Iron deficiency is one of the most commonly underdiagnosed conditions that I see in my practice, especially in women. Low iron can lead to a multitude of symptoms, and it can often be a challenge to maintain healthy levels of this nutritionally critical mineral. The following looks at how to identify whether you may be iron deficient, why some people become more deficient than others, and how to increase your iron stores naturally.
Iron deficiency can manifest in a variety of symptoms. Common indicators include:
· Fatigue
· Weakness
· Headaches
· Hair loss
· Brittle nails
· Pale skin
· Restless leg syndrome
· Reduced resistance to infections
· Cracks at the corners of the mouth
· Feeling cold
· Pale skin
· Hormonal imbalance (iron helps to optimize thyroid function)
Identifying Deficiency Through Lab Testing
Routine blood work usually looks at the complete blood count as an initial screening tool to assess for anemia risk, however the best test to evaluate iron deficiency is serum ferritin, an iron storage protein that represent your body’s iron reserves. A ferritin score of under 45ng/mL is suggestive of anemia, and with low ferritin levels, you may have symptoms of iron deficiency anemia even if your hemoglobin levels and red blood cells are normal.
Building and Maintaining Healthy Iron Levels
How can you start to build your iron reserves and keep them up? My top three approaches are to identify and treat the cause, increase consumption through diet and/or supplements, and work on enhancing absorption.
Common Causes of Iron Deficiency
· Blood loss: During the childbearing years, iron requirements for women are about 80% higher than for men, primarily due to blood loss through menstruation. Other causes of blood loss include ulcers, uterine fibroids, and gastrointestinal tract bleeding which may or may not be visible (this is often identified through fecal occult blood testing).
· Increased Need for Iron: During pregnancy, a significant increase in blood volume creates a greater demand for iron. I always like to assess women’s iron levels before they become pregnant, and to work on maintaining healthy iron stores throughout pregnancy, especially during the third trimester.
· Diet: Vegetarian and vegan diets often contain less iron, especially the more absorbable and bioavailable “heme” form of iron.
· Compromised Digestion: Poor digestive function and the use of antacids can significantly compromise iron absorption in the small intestine. Health conditions affecting intestinal absorption, such as Crohn’s disease and celiac disease also impair iron absorption.
· Chronic infections: Microbial biolfilms can affect mineral balance in the body, with evidence that some forms of bacteria use iron as a fuel source. It is essential to treat chronic infections and support a healthy microbiome in order to achieve healthy iron levels.
Boosting iron Consumption:
· Supplements: If your ferritin levels are low enough that you are starting to show physical signs of iron deficiency, often dietary changes are not enough to provide you with a therapeutic dosage of iron. Iron supplements are notorious for having poor absorption and often contributing to nausea and constipation. Iron should ideally be bound to a protein or carbohydrate molecule for optimal absorption, which is why trying to digest the majority of iron supplements is like trying to digest a rock.
· Increasing your consumption of iron rich foods: Make sure you are having a minimum of 2-3 servings of iron-rich foods/day, including red meat, chicken, seafood, seaweed, beans, lentils, and dark leafy greens (see below on how to prepare).
· Herbal infusions: Making teas (hot or iced) out of iron-rich herbs is a great way to add bioavailable minerals to your diet. Nettle, red raspberry leaf, and dandelion are all excellent sources of iron. Herbs should ideally be left to infuse overnight. I use loose leaf herbs and leave them infusing overnight in the fridge.
Enhancing Iron Absorption Naturally
· Support healthy levels of stomach acid: Iron is best absorbed in a more acidic stomach environment. Try taking a teaspoon of apple cider vinegar before meals, or taking your vitamin C (ascorbic acid) supplement with iron-rich foods to enhance absorption naturally. Adding acidic dressings containing lemon or vinegar to iron-rich foods also supports iron absorption.
· Cook Your Greens: Although dark leafy greens are a great source of iron, steaming or cooking greens is essential for breaking down the plant cell walls to render the minerals more absorbable. Also, raw spinach, kale, and chard are notoriously high in oxalic acid, which binds to both calcium and iron, making them difficult to absorb. Cooking helps to reduce the oxalic acid content of these vegetables.
· Avoid wines and teas rich in tannins, which interfere with iron absorption.
Because there can be different causes of iron deficiency, an individualized naturopathic plan is often the best approach to building and maintaining healthy iron levels naturally. Book an appointment to determine the best treatment approach for you.