

Careful planning is key to a successful diet containing adequate amounts of iron. If you’re a person at risk, check out some of the links above and make note of what foods you can include in your daily eating.

Last updated on July 2, 2014


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