Iron – Part 2

As explained in last week’s corner there are many different populations that could be at risk for iron deficiency. 

Symptoms include:

  • Extreme fatigue
  • Weakness
  • Pale skin
  • Chest pain, rapid heartbeat or shortness of breath
  • Headache, dizziness or light-headedness
  • Cold hands and feet
  • Sore or inflamed tongue
  • Brittle nails
  • Pica – craving for non food substances (ice, clay, paint, starch, dirt…). It’s often noticed in pregnant women. 
  • Poor appetite, in infants and children might indicate iron deficiency anemia

If you experience any of the above your doctor will able to assess if you are low or deficient with a blood test in addition to certain questions and or history:

Blood analyses from blood work:

Red blood cell size and color: Remember with iron anemia red blood cells are smaller and also paler in color than normal.

Hematocrit: This is the percentage of your blood volume made up by red blood cells which contain hemoglobin. Normal levels are generally between 35.5 and 44.9 percent for adult women and 38.3 to 48.6 percent for adult men and may change depending on age.

Hemoglobin: Lower than normal hemoglobin levels indicate anemia, as again this is the protein molecule in red blood cells that carries oxygen. Normal range is generally defined as 13.2 to 16.6 grams (g) of hemoglobin per deciliter (dL) of blood for men and 11.6 to 15. g/dL for women.

Ferritin: This protein helps store iron in your body, and a low level of ferritin usually indicates a low level of stored iron. 

Your doctor will decide if you are just low or deficient and what to prescribe supplement or food wise. Whether you need rebuild iron stores slowly or quickly and how a supplement may react with you. The different supplements that may be prescribed and what they mean as follows:

Elemental iron is the total amount of iron in the supplement available for absorption by your body. Each type of iron has a different percent of elemental iron. For instance:

  • Carbonyl has 100% elemental iron. (but is only absorbed at the rate that gastric acid is produced)
  • Ferrous fumarate has approximately 33% elemental iron. (high strength tablets or syrup)
  • Ferrous sulfate has 20% elemental iron. (high strength tablets)
  • Ferrous gluconate has 12% elemental iron. (medium strength) least constipating but replaces iron slower
  • Vitamin C is often added to iron supplements, but rarely in amounts sufficient to aid in iron absorption. 

Sometimes you may just be low but not deficient and all you need to do is enhance your absorption especially if vegetarian. Remember heme iron from animal foods is easily absorbed whereas non-heme iron from plant foods is not easily absorbed as the iron is usually bound up in these foods. However, there is a way to unbind the iron from non-heme plant foods by simply adding Vitamin C and avoiding certain other food groups, substances or minerals within a period of time to enhance iron uptake.  Even heme iron absorption is enhanced when taken alongside Vitamin C. Below are some great plant-based foods followed by foods high in Vitamin C to mix and match to allow high iron uptake and absorption as well as other foods/minerals/substances to avoid as to not inhibit iron absorption: 

Non-heme iron foods:

  • Whole wheat breads, cereals, pastas, quinoa and oatmeal 
  • Avocado
  • Cooked spinach; cooked mushrooms
  • Baked potato
  • Legumes, soybeans, tofu and lentils

Vitamin C foods to mix with above:

  • Citrus fruits and juices
  • Chard
  • Broccoli
  • Red or green bell peppers
  • Kiwi, strawberries, tomatoes, cantaloupe and papaya

Things to Avoid within 1-2 hours of eating above iron/vitamin C foods and or if taking an iron supplement as to not inhibit uptake:

  • Calcium 
  • Dairy 
  • Antacids
  • Caffeine (coffee or black tea) 
  • Enteric coated supplements

Because there can be so many different populations and criteria for iron intake check out for your daily requirements.

Mikkie Nettles, Certified Personal Trainer/Holistic & Sports Nutritionist

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