Iron helps your body to make haemoglobin. Haemoglobin (Hb) is a protein found in the red blood cells that carries oxygen in your body and gives blood its red colour.
Haemoglobin levels vary from person to person. Men usually have higher levels than women.
Iron deficient? How did I get here?
Blood loss is the most common (not the only) cause of iron deficiency. This blood loss may result from a gynaecological issue (E.G. fibroids, endometriosis, adenomyosis and polyps), excessive menstrual losses which can be overlooked by many women as to them it’s “normal” and therefore report it as such or as part of a gastrointestinal issue, or inflammatory bowel diseases (IBS, Crohn’s or Coeliac disease).
Due to the marked differences amongst women with regard to menstrual blood loss (10-250 mL per menses), detailed questions need to be asked about their menstrual history as well as dietary habits.
Unaddressed or unrecognised, these conditions or reasons for, can lead to iron deficiency anaemia.
What is iron deficiency anaemia?
Iron deficiency anaemia is the most common type of anaemia that women present with.
Insufficient iron equals insufficient haemoglobin and decreased levels of circulating oxygen.
Many people remain unaware they have iron deficiency anaemia as it’s possible to experience the symptoms for years without ever having it diagnosed, or the cause of the iron deficiency diagnosed. It is a serious issue that needs some serious attention.
In women of childbearing age, the most common cause of iron deficiency anaemia is a loss of iron in the blood due to heavy menstruation or pregnancy.
A poor diet (the next most common clinical reason I see), or certain intestinal diseases that affect how the body absorbs iron can also cause iron deficiency anaemia.
Women who adopt a vegan diet will also be prone to being iron deficient and vitamin B12 deficient. This is something I have seen more frequently in clinic over the last 5-10 years with an increasing prevalence in younger teenage - mid 20's women.
Complications /Implications of low iron deficiency anaemia
The symptoms of iron deficiency anaemia can be mild at first, consequently people may not even notice them and remain blissfully unaware that they may be low in iron.
Symptoms of moderate to severe iron deficiency anaemia include:
general fatigue
weakness
pale skin
Bruising easy
shortness of breath
Palpitations
dizziness
Strange cravings to eat items that aren’t food, such as dirt, ice, or clay (yes it’s a thing!)
Tingling or crawling feeling in the legs
Tongue swelling or soreness
Cold hands and feet
Tachycardia
Brittle nails
Headaches and migraines
Sore joints
Brain fog and lack of concentration.
But wait, there's more serious complications of unmanaged iron deficiency:
Depression
Heart problems. If you do not have enough haemoglobin-carrying red blood cells, your heart has to work harder to move oxygen-rich blood through your body. Cells in tissues need a steady supply of oxygen to work well. Normally, haemoglobin in red blood cells takes up oxygen in the lungs and carries it to all the tissues of the body. When your heart has to work harder, this can lead to several conditions: irregular heartbeats called arrhythmias, a heart murmur, an enlarged heart, or even heart failure.
Increased risk of infections
Motor or cognitive development delays in children
Pregnancy complications, such as preterm delivery or giving birth to a baby with low birth weight
Tiredness- As iron deficiency anaemia can leave you tired and lethargic (lacking in energy), you may be less productive and active at work. Your ability to stay awake and focus can be reduced, and you may not feel able to exercise regularly.
Fainting– Low iron can cause fainting, and this could be dangerous in many situations, especially at workplaces, or working on machinery, or driving a car.
Cold Intolerance– Cold intolerance develops in one fifth of patients with chronic iron deficiency anaemia and is manifested by neurologic pain, vasomotor disturbances, or numbness and tingling.
Migraines– Research has now shown that there are certain types of migraines caused by iron deficiency.
Chronic Health Conditions worsened- In people with chronic conditions, iron-deficiency anaemia can make their condition worse or result in treatments not working as well.
So where does iron come from?
As iron is found in a variety of foods, you can usually get enough from a balanced diet. The major sources of iron are meat and meat-based foods, cereals and cereal products, and vegetables.
What can I do to boost my iron levels?
You are what you eat so in keeping it simple, if your presentation is mild, changes to diet is the preferred starting point. If your presentation is more pronounced supplements or the swiftest option, iron infusion.
We also need to make sure the cause of the iron deficiency is addressed.
Not readily absorbed, good Iron levels need a regular supply of it. Try to eat a well-balanced diet. Also, every day, try to eat three portions of food that are good sources of iron.
These foods are good sources of iron:
Pulses and beans
Eggs
Breakfast cereals – some cereals are fortified with iron
Lean red meat, turkey and chicken
Fish – including frozen and canned fish such as mackerel, sardines, salmon and pilchards
Nuts
Brown rice
Tofu
Bread – especially whole meal or brown breads
Leafy green vegetables – especially spinach curly kale, watercress and broccoli
Dried fruit – in particular apricots, raisins and prunes.
The amount of animal fat in your diet should be kept low. So, when eating meat, try to choose lean meat. It is also better to grill, steam, roast or microwave food rather than fry it.
A note about tea: tea may reduce the absorption of iron from foods. Avoid drinking tea just before, after or with meals or when taking iron supplements.
Vitamin C
Vitamin C (ascorbic acid) helps you to absorb more iron. So, to get the most from the food you eat, have vitamin C rich foods with meals: for example, fresh fruits and vegetables or drinks such as fresh orange juice.
What if I am a vegetarian or vegan?
Although iron from non-meat sources is more difficult for the body to absorb, people following a well-balanced diet should be able to get enough iron in their diet.
References / Reading
https://www.ncbi.nlm.nih.gov/books/NBK310577/