Today I thought I’d do a blog post discussing a bit about IRON. Iron is a common micronutrient deficiency in the populations I work with and it can take a little intentionality to be consuming adequate amounts of iron in your diet on a regular basis (and in ways that promote optimal absorption – more on that later).

In this post we will be thinking about:

• • Why is iron important and who is at increased risk for iron-deficiency anemia (IDA)?
  • What are common symptoms of iron-deficiency anemia?
  • What are some ways I can increase both my iron intake and my ability to effectively absorb the iron I do consume?

Why is iron important and who may be at increased risk for an iron deficiency? 

First, the basics. Iron is the most abundant mineral in your body and is a key component of hemoglobin, the protein in red blood cells that delivers oxygen throughout the body. Iron is so important for oxygen and energy metabolism that the body very tightly regulates its iron absorption, utilization, and storage, doing everything it can to prevent a potential deficiency (or overload) from occurring.

More specific to our purposes here on this blog, several key groups are at increased risk for iron deficiency. These include (but are not limited to):

• Menstruating women –> blood losses that occur each month mean that women who are menstruating have higher iron requirements than men or post-menopausal women.
• Pregnant women –> pregnant women have increased needs for iron due to the significant blood volume expansion that occurs during pregnancy.
• Athletes –> increased demands for oxygen delivery during exercise means that athletes/people who regularly exercise have higher iron needs. This is particularly true for those engaging in aerobic exercise, especially longer-distance running. (Thus, women runners are at even greater increased risk).
• Disordered eating –> people experiencing disordered eating and/or a diagnosed eating disorder are often at increased risk due to a number of potential factors: decreased food intake in general, chaotic food patterns, avoidance of high-iron food sources (aka meat), etc.
• Vegetarians and vegans –> as we will get into below, animal sources of iron are better absorbed by the body than plant sources. Therefore, not consuming meat is definitely a risk factor for increased iron deficiency and people falling into this category will need to be more intentional about consuming adequate amounts of iron and in ways that promote optimal bodily absorption.

The recommended dietary allowance (RDA) for iron intake (in other words, the amount a person likely generally needs to be consuming for good health) include:

• • 15 mg/day for women ages 14-18 years
  • 18 mg/day for women ages 19-50 years
  • 8 mg/day for women ages 51+
  • 27 mg/day for pregnant women (iron supplements generally recommended)

See this table for a more complete breakdown of iron needs for various populations.

What are some common symptoms of iron-deficiency anemia? 

IDA is a condition where there is generally either a decrease in (1) the number of circulating red blood cells per a given volume of blood or (2) the level of hemoglobin. There are a number of lab tests that can help determine iron-deficiency anemia from other nutritional anemias.

The classic symptom of low levels of iron is going to be FATIGUE. Other common symptoms include feeling cold more often, restless leg syndrome, impaired immunity, and tachycardia (heart rate >100 beats per minute).

While these symptoms can indicate a potential iron deficiency, a complete blood analysis is the most helpful way to determine if you are low in iron. I recommend people in the increased risk factor groups above regularly have their iron levels checked, in addition to working on the food-related strategies we will dive into below. I also recommend that the general population keep somewhat regular tabs on their iron levels given its importance for the body!! A dietitian or doctor should be able to interpret your blood chemistry results to help you determine if you are experiencing IDA or any other nutritional anemia (such as B12 or folate).

What are some strategies I can use to increase my iron intake and ability to effectively absorb iron?

There are two categories of iron in the diet: heme iron and non-heme iron. Heme iron is found in animal food sources such as red meat, fish, and poultry. Non-heme iron is found in plant foods such as spinach, beans, blackstrap molasses, dark chocolate, and fortified cereals/grains.

It is important to know that heme iron is more readily absorbed by the body than non-heme iron. In other words, if you were to intake an equivalent amount of iron from a steak and from a bowl of spinach, the amount of iron actually absorbed by your body would be greater from the steak than from the spinach. Approximately 15-35% of iron intake from heme iron sources will be assimilated into the body, compared with 2-20% of non-heme iron sources. To our point above, those avoiding or consuming minimal amounts of meat need to be extra cautious about consuming adequate absorbable iron.

Red meat in particular is an excellent source of readily-absorbed iron. While red meat tends to get a bad rap in the media, I highly recommend consuming it on a regular basis! A high-quality source of red meat a couple of times a week (or even month) is going to do wonders for your iron levels as well as other micronutrient levels (such as zinc, B vitamins, etc.). I tend to recommend a well-balanced diet, red meat included, for optimal macro and micronutrient consumption.

Other strategies for increasing iron intake and absorption include:

• • Consuming a source of vitamin C along with your iron source. Vitamin C is well-known for its ability to help with iron absorption. People who are really struggling with iron absorption can be advised to drink a glass of orange juice along with an iron source like spinach. Other more natural pairings of iron/vitamin C include things like steak with grilled bell peppers, chicken or fish with a fruity salsa, or dark chocolate and a citrus fruit. (Look for a high-quality dark chocolate with at least 10% of the iron RDA listed on the label. My favorite organic 72% cacao dark chocolate bar from TJ’s  has 30% of the iron RDA. Tasty iron consumption methods for the win!).
  • Careful monitoring of supplementation. Excessive intake/supplementation of minerals including calcium, zinc, copper, or manganese can interfere with iron absorption so you want to be careful to not over-supplement on these (or any) micronutrients. When supplementing any nutrient, it is advised to take an individualized and monitored approach.
  • If you are supplementing iron for any reason, avoid taking your iron supplement with milk, coffee, or tea. Calcium and components of coffee/tea tend to block iron absorption. It is my recommendation in general to NOT take any morning supplements with your coffee or tea as they tend to block absorption of various vitamins/minerals! Consider a light just-before-breakfast juice/caloric drink/snack with your supplements instead (as you also don’t want to be taking supplements on any empty stomach).

Ideas of iron-rich recipes for you to try:

Tuscan-style beef and lentil soup (one of my favorites!)
Teriyaki steak with bell peppers
Goat cheese and spinach stuffed chicken breasts
Beet molasses superhero muffins
Dark chocolate pomegranate truffles (yum!)

Enjoy the rest of your Wednesday, friends!