What happens if your iron is too low?
Published May 6, 2021
What is iron?
Iron is a mineral and a biologically essential component of every living organism.
It’s a vital part of hundreds of proteins and enzymes needed for your body to function.
In your body, two-thirds of your iron is found in your blood, twenty-five percent is stored throughout the body waiting to be used and fifteen percent is being used by the muscles and other enzymes.
Why is iron important?
Iron is essential for many important bodily functions including:
- Oxygen transport —Iron is necessary for the formation of two molecules: hemoglobin which transports oxygen to the body’s tissues and myoglobin which is involved in the transport and short‐term storage of oxygen in muscle cells.
- Energy production —Iron is needed for the activation of a key enzyme involved in energy production.
- Brain and nerve function —Iron is an essential co-factor in the synthesis of brain chemicals such as dopamine, norepinephrine and serotonin.
- Immunity —Iron is required for several immune functions
- Cell proliferation and DNA — Iron is essential for the group of enzymes involved in cell proliferation and DNA repair
What happens if my iron is too low?
Symptoms of iron deficiency can often be associated with several clinical conditions, if you experience any of the below signs or symptoms chat to your healthcare professional about whether you may be iron deficient. Signs and symptoms indicating the investigation of low iron:
- Reduced endurance capacity during exercise
- Poor immune defences
- Decreased general health and wellbeing
- Difficulty maintaining normal body temperature in a cold environment
- Impaired mental function
- Ice craving
- Brittle nails
- Hair loss
What can cause low iron?
Iron absorption issues
The amount of iron you absorb from food is typically low, ranging from 5-25% depending on circumstance and the type of iron being eaten. So making sure you eat enough iron-rich foods in your diet is important to help maintain healthy iron levels.
Absorption of iron depends on many factors, but it starts in the small intestine and is influenced by the pH of the stomach. So people on medication to lower stomach acid, or people with gastrointestinal disorders can have impaired iron absorption.
High iron vs low iron foods
The type of iron you eat can also have an impact on your iron levels. There are two types of iron in foods:
- Heme iron — Heme iron is highly bioavailable (15%-35%) and dietary factors have little effect on its absorption. Sources include meat, poultry and fish.
- Non-heme iron — Non-heme iron absorption is lower than heme iron (2%-20%). The absorption of non-heme iron is strongly influenced by the presence of other foods. Sources of non-heme iron include cereals, pulses, legumes, fruits and vegetables.
Iron enhancers vs Iron inhibitors
Some foods inhibit the absorption of iron from your diet, while others enhance the absorption:
- Iron inhibitors — Inhibitors of iron absorption include phytic acid from grains, polyphenols commonly found in black tea, calcium, proteins from milk products and soy proteins.
- Iron enhancers — Enhancers of iron absorption are ascorbic acid and meat, fish and poultry when added to a high non-heme meal. Ascorbic acid will overcome the negative effect on iron absorption of inhibitors.
Who is at risk of low iron?
- Children and Adolescents — Iron is needed during periods of rapid growth. Children and adolescents benefit from an iron-rich diet.
- Women of reproductive age — Blood loss from heavy menstrual periods may contribute to iron deficiency.
- Pregnant and breastfeeding women —The expanded blood volumes of pregnancy and the increased nutritional requirements of breastfeeding could lead to a deficiency if dietary intake is inadequate.
- Vegetarians and vegans — Plant sources of iron are generally not as well absorbed as animal sources. Adding some vitamin C and avoiding inhibitors of iron absorption at mealtimes will help absorption.
- Athletes in training — Intense exercise can cause a loss of iron.
- High cow’s milk diet — Cow’s milk has been shown to inhibit iron absorption.
- Gastrointestinal health issues — Untreated intestinal worms will deplete your body’s stores of iron. Gut conditions with a predisposition to bleeding eg. stomach ulcers can also deplete your iron levels. People who have had gastrointestinal surgery will also be vulnerable to impaired iron absorption.
- Frequent blood donors — Those who donate blood within every 6 months may deplete iron stores.
- Medications — Several medications can cause issues with iron. Speak to your healthcare professional about your medications and their interaction with iron.
How can you find out if you are low in iron?
Iron deficiency is diagnosed by your healthcare professional after a detailed case history and a blood test.
Iron depletion and deficiency progress through several stages which are identifiable with a blood test:
- Mild deficiency or storage iron depletion.
- Marginal deficiency or mild functional deficiency.
- Iron Deficiency Anaemia (IDA)
The recommended treatment will depend on your stage of iron deficiency and the potential underlying cause of iron deficiency.
In conjunction with treating the underlying cause other treatments can include:
- Dietary modification — Increasing iron-rich foods and reducing foods that inhibit iron absorption may be all that is required to treat a mild deficiency.
- Oral supplementation — Iron tablets may be prescribed by your healthcare practitioner.
- Intravenous iron — Intravenous iron may be recommended in cases where gastrointestinal absorption is compromised or the need for a rapid increase in iron levels is warranted. Intravenous iron is administered by a doctor in a healthcare facility.
Research into iron deficiency has come along way in the last few decades. Understanding the underlying cause of your iron deficiency can help you work out a treatment plan while you boost your iron levels and reduce deficiency symptoms.
Increasing iron-rich foods in your diet while reducing diet or lifestyle factors that could inhibit iron absorption can be beneficial. Iron supplementation may also be required. Speak to your healthcare practitioner to see if supplementation is right for you.
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