Low Iron is one of the most common health concerns which impacts women. This is thought to be attributed to menstruation, pregnancy, menopause and plant based dietary trends.
It is estimated that roughly 1.1 million Australians are iron deficient making it incredibly common (1).
Iron is essential for the development of red blood cells and delivery of oxygen to the body. This is why the most common symptom associated with iron deficiency is fatigue and low energy.
However, it is also not common for women to experience:
- Pale Skin
- Dark Circles Around The Eyes
- Extreme Fatigue
- Weakness
- Low Motivation
- Dizziness and Lightheadedness
- Disrupted Menstrual Cycles
- PMS
- Cold Hands & Feet
- Brittle Hair & Nails.
The two most common iron solutions suggested are often iron tables or iron infusions. However, despite these options, many women find that they are unable to find resolution from their symptoms and that iron levels do not improve.
In this article we present 3 reasons why Your Iron levels are not budging + provide a simple and complete solution which may help resolve the issue.
1. You Are Taking Too Much Iron
The vast majority of people looking to correct an iron deficiency will be put on a synthetic iron tablet such as ferrous sulphate or ferrous fumarate.
The first concern with these tablets is that they can lead to significant gastrointestinal side effects in adults (2). The second concern is that they can also contain additives like titanium dioxide and artificial colourings.
In regards to increasing iron levels, iron tablets can actually reduce iron levels if not taken correctly.
For example, one study found that doses of 60mg or more of synthetic iron increases something in the body called hepcidin for 24 hours (3). Hepcidin lowers iron absorption the next day. 60 mg or more is a dose commonly found in iron and multivitamin supplements.
This is why some health professionals recommend taking an iron tablet every 2nd day rather than everyday for best results.
However, despite taking an iron tablet every second day some people are still non responders to iron tablets regardless of timing. This comes down to the fact that typically only 10% of iron from an oral tablet is absorbed.
2. You Are Taking Too Much Iron & Have Gut Issues
Following on from the first point, too much iron can actually worsen your symptoms and absorption in the long run if you have gut issues.
This is because large amounts of iron are not completely absorbed. It is believed that roughly 10% of oral iron is absorbed with the remainder passing into the intestine unbound.
The first concern is that gut issues can lead to poor absorption of iron.
Secondly, iron has been shown to feed pathogenic bacteria in the gut (4). For example, one study found that iron supplementation promoted the growth of pathogenic species like E.Coli and Clostridium while inhibiting the growth of beneficial specialties like Lactobacillus and Bifidobacterium (5)(6).
As a result, people who suffer from gut issues tend to feel a lot worse when taking synthetic iron tablets while also not improving their iron status (7).
3. You Are Not Taking Iron With Iron Boosting Cofactors
Another reason your iron levels might not be improving is because you are not taking iron with iron boosting cofactors.
Iron comes in two main forms in its natural state. The first is Haem Iron which has about a 25-30% absorption rate (8). It comes from eating animal foods. The second form is non haem which has about a 0-15% absorption rate, is poorly absorbed and typically comes from plants (9).
When you isolate iron and put it into a supplement you strip away the other nutrients which assist with its absorption.
Iron is never found in isolation which is why so many people have a tough time taking just iron alone.
For example, if you look at a piece of beef liver, you are not only getting haem iron but you are also getting nutrients like Vitamin A, Folate and B12, which boost and assist with iron absorption.
Vitamin A & Iron
One great meta analysis showed that vitamin A supplementation alone (in the absence of iron) reduced anaemia risk by 26% (10). It did this by improving haemoglobin and ferritin levels in individuals with low serum retinol levels (11).
Folate & Iron
One study found that Iron plus folate is more effective than iron alone in treating iron deficiency during pregnancy (12). Many people can also mistake an iron deficiency for a folate deficiency which can also cause anaemia.
Vitamin B12 & Iron
Vitamin B12 is indirectly responsible for elevating blood irons levels. A deficiency in B12 can actually lead to a deficiency in iron (13). People may think they are lacking Iron but it might just be masking their deficiency for B12.
Iron, Folate and B12 work in an important interplay which is why getting adequate amounts together is important for fighting anaemia.
Copper & Iron
Low copper is heavily connected with an iron deficiency and anaemia (14)(15).
When the body is low in copper it reduces the absorption of iron in the gut, reduces haem synthesis, impairs iron uptake by the mitochondria and can lead to an iron deficiency (16)(17).
Choline & Iron
Choline is another underrated nutrient which has been show to help with iron levels.
One study found that gestational iron deficiency can be attenuated by prenatal choline supplementation (18). Another studies also show the benefit of choline supplementation for offsetting side effects of iron deficiency (19).
The No 1 Complete Solution To Boosting Your Iron Levels
The long term solution for correcting an iron deficiency is to eat foods which have good amounts of non haem iron (not large amounts) but also have high quantities of cofactors like vitamin A, B12 and folate.
This allows the body to steadily increase iron levels overtime in a healthy manner which does not trigger gut issues which may come from large doses of iron.
A good place to start is by eating nutrient dense foods like beef liver, which have a good amount of haem iron but also outstanding nutrient profiles for Vitamin A, B12, Folate, Copper and Choline.
If you do not wish to consume liver then freeze dried beef liver supplements are a good option as they can be mixed into smoothies, sauces and your favourite dishes. They also have a much more neutral taste.
At Nahla earth, out beef liver powder is organic, grass fed and grass finished and comes from Certified Organic Cattle which graze the rich pastures across Central Queensland.
You can check it out HERE if you’re interested.
References
- Cook J. D. (2005). Diagnosis and management of iron-deficiency anaemia. Best practice & research. Clinical haematology, 18(2), 319–332. https://doi.org/10.1016/j.beha.2004.08.022
- Tolkien, Z., Stecher, L., Mander, A. P., Pereira, D. I., & Powell, J. J. (2015). Ferrous sulfate supplementation causes significant gastrointestinal side-effects in adults: a systematic review and meta-analysis. PloS one, 10(2), e0117383. https://doi.org/10.1371/journal.pone.0117383
- Moretti, D., Goede, J. S., Zeder, C., Jiskra, M., Chatzinakou, V., Tjalsma, H., Melse-Boonstra, A., Brittenham, G., Swinkels, D. W., & Zimmermann, M. B. (2015). Oral iron supplements increase hepcidin and decrease iron absorption from daily or twice-daily doses in iron-depleted young women. Blood, 126(17), 1981–1989. https://doi.org/10.1182/blood-2015-05-642223
- Parmanand, B. A., Kellingray, L., Le Gall, G., Basit, A. W., Fairweather-Tait, S., & Narbad, A. (2019). A decrease in iron availability to human gut microbiome reduces the growth of potentially pathogenic gut bacteria; an in vitro colonic fermentation study. The Journal of nutritional biochemistry, 67, 20–27. https://doi.org/10.1016/j.jnutbio.2019.01.010
- Jaeggi, T., Kortman, G. A., Moretti, D., Chassard, C., Holding, P., Dostal, A., Boekhorst, J., Timmerman, H. M., Swinkels, D. W., Tjalsma, H., Njenga, J., Mwangi, A., Kvalsvig, J., Lacroix, C., & Zimmermann, M. B. (2015). Iron fortification adversely affects the gut microbiome, increases pathogen abundance and induces intestinal inflammation in Kenyan infants. Gut, 64(5), 731–742. https://doi.org/10.1136/gutjnl-2014-307720
- Parmanand, B. A., Kellingray, L., Le Gall, G., Basit, A. W., Fairweather-Tait, S., & Narbad, A. (2019). A decrease in iron availability to human gut microbiome reduces the growth of potentially pathogenic gut bacteria; an in vitro colonic fermentation study. The Journal of nutritional biochemistry, 67, 20–27. https://doi.org/10.1016/j.jnutbio.2019.01.010
- Kalipatnapu, S., Kuppuswamy, S., Venugopal, G., Kaliaperumal, V., & Ramadass, B. (2017). Fecal total iron concentration is inversely associated with fecal Lactobacillus in preschool children. Journal of gastroenterology and hepatology, 32(8), 1475–1479. https://doi.org/10.1111/jgh.13725
- Parmanand, B. A., Kellingray, L., Le Gall, G., Basit, A. W., Fairweather-Tait, S., & Narbad, A. (2019). A decrease in iron availability to human gut microbiome reduces the growth of potentially pathogenic gut bacteria; an in vitro colonic fermentation study. The Journal of nutritional biochemistry, 67, 20–27. https://doi.org/10.1016/j.jnutbio.2019.01.010
- Parmanand, B. A., Kellingray, L., Le Gall, G., Basit, A. W., Fairweather-Tait, S., & Narbad, A. (2019). A decrease in iron availability to human gut microbiome reduces the growth of potentially pathogenic gut bacteria; an in vitro colonic fermentation study. The Journal of nutritional biochemistry, 67, 20–27. https://doi.org/10.1016/j.jnutbio.2019.01.010
- da Cunha, M., Campos Hankins, N. A., & Arruda, S. F. (2019). Effect of vitamin A supplementation on iron status in humans: A systematic review and meta-analysis. Critical reviews in food science and nutrition, 59(11), 1767–1781. https://doi.org/10.1080/10408398.2018.1427552
- Ibid.
- Juarez-Vazquez, J., Bonizzoni, E., & Scotti, A. (2002). Iron plus folate is more effective than iron alone in the treatment of iron deficiency anaemia in pregnancy: a randomised, double blind clinical trial. BJOG : an international journal of obstetrics and gynaecology, 109(9), 1009–1014. https://doi.org/10.1111/j.1471-0528.2002.01378.x
- Carmel, R., Weiner, J. M., & Johnson, C. S. (1987). Iron deficiency occurs frequently in patients with pernicious anemia. JAMA, 257(8), 1081–1083.
- Reeves, P. G., & DeMars, L. C. (2004). Copper deficiency reduces iron absorption and biological half-life in male rats. The Journal of nutrition, 134(8), 1953–1957. https://doi.org/10.1093/jn/134.8.1953
- Prohaska, J. R., & Lukasewycz, O. A. (1981). Copper deficiency suppresses the immune response of mice. Science (New York, N.Y.), 213(4507), 559–561. https://doi.org/10.1126/science.7244654
- Collins, J. F., Prohaska, J. R., & Knutson, M. D. (2010). Metabolic crossroads of iron and copper. Nutrition reviews, 68(3), 133–147. https://doi.org/10.1111/j.1753-4887.2010.00271.x
- Reeves, P. G., & DeMars, L. C. (2004). Copper deficiency reduces iron absorption and biological half-life in male rats. The Journal of nutrition, 134(8), 1953–1957. https://doi.org/10.1093/jn/134.8.1953
- Bruce C. Kennedy, Jiva G. Dimova, Asha J. M. Siddappa, Phu V. Tran, Jonathan C. Gewirtz, Michael K. Georgieff, Prenatal Choline Supplementation Ameliorates the Long-Term Neurobehavioral Effects of Fetal-Neonatal Iron Deficiency in Rats, The Journal of Nutrition, Volume 144, Issue 11, November 2014, Pages 1858–1865, https://doi.org/10.3945/jn.114.198739
- Tran, P. V., Kennedy, B. C., Pisansky, M. T., Won, K. J., Gewirtz, J. C., Simmons, R. A., & Georgieff, M. K. (2016). Prenatal Choline Supplementation Diminishes Early-Life Iron Deficiency-Induced Reprogramming of Molecular Networks Associated with Behavioral Abnormalities in the Adult Rat Hippocampus. The Journal of nutrition, 146(3), 484–493. https://doi.org/10.3945/jn.115.227561