Iron deficiency can lead to symptoms such as weakness, fatigue, dizziness, pale skin, hair loss, brittle nails, headaches, rapid heart rate, restless legs and reduced tolerance to exercise.
Women are particularly at risk for deficiency due to blood loss with menstruation and increased iron needs during pregnancy. Other possible causes of iron deficiency include low dietary intake, poor nutrient absorption such as celiac disease, heavy menstrual bleeding or other sources of bleeding.
If you suspect iron deficiency, consult with your health care practitioner who can order blood tests to assess levels. Iron supplementation should be monitored by blood testing as too much iron can be harmful.
Choose iron-rich foods
Heme iron from meat and fish is most easily absorbed. Excellent sources of heme iron include liver, bison, organic beef, sardines, oysters, wild salmon, poultry and bone broth. Vegetarian sources of iron include dark green veggies (kale, chard, and broccoli), spirulina, lentils/beans, nuts/seeds, dried prunes/apricots and molasses.
Orange, red and green veggies are rich in vitamin C which will boost iron absorption. Foods that block iron absorption include coffee, tea and calcium rich foods or supplements. Take calcium and antacids away from iron supplements.
Iron supplementation
- Take iron on an empty stomach to optimize absorption. If this causes you digestive side effects, take iron with food.
- Take iron with vitamin C
- Iron can interfere with some medications, be sure to check with your pharmacist.
- Low dose vs high dose: for low ferritin in the absence of anemia, low to moderate doses of iron (20-60mg) are recommended to rebuild stores. For iron deficiency anemia, high doses of iron (60-120mg) may be recommended.
- Elemental iron: when dosing iron, it is important to dose based on the elemental iron listed on the formula. For example, ferrous fumarate is 33% elemental iron (100mg contains 33mg of elemental iron).
- Keep iron supplements out of reach of children. Iron poisoning in infants and children can be life threatening.
The best types of iron
Iron amino acid chelate: such as iron bisglycinate has a high absorption rate and is easy on the digestive system. It is absorbed differently than dietary iron and is less likely to bind to oxalates and phytates from food which can impede absorption. - SunActive Iron: ferric pyrophosphate is an easily absorbable iron that is gentle on the stomach.
- Iron polysaccharide complex: such as FeraMAX 150 is iron bound to starch complexes. It is absorbed slowly as it passes through the intestine. It has low digestive side effects.
- Carbonyl iron: is absorbed slowly as it travels through the intestine. For this reason it has low side effects, good absorption and poses less toxicity risk to children compared to iron salts.
- Heme iron polypeptide is animal sourced heme iron. It is absorbed extremely well and therefore low doses can be used. It is easy on the digestive system.
- Iron salts: such as ferrous sulfate, fumarate and gluconate are the most commonly prescribed iron. They are relatively inexpensive but are more likely to cause digestive symptoms such as heart burn, abdominal pain, constipation and black/tarry stool.
5 easy to absorb iron formulas:
AOR Ortho Iron: contains 30mg SunActive Iron. It is a complete blood builder as it includes other nutrients such as vitamin B6, B12, folate and vitamin C to enhance absorption. - FeraMAX 150: 150mg iron, high dose iron that is gentle on the digestive system.
- New Roots Iron Bisglycinate: 35mg iron
- Natural Factors HemoFactors Iron: SunActive Iron in 20mg chewable tablets.
- Salus Floradix Formula: plant based easy to absorb liquid iron providing 20mg iron.
Dr. Shannon Sarrasin is a naturopathic doctor who is clinically trained and naturally focused.
She is co-owner of Flourish Naturopathic at Moss Street Healthcare Centre.
Learn more at FlourishND.com
