Both low and high iron levels impact our health negatively, so it is important to pay attention to symptoms that might suggest low levels, while avoiding supplementing with iron unless it is clear through a blood test that our levels are low.

Historically, I have warned people about the connection between having high levels of iron and negative health events. Some of these include Alzheimer’s disease, cancer, and heart disease.

This week I found out another person I care about has an iron deficiency….not anemia, but low ferritin (body’s iron stores). In hindsight, this may have been going on for quite sometime, but because typically doctors check hemoglobin levels only, iron deficiency without anemia can be missed. There are over 100 different causes of anemia (when your body lacks enough healthy red blood cells), but iron deficiency anemia is the most common type of anemia world wide. Any of the following symptom can be associated with iron deficiency and iron deficiency anemia, so if you are struggling to explain any of these symptoms you might want to ask your physician about having your hemoglobin AND ferritin levels checked.

symptoms of iron deficiency:

Fatigue
Weakness
Problems with memory, concentration and thinking
Irritable
Poor endurance
Feeling cold (especially hands and feet)
Headaches or dizziness
Dry, brittle hair, skin, and nails and hair loss
Pica (strange cravings for metal, dirt, paper, or starchy food)
Glossitis (red, inflamed tongue)
Frequent infections
Heart palpitations
Shortness of breath
Restless legs syndrome
Anxiety, panic and/or depression
Angular Cheilitis (cracks in corners of mouth)
Underactive thyroid (hypothyroidism)

who is most likely to have low iron levels?

Not Eating Enough Iron-containing Foods: What?!? My breve’ latte’s contain NO iron and if you are vegetarian or vegan you may be prone to an iron deficiency because plant iron (non-heme) is less absorbable than meat iron (heme). Those that are on a low-calorie diet may also be limiting their iron intake.
Limited Absorption: In addition to the difference between eating non-heme and heme iron there are other choices that can impact absorption. Calcium will interfere with absorbing enough iron. There are illnesses that prevent adequate absorption, including irritable bowel syndrome, lupus, and celiac disease. Finally, having had gastric bypass surgery, removal of sections of the stomach and/or intestines interfere with adequate iron absorption.

Extra Iron Requirements: Pregnant women, growing babies, children and teens require increased iron. Normal or heavy menstrual bleeding can lead to iron deficiency anemia. Athletes, especially women, through hard training and sweating, have an increased need for iron, while at the same time high iron loss.
Blood Loss: In addition to menstrual bleeding, ulcers, hemorrhoids, polyps, colon cancer, or other medical conditions that cause chronic bleeding can also lead to blood loss. One study found that in males, iron deficiency anemia is notably connected with colon cancer (14%), whereas 1% of women had colon cancer! Bleeding due to surgery, childbirth, or an injury can also cause excessive blood loss. Even after donating blood, you might be a little low, but this generally will correct without noticeable issue.

tips for maintaining healthy iron levels:

What we eat: Foods that are high in dietary iron include meat, poultry, legumes, oysters, tuna, pork, nuts, dark green vegetables, tomato juice, and potatoes. As mentioned earlier, meat (heme iron) is much better absorbed that iron from plant sources. Oily fish, such as salmon, increase the bioavailability of iron. Those that avoid iron-fortified foods, such as bread, cereal and pasta should recognize that along with the benefits there is a reduction in iron consumption. Studies have shown that fermented foods and probiotics that contain Lactobacillus fermentum, Lactobacillus plantarum, and Lactobacillus acidophilus help increase absorption. In addition, taking iron supplements might negatively impact our gut biome. Finally, it is important to note that foods containing Vitamin C increase absorption when consumed with iron.
When we eat: Factors that negatively impact absorption include consuming calcium, coffee, and tea. This doesn't mean we need to completely eliminate our beloved coffee, but instead try separating our iron-rich foods and coffee by an hour.
Unlikely to have a lasting impact: One study found that using cast iron pots to cook our food is helpful in the short-term, but not long-term. A high-fiber diet, has been blamed for iron deficiency anemia in the past, but this has been disproven. Many people who consume a lot of fiber due so to avoid constipation. And while constipation itself does not cause iron deficiency, those who routinely experience trouble having bowel movements may purposefully avoid iron-rich foods. This diet shift can lead to low iron levels.

What are healthy blood levels?

Normal ranges of ferritin levels on labs start at 12 μg/ml and go to 300 for men, and 12 to 150 for women. Levels higher than 40 μg/ml in a healthy person are considered optimal. For example, my doctor told me that my heart palpitations would not go away until I got my levels up to 40-45, and that fit my experience.

safety!

Again, although paying attention to eating enough iron rich foods is valuable to everyone. Taking supplements can be toxic for those who do not have an iron deficiency.

One VERY CONFUSING aspect to supplementing I wanted to highlight is that if your doctor tells you to take 325 mg of iron that is talking about ferrous sulfate and is the equivalent to 65 mg of elemental iron. You are not being asked to take 5 pills of a RX grade over-the-counter iron, such as the brand Feosol!!

Update from previous blog.

Wendy Dellis is a certified wellness coach. She joins years of training and work in the area of behavior change, experience as a fitness instructor and run club coordinator with a passion for adventure and people. She lives in Minnesota with her husband, Jay, and two sons.

The information contained on this page is for general information purposes only. Nothing here should be construed as medical or healthcare advice, but only topics for discussion. No physician-patient relationship exists; please consult your physician before making changes in diet or lifestyle.