Iron Supplementation
Iron is an important dietary mineral that is involved in various bodily functions, including the transport of oxygen in the blood. This is essential in providing energy for daily life. Iron deficiency means less oxygen is delivered to the cells. This can lead to fatigue, tiredness and decreased immunity. Other symptoms may include: hair loss, irritability, weakness, brittle or grooved nails, atrophy of the mucous membrane covering the tongue, the pharynx and the oesophagus, and impaired immune function
Iron deficiency is a common health problem
Iron deficiency is a common problem. High-risk groups include menstruating women, pregnant women, babies and toddlers, teenage girls and female athletes. Without intervention, a person whose dietary intake of iron is inadequate to meet their body’s needs will eventually deplete their iron stores and develop iron deficiency anaemia. It is important you have your levels tested if you suspect they are low. Do not self diagnose as these symptoms are common to many other conditions – not just iron deficiency. If you supplement iron unnecessarily you can be causing yourself harm. Iron is a strong oxidising agent and can cause oxidative stress in the body if levels are elevated. We never recommend iron supplements unless it has been tested and shown to be deficient.
Causes of iron deficiency
Some of the common causes of iron deficiency in adults include:
- Inadequate dietary intake – the two types of iron include haem iron (found in animal foods) and non-haem iron (from plant products). The body absorbs haem iron much more easily than non-haem iron. There are many reasons why the dietary intake of iron could be inadequate, including a poorly balanced vegetarian diet, chronic fad dieting or limited access to a wide range of fresh foods – for example, as a result of living in remote areas or having a low income.
- Blood loss – iron deficiency easily occurs in situations of blood loss such as heavy menstrual periods, regular blood donation, chronic disorders that involve bleeding (such as peptic ulcers, polyps or cancers in the large intestine) and certain medications, particularly aspirin.
- Increased need – the adolescent growth spurt, pregnancy and breastfeeding are situations when the body requires more iron. If this increased need isn’t met, a deficiency can quickly occur.
- Exercise – athletes are prone to iron deficiency because regular exercise increases the body’s need for iron in a number of ways; for example, hard training promotes red blood cell production, while iron is lost through sweating.
- Inability to absorb iron – healthy adults absorb about 10 to 15 per cent of dietary iron but some people’s bodies are unable to absorb or use iron from food.
Diagnosis
Ask your doctor to test for iron. Testing for Ferritin is the most sensitive index of early iron deficiency. We recommend your ferritin level, as a minimum, should be above 90 despite the fact that most pathology labs report a so called normal reference range minimum to be around 30. Recent research suggests this is too low. Most patients feel better when higher levels around 90 to 100 are achieved.
Iron-rich foods
Good sources of dietary iron include red meat, fish, poultry, lentils, beans, leaf vegetables, tofu, chickpeas and black-eyed peas. Lower amounts are also found in molasses.
Iron from different foods is absorbed and processed differently by the body; for instance, iron in meat (heme iron source) is more easily broken down and absorbed than iron in grains and vegetables (“non-heme” iron source).
Iron absorption by the body can be affected by the amount and type of iron consumed, dietary factors that enhance or inhibit iron absorption and an individual’s need for iron (when the body is low in iron, it absorbs a higher percentage from food). Absorption of iron from food is about 18 per cent from a typical western diet (including animal foods) and about 10 per cent from a vegetarian diet.
In many cases we find that ferritin levels do not rise substantially if only on an iron rich diet. Usually supplements are also required in order to achieve reasonable levels.
Iron Supplements
The amount of iron absorbed decreases with increasing doses. For this reason, it is recommended that most people take their prescribed daily iron supplement in two or three equally spaced doses. For adults who are not pregnant we recommend using from 20mg daily twice daily to 20mg three times a day. Each person is different so you need to dose according to individual needs.
The absorption of iron differs depending on the form used. Ferrous sulphate, often prescribed by doctors, is poorly absorbed and thus causes side effects such as constipation. Vitamin C is reported to improve absorption but only marginally. We recommend iron gluconate or fumerate as these are the most highly absorbed forms available and thus rarely causes constipation.
Our laboratory produces 20mg elemental iron capsules in the form of iron gluconate. For those who suffer from malabsorption and related conditions where gut absorption is low we also produce a sublingual lozenge or transdermal cream to overcome this problem. Both are available online from our lab. To order you must register for an online consultation which is free or alternatively contact us.
We recommend a 3 month course before being retested to determine if you need to continue with the supplements or not.
