Iron deficiency is not uncommon; globally, up to nine percent of the world’s population contends with this problem in the form of anemia (inadequate hemoglobin in the blood). Of those, most are children and women. In fact, a World Health Organization survey determined that iron deficiency is a health issue to various degrees for all of the almost two hundred countries included in the study. For most countries, there is at least a moderate concern for the general population. The rate of anemia in the Americas is less than in other parts of the world, however, an estimated seventeen million people are seriously iron-deprived.
On a global scale, iron deficiency accounts for fifty percent of all anemia. This contributes to premature mortality of children and women, in addition to cognitive impairment, decreased work productivity, and death from severe anemia.Women are much more likely than men to have an iron deficiency due to regular monthly menstruation and consequent blood loss.
The most common and apparent symptom of iron deficiency is fatigue. This is because iron is a mineral component of hemoglobin, the part of red blood cells that is responsible for the transportation of oxygen throughout the body.
Without an adequate supply of iron, cells are trying to work without enough oxygen—this can translate to physical and mental fatigue.
Anemia caused by iron deficiency is common in combination with thyroid dysfunction but they don’t always go hand-in-hand; you can experience one without the other.
For people experiencing thyroid dysfunction, iron deficiency can compound the problem: although the exact mechanism of the relationship is not definitive, thyroid dysfunction can contribute to anemia while iron plays a part in the production of thyroid hormones. It’s a circle of cause and effect:
“…iron is vital for the activity of thyroid peroxidase, an iron-containing enzyme that is crucial in the first steps of thyroid hormone synthesis. Experimental studies demonstrated that iron deficiency decreases thyroid peroxidase activity, and therefore may contribute to the depression of thyroid function…Therefore, there is a bilateral relationship between anemia and thyroid and metabolic status.”
Symptoms of Iron Deficiency
It makes sense then that iron deficiency and thyroid dysfunction can share symptoms:
- Pale skin
- Reduced immune system function (susceptible to illness)
- Reduced cognitive ability – difficulty concentrating, brain fog
- Headaches and migraine
- Fatigue and exhaustion (often chronic)
- Muscular cramps, spasms, aches, and reduced strength
- Shortness of breath
- Reduced physical stamina and aerobic capacity
- Heart palpitations
- Hair loss
- Dry hair, skin, and nails
- Swollen tongue or sore mouth
- Restless leg syndrome
- Cold appendages
You can easily see how all of the symptoms above can be caused by cells’ lack of oxygen.
If you don’t have enough iron in your diet, you may think that popping a pill supplement will fix the problem. Not necessarily so. There are many reasons for this: many iron supplements are not in the right form for the body to use. Additionally, proper absorption of iron in the blood requires other nutrients, such as vitamin C.
Raw iron isn’t readily bioavailable, although it’s abundant on Earth. When ingested, it binds to proteins and enzymes. Without these co-factors, the body can’t absorb iron. Even with the other required nutrients, only five to thirty-five percent is actually absorbed by cells. The amount of iron absorbed depends largely on gut (intestinal) function. In the case of digestive problems, disease, or the presence of some medications, the rate of absorption plummets. Because iron is recycled by the body and not readily excreted, levels are regulated by the rate of absorption.
Hormones secreted by the liver are actively involved in iron absorption, which follow into the lower digestive tract. These hormones are, in turn, regulated by other factors. Hormone imbalance due to heredity or environment can impact how iron is metabolized.
Iron in the foods we eat comes in two forms: heme and non-heme. Heme iron is found in animals and is easily absorbed by the body. Non-heme iron is found in plants and is more difficult for the body to use. Inhibitors of iron bioavailability include calcium, polyphenols, phytic acid, some proteins, coffee and tea when drunk with meals. Ascorbic acid (vitamin C) is the only known compound to facilitate iron absorption (think lots of colorful vegetables to go along with your protein at meal time).
“Iron deficiency results from depletion of iron stores and occurs when iron absorption cannot keep pace over an extended period with the metabolic demands for iron to sustain growth and to replenish iron loss, which is primarily related to blood loss. The primary causes of iron deficiency include low intake of bioavailable iron, increased iron requirements as a result of rapid growth, pregnancy, menstruation, and excess blood loss caused by pathologic infections.”
Because the rate of iron absorption is directly related to a healthy digestive system, start there. The condition of your gut affects every other system and organ in your body, from blood to muscles to brain. To improve your digestion:
- Chew food thoroughly. The digestive process starts in the mouth as saliva begins to break down food. The more you chew, the more food is broken down, expediting the process and leaving less of the responsibility to your stomach and lower digestive tract. Chewing also stimulates digestive enzymes that then prepare for receiving food.
- Avoid refined sugar and artificial sweeteners and reduce the amount of complex carbohydrates you eat (e.g., bread, pasta, rice).
- Increase the amount of probiotic foods you eat. Probiotics are healthy bacteria necessary for proper digestion. They can be found in spirulina and fermented foods like yogurt, pickles, kimchi, kombucha, kefir, raw organic apple cider vinegar, and sauerkraut. Probiotic supplements are also available but make sure you pick a high-quality one with lots of active cultures.
- Drink teas known to promote healthy digestion: green, kombucha, ginger, peppermint, chamomile.
- Cut out toxic vegetable oils from your diet and replace with healthy fats: coconut, walnut, sesame, avocado, and extra virgin olive oils and grass-fed butter.
2. Eat Iron-rich Food Along with Vitamin C
As we’ve discussed, ascorbic acid is the only substance known to improve the bioavailability of dietary iron. These two nutrients aken together in a meal improves your body’s ability to absorb iron. Sources of iron:
- Organic/grass-fed meat (especially liver), wild fish, and organic and free range eggs
- leafy greens – spinach, kale, Brussels sprouts, chard, collard, and beet greens
- legumes – lentils, peas, and beans
- nuts and seeds
- oyster mushrooms
- palm hearts
- whole grains – amaranth, spelt, oats, quinoa
- dried fruit
- prune juice
- blackstrap molasses
- coconut milk
- dark chocolate/raw cocoa
Sources of vitamin C:
- citrus fruits
- raisins and currants
- herbs – thyme, parsley, cilantro, chive, basil
- cruciferous vegetables – broccoli, Brussels sprouts, cauliflower, kale
3. Supplement When Necessary
The only sure way to know if you have an iron deficiency is by having your blood tested. If you choose to take supplements to increase iron levels, here are some things to keep in mind:
- too much iron is toxic, although it’s very difficult to get too much iron from food alone
- take iron on an empty stomach and with either a high-quality whole-food vitamin C supplement or a small amount of fruit or vegetable high in vitamin C
- look for ferrous sulfate and ferrous gluconate, as these forms of iron are the most bioavailable
- avoid dairy and coffee close to the time you take the supplement
- if you are taking any medication, consult your healthcare provider before supplementing with iron; antacids, antibiotics, tetracycline, salicylic acid (aspirin), thyroid drugs, and other medications are known to create adverse conditions with an iron supplement.
If you suspect you may be iron deficient, a routine blood test can confirm your iron level. Girls and women must be especially vigilant when it comes to regulating iron, as they are more susceptible to deficiency. If levels are low, you can boost your intake of natural iron sources and should feel better after your body has had a chance to store up some of this vital mineral.