The Iron Paradox

“My hair is falling out and it seems no matter how much I sleep I still have low energy during the day.” These were the words of Stephanie, a 45-year-old patient of mine.  Her lab testing revealed that she had low iron stores, as the blood test ferritin demonstrated. Like many patients I test, Stephanie did not have iron deficiency anemia, but she did have low iron stores. After two months of eating iron rich foods and supplementing a well absorbed iron her ferritin level normalized and her hair loss stopped and her energy level normalized.
The Energy Mineral
Iron is an important mineral that we must get from our diet or supplements. It is an essential component of the oxygen carrying protein hemoglobin in our red blood cells. It also is a component of myoglobin, a protein that contains oxygen that is required for muscle metabolism. Iron has several other roles including growth, neurological development, normal cell functioning, and the synthesis of some hormones such as thyroid.
People with iron deficiency often experience weakness, fatigue, impaired cognitive function, problems with exercise, decreased immunity, hair and nail abnormalities, pale skin, rapid breathing with activity, poor circulation, problems with body temperature regulation, certain autoimmune diseases, chronic kidney disease, restless leg syndrome, and learning difficulties, especially in children.
Iron deficiency, and low iron stores, is common in the United States. This is especially true for young children, women younger than 50, and pregnant women. It also occurs with athletes, people with an iron deficient diet, malabsorption disorders, blood loss (e.g. heavy or prolonged menses), cancer and heart failure.
Iron Essentials
There are two main types of iron known as heme and nonheme. The nonheme iron foods are found in plants and is not absorbed as well as heme iron found in meat, seafood, and poultry (these animal foods also contain nonheme). The richest source if iron is red meat. Vitamin C in foods and supplements enhance the absorption of iron. Examples of plant sources of nonheme iron include white beans, dark chocolate, raisins, lentils, spinach, tofu, kidney beans, chickpeas, tomatoes, and cashews.
The Recommended Daily Allowance (RDA) for adults ages 19 to 50 is 8 mg for males and 18 mg for females. For pregnant women, the RDA is 27 mg. For adults 51 years and older the RDA is 8 mg for both males and females.
High Iron Is Toxic
Oppositely, people with high iron levels are at risk for damage to their cells and organs since. This is why I do not recommend supplementing iron unless one knows there is a need for it. For example, people with the genetic disease known as hemochromatosis, are prone to the accumulation of iron in the body. This can lead to liver damage, liver cancer, heart disease, joint pain, fatigue, damaged pancreas and Type 2 diabetes, and other problems
Supplementation Recommendations
For patients that require iron supplementation based on lab testing I recommend iron glycinate, as found in our Iron Wellness. Some forms of iron supplements often cause constipation and digestive upset.
Smart Testing
Blood tests can check for iron levels as well as the storage form known as ferritin. I like to check both markers, along with red blood cell and hemoglobin levels, since one may have normal iron levels but low ferritin. However, be aware that ferritin levels can rise due to inflammation, such as an infection.
As you can see low levels of iron can cause all sorts of health issues. Oppositely, one should not supplement iron unless lab testing shows low levels since the accumulation of iron is a health hazard.