Iron is the most common micronutrient deficiency, accounting for about 1.6 billion people iron-deficiency anemic. Iron deficiency is a factor for over 20,000 deaths per year in children under the age of 5 and about a fifth of pregnancy related deaths. It is especially common in menstruating and pregnant women as well as in children. Iron balance is vital for growth, development, and human health; it’s no wonder that iron deficiency is a priority of many organizations around the world. Do you think you may have an iron deficiency? This article will give you the ins and outs of the condition as well as measures for prevention and treatment.
Why do we need iron? Iron is a vital mineral needed in trace amounts; while too much will lead to toxicity, a deficiency can lead to a slew of health problems, including iron-deficiency anemia. Hemoglobin is an iron-rich protein in our red blood cells that takes up oxygen from the lungs, distributing it around the body. During a deficiency, your body will first steal iron from your body stores. Once those stores are used up, your body may make fewer red blood cells that have less hemoglobin. This is a double whammy in terms of oxygen uptake. A deficiency in iron will ultimately lead to a decrease in oxygen uptake by our red blood cells.
Iron-deficiency symptoms include fatigue, shortness of breath, decreased cognitive ability, and altered immune response which may result in an increased occurrence of infections. If an iron deficiency isn’t treated, eventually iron-deficiency anemia (hemoglobin <100g/L plus iron deficiency) will occur. Signs of iron deficiency anemia include fatigue, slowed social and mental development in childhood, decreased ability to keep warm, decreased immune function, increased occurrence of infections, and potentially a swollen tongue. The decrease in your body’s overall physical performance ability in both an iron deficiency and iron deficiency anemia can be debilitating and should be taken very seriously.
What are some factors that contribute to an iron deficiency? Iron Deficiency is often related to factors like socioeconomic status, genetics, disease, and even life stage. Iron deficiency occurs when you don’t meet your body’s requirements, which is sometimes hard to determine because those requirements will be different from individual to individual. The iron requirements can increase with body mass (e.g. pregnancy, obesity, and child growth) or blood loss (e.g. menstruation). For example, the iron requirements during pregnancy are doubled to over 4mg/day. This amount is hard to achieve, even while eating a westernised diet that is typically higher in bioavailable iron (e.g. iron from meat). An increase in activity may also raise the body’s iron requirements due to the higher oxygen demands. These increased iron requirements put growing children, pregnant women, athletes (primarily females), and women at a reproductive age at a higher risk for an iron deficiency.
Vegetarians are also at an increased risk for an iron deficiency. The absorption of non-heme (plant-derived) iron is low at only about 5%. Furthermore, many common factors in a plant-based diet (e.g. phytates and polyphenols) will diminish iron uptake even more. What are some steps we can take here? Grains, nuts, and legumes are common phytate sources; the phytate content can be decreased by soaking them in water overnight, which is an effective practice to boost their nutrient profiles as well. A reduced amount of consumed grains in place with more vegetables and fruits may not be a bad idea either. Lastly, the addition of vitamin C will help boost your body’s ability to absorb non-heme iron, especially when taken in the same meal. Good sources of non-heme iron include peas, beans, soy, chickpeas, dried fruits, and dark leafy greens, and good sources of vitamin C include melons, oranges, cabbage, broccoli, and more.
Finally, a deficiency may also be due to impaired iron absorption, which may be caused by something like an enzyme deficiency, a damaged digestive tract (like in celiac disease), or even bariatric surgery. For this reason, it’s really important to get tests done to determine what the cause for your iron deficiency is. Are you just not getting enough from your diet or do you have internal bleeding, a damaged digestive tract, or an enzyme deficiency? All of the above can usually be treated, so long as the tests were run.
Think you have an iron deficiency and don’t know how to go about taking care of it? First step, visit your doctor or naturopath! In order to screen for an iron deficiency, blood work is required. Since iron deficiencies can be caused by a number of factors, it’s best to determine the root of the problem before attempting to self-treat yourself. Treatment will vary depending on the cause, your age, your dietary preferences, and your overall health. Nonetheless, it will typically include an iron supplement and continued monitoring of your hemoglobin or hematocrit blood levels.
Iron supplements are used to quickly rebuild your iron levels and can correct a deficiency within months. Continued supplementation after this point may result in toxicity. Furthermore, large amounts of iron even during the iron building stage can be toxic. Given the risks associated with iron supplementation, it’s important to only supplement under the watch of a health care professional; too much iron will damage your organs.
Iron deficiencies are a serious health problem that should be taken very seriously. When it is caused by our diet, a deficiency can often be prevented by seeking good sources of dietary iron. While heme-iron (animal derived) is much more bioavailable than non-heme iron (plant derived), you can meet your body's requirements by taking simple steps like combining your iron with vitamin C (e.g. an orange). Lastly, if you have any of the symptoms for iron deficiency, don’t wait; go see a doctor or naturopath to get it taken care of before anemia occurs!
Berger J, Wieringa F, Lacroux A, Dijkhuizen M. (2011) Strategies to prevent iron deficiency and improve reproductive health.doi:10.1111/j.1753-4887.2011.00436.x
Geissler C, Singh M. (2011) Iron, Meat and Health.doi:10.3390/nu3030283.
Tussing-Humphreys L, Pustacioglu C, Nemeth E, Braunschweig C. (2012) Rethinking Iron Regulation and Assessment in Iron Deficiency, Anemia of Chronic Disease, and Obesity: Introducing Hepcidin. doi:10.1016/j.jada.2011.08.038.
See this and other articles on Jennifer Novakovich's website JennovaFoodBlog.com