iron

Are you tired of being tired?
Is your iron supplement making you constipated, nauseous and bloated?
Are you having difficulty getting your iron levels up?

Functions of iron

• Blood production: Essential to efficiently carry oxygen to your lungs, muscles, tissues.

• Immune function: Helps body fight infections (but excess can be inflammatory ).

• Brain function. Plays an important role in learning and memory.

• Growth. Such as in a bodybuilder, pregnant woman or child.

• Healing. Iron brings oxygen to damaged tissues to assist healing.

Signs you might be iron deficient

• Fatigue

• Shortness of breath after light activity (e.g., walking up the stairs)

• Heightened anxiety

• Light-headed or dizzy

• Easy bruising 

• Slow healing

• Pale skin

• Cold intolerance

• Heart flutters or palpitations

• Restless leg

• Headaches

• Frequent infections

• Poor concentration

• Hair loss, brittle nails

Why It’s Important to Confirm If You’re Deficient (And Not Just Supplement)

Test, don’t guess! We must know your current or recent (i.e., past 6 months) iron levels before we start you iron supplement and/or determine a suitable dose. Excess iron is toxic and can cause a multitude of problems including nausea, diarrhea, liver damage and more!

What blood tests?

• Complete blood count (CBC) + differential: This gives information about your blood cells. Decreased red blood cells (RBC), hemoglobin (Hgb, MCHC), hematocrit (Hct), RBC size (MCV) and RDW are diagnostic of iron deficiency anemia. Anemia is when you do not have enough healthy RBC or hemoglobin to adequately carry oxygen to the rest of your body to function efficiently. As a result, you feel tired, short of breath, and can’t heal as fast (hence the bruising).

• Ferritin: A marker of your iron stores (ferr = iron, tin = “storage container”). Ideally, we want ferritin around 70ng/ml. This will ensure you’re not at risk of anemia if you have a heavy bleed.

• Note: It may also be important to rule out other causes of fatigue by testing thyroid function, vitamin B12, blood sugar and immune markers.

Determine the Cause

An important factor to understand is why you’re deficient. Determining and addressing the cause can prevent the need for iron in the first place. Supplementation just provides a “band-aid effect” and quick fix.

Excessive Output

• Blood loss (e.g., heavy periods, frequent blood donations, recurrent nose bleeds)

• Increased demand for iron (e.g., pregnancy, excessive exercise)

Deficient Input

• Insufficient iron in your diet (e.g., meat, green leafies, legumes, whole grains)

• Inability to absorb iron in your gut (e.g., low stomach acid, Crohn’s, celiac, antacids)

Foods Rich in Iron

Food, a safe way to get your iron.

Animal Sources

• Organ meats (liver pate, kidney)

• Dark turkey meat (red/dark = blood = iron)

• Grass-fed beef

• Eggs

 Plant Sources

• Whole grains

• Legumes (e.g., red beans)

• Dark leafy vegetables

• Sunflower and pumpkin seeds

• Organic unsulphured dried fruits (e.g., raisins, prunes, figs, apricots, cherries)

• Blackstrap molasses

• Beets

• Seaweed (kelp/kombu, dulse) …  refer to microbiotic cookbooks for recipes, or sprinkle on foods 

If you’re vegetarian you can still get sufficient amounts of iron through your diet. To get the best bang for your buck consume vegetarian iron sources with vitamin C rich foods (= brightly colored fruits and vegetables). For example, salsa with your bean burrito, peppers with your lentils, or strawberries and kiwi with your oatmeal. 

Recipe Ideas

• Prepare a stew with vegetables, organic beef, and a tomato base and aim to eat it 3x per week.

• Blackstrap molasses you say? How the heck do I eat this? Try drizzling it over your oatmeal or baking healthy blackstrap molasses cookies/muffins.

Othere Tips

• Cooking in cast iron pots can also increase the iron contents of food, so use them whenever possible.

Supplementation

“I dread taking my iron supplement because it makes me constipated”. 

Hacks to Optimize Asborption

• Take WITH vitamin C (250-500mg) & B-vitamins. Good supplements already include these. Either way, it doesn’t hurt to take iron with a vitamin C rich snack (= any colorful fruit or vegetable).

• Take AWAY from all foods, drinks and medications. Especially prescription medications, black or green tea, coffee, calcium, dairy, soda and heavy meals (by at least 2 hours)

• Take BEFORE BED to reduce GI upset.

• Start low and build slow. Start supplementing with 10-30 mg and slowly build (i.e., over a few weeks) to a max of 60mg. 
  Higher doses are not absorbed and can cause constipation #NoThanks. 

• Choose a supplement with limited/no additives, preservatives, food colorings.

• Choose an absorbable form of iron. The most absorbable forms of iron are ferrous gluconate, ferrous fumarate, and ferrous lactate. Chelated forms are preferred (chelated = bound to another substance that allows it to be more absorbable).

• Try every second day dosing. If you are taking a high dose of iron, feeling constipated and nothing else has worked, then try taking it every other day. 

A few of my favorites are NFH Heme Iron SAP, ITI Iron Complex (best if extremely low), Oxygheme Intensive, Floravit, Floradix, and Ferrasorb (vegetarian). Ferramax’s dose is too high for my liking.

Common Side Effects

• Constipation

• Upset stomach

• Nausea, vomiting

• Dark stools