Have you ever thought about how much iron you eat? If not, you might want to consider it! Iron, although frequently overlooked, is an essential part of a healthy diet. Keep reading our Ultimate Guide to Iron to learn why it’s so important, how to tell if you may be deficient or at risk for deficiency, and how to add more into your diet!

WHAT IS IRON AND WHY IS IT SO IMPORTANT?

Iron is a mineral that contributes to many important processes of daily life. In the body, iron is stored in the form of a protein, called ferritin. When needed, ferritin releases iron, which is transported to our bone marrow by another protein, called transferrin. In the bone marrow, iron is used to create a red blood cell protein called hemoglobin.

As a component of hemoglobin, iron is an important component of our red blood cells, and helps to deliver oxygen to our organs and tissues. As a result, iron contributes to energy production (1); iron also contributes to many other metabolic processes, including DNA production (2).

Iron cannot be made in the body, and therefore, must be consumed through the foods we eat. There are two types of iron found in food: heme, and non-heme iron. Heme iron comes from animal sources, such as meat, poultry and seafood. Non-heme iron comes from plant sources, such as dark leafy greens, beans, lentils, whole grains, and foods fortified with iron.

Both forms of iron are important and beneficial; however, they do not behave the same way in the body. As it turns out, the body absorbs heme iron more efficiently than non-heme iron. But not to worry, vegetarians and vegans, there are ways to increase iron absorption from non-heme sources as well. We will discuss this in more detail below- so keep reading!

ARE YOU IRON DEFICIENT?

Iron deficiency can occur if someone does not have enough iron stored in their body. In other words, you may be iron deficient if you do not have enough ferritin. Iron deficiency may also occur if you have altered levels of transferrin.

Although you must have a blood test to confirm and diagnose an iron deficiency, common signs and symptoms of iron deficiency include the following:

• Fatigue
• Hair Loss (as discussed in more detail here)
• Canker sores
• Ridging on fingernails
• Pale appearance (especially on the inside of the eyelids)
• Pain in tongue and mouth

If you have no underlying conditions, diet (and in some cases supplements) can typically resolve iron deficiency, as we will discuss below. However, unresolved iron deficiency can result in further complications. In either case, if you are experiencing any of these symptoms, we recommend you visit a doctor for a physical assessment and blood test. We also recommend you visit a registered dietitian to discuss supplement options.

IRON DEFICIENCY ANEMIA

Unresolved iron deficiency may result in iron deficiency anemia. As we know, iron helps transport oxygen to the body’s cells; however, in the case of anemia, inadequate iron prevents oxygen from reaching our cells.

As with iron deficiency, you must have a blood test to diagnose iron deficiency anemia. However, in addition to the symptoms above, the following may also be signs of iron deficiency anemia:

• Weakness
• Chest Pain
• Headaches
• Cold Extremities
• Weak fingernails and hair
• Loss of Appetite
• Exercise Intolerance
• Weight Loss (if you have additional health conditions)
• Difficulty Losing Weight

Additionally, certain populations may be more susceptible to iron deficiency anemia, as a result of their lifestyle and/or genetics. For example, many Indian women who follow a vegetarian diet are at increased risk for developing iron deficiency anemia due to their blood loss through menstruation and intake of primarily non-heme iron. Further, some populations may be genetically predisposed to iron deficiency, and may actually have trouble absorbing iron, even in supplement form (3).

However, similar to iron deficiency, if no other underlying conditions exist, most people can manage iron deficiency anemia through diet (and in some cases supplements). But again, if not managed, serious health complications can result. For example, iron deficiency anemia can impact thyroid function in some people, and may even lead to a misdiagnosis of hypothyroidism (4)!

Therefore, if you are experiencing any of these symptoms, we recommend you visit a doctor for a physical assessment and blood test. We also recommend you visit a registered dietitian to discuss supplementation options.

RISK FACTORS

The Recommended Dietary Allowance (RDA) for iron varies by age and gender, and depends on wether a woman is pregnant or lactating. However, it is generally recommended that males aged 19-50 consume 8 mg/day of dietary iron, and that women of the same age consume 18 mg/day of dietary iron (5). While iron deficiency and iron deficiency anemia are fairly rare in the general US population, especially among men, iron deficiency anemia affects nearly 10% of menstruating women, and 9% of children aged 1-3 years old (6).

Common risk factors for iron deficiency include the following (7):

• Menstruation
• Pregnancy
• Inflammatory Bowel Disease
• GI Ulcers
• Some Cancers

Therefore, if you fit into one of these categories, and are experiencing any of the symptoms discussed above, it is especially important that you visit a doctor for proper testing, diagnosis, and treatment. You should also discuss supplementation options with a registered dietitian.

HOW TO ADD IRON TO YOUR DIET

So by now, we know the basics- iron is necessary to transport oxygen to our body’s cells and tissues, among other things. Our body doesn’t produce iron, so we must consume it through food to prevent iron deficiency and its associated complications.

We also know there are two types of iron: heme and non-heme. To review, heme iron comes from animal sources, such as meat, poultry and seafood while non-heme iron comes from plant sources, such as dark leafy greens, beans, lentils, whole grains, and foods fortified with iron.

As mentioned, the body more readily absorbs heme iron compared with non-heme iron. Therefore, if possible, we recommend consuming adequate meat, poultry and seafood as part of a balanced diet. However, if you follow a vegan or vegetarian diet, there are ways to increase iron absorption from non-heme iron! In particular, it is well established that consuming Vitamin C along with non-heme iron can increase absorption of non-heme iron in the body (8). You can do this by squeezing lemon over your dark leafy greens, or adding tomatoes and bell peppers to your grain based meals! For more individual suggestions, also consider visiting a registered dietitian.

Note: Keep in mind that just like anything else- you can eat too much iron! For this reason, we recommend you stick to the current RDA when increasing your iron intake. You can find the appropriate RDA for your age and gender here.

WHATS THE BOTTOM LINE?

Iron is an essential part of the human diet. If you think you may be deficient, you should consult a doctor for blood work, and visit a registered dietitian to learn how to add more iron into your diet.