It’s iron week! *cue ferritin-fueled dancing*
This week, we’re talking all about this essential mineral, and we’ll be sharing guidance from experts as well as some delicious recipes that will help you keep your iron levels in a healthy range. To kick things off, we’re getting the facts from leading fertility dietitian Stefanie Valakas. She–like so many women–has personal experience with low iron, and she’s here to arm you with the info you need to know.
Take it away, Stefanie!
What is iron?
Iron is an essential mineral responsible for oxygen transport throughout your body via red blood cells. That is, it is responsible for oxygenating every tissue in your entire body! Talk about critical!
It also helps with keeping your immune function in check and also supplying oxygen to your muscles.
Most of your iron is found in your red blood cells, transporter and storage proteins as well as in your muscle with some floating around in your blood (serum) too.
What foods contain iron?
Iron is found in many found in many different foods, the most absorbable form is heme iron (meaning iron from blood) which is found in:
- Organ meats
The general rule is, the redder the meat the richer it will be in heme iron.
Iron is also found in many different plant & non-meat foods too, these are in the form of non-haem iron which may not be as absorbable by the body but it can be enhanced to improve absorption, so listen up to you non-meat eaters!
- Legumes, lentils & beans such as kidney beans, green lentils, chickpeas
- Nuts & seeds
- Fortified cereals such as WeetBix, AllBran, wholegrain pasta, rolled oats, brown rice, wholegrain bread
- Some flours (e.g. Teff)
- Vegetables especially spinach & broccoli
- Dried apricots
How much do I need?
Women are at a particular risk of being low in iron due to regular losses of iron via menstruation. Therefore, their need for iron is much increased in women compared to men. Children are also at risk of iron deficiency, especially if they consume lots of milk as calcium can block the absorption of iron and can often displace iron-rich protein foods in the diet when consumed in excess.
Non-pregnant & pre-menopausal women (19-50 years): 18 mg/day
Post-menopausal women (51 years +): 8 mg/day
Pregnant women (any age): 27 mg/day (during 2nd and 3rd trimesters, especially)
How do I know if my iron is low?
Common symptoms of low iron or iron deficiency include:
- Fatigue, that does not get better with rest or sleep!
- Poor concentration and brain fog
- Impaired immunity – getting sick more often
- Reduced physical ability to work (e.g. exercise)
- Pale skin
- Shortness of breath
- High resting heart rate or irregularly
- Brittle nails, cracking at the side of the mouth
- Spooning of the nails (i.e. they are dipped from a profile view)
The best way to know for sure if your iron is low is to ask your doctor for a blood test, known as “Iron Studies” and also a “Full Blood Count”.
What is the role of iron when trying to conceive?
There isn’t much good scientific evidence available that really gets to the role of iron in fertility and conception. However, it is usually strongly recommended that you are “iron replete” and have your ferritin topped up before pregnancy. Most prenatal vitamins (which should be commenced at least 3 months before planned conception) contain some iron but doses vary between brands. It is often not enough to restore low iron stores or deficiency in women looking to conceive soon with poor iron status.
One study of 438 women over 8 years showed that women who took iron supplements were at a lower risk of ovulatory infertility (that is infertility due to issues with ovulation). Studies in rats also showed a reduced ability to conceive when severe iron deficiency was present. However, make sure you read the rest of this blog before running out to supplement your iron (especially, blindly – i.e. without bloodwork!)
What is the role of iron during pregnancy?
Despite losses being reduced during pregnancy as menstruation has ceased, requirements quickly escalate! Particularly during the second and third trimesters, a woman’s blood volume increases to support baby’s own blood supply. With more blood comes an increased requirement for iron! It is important to help keep Mum’s energy levels up and to oxygenate all her cells and tissues as well as her growing baby’s and the placenta.
However, 27 mg a day is near impossible to achieve from diet alone (especially if you’re vegetarian!) so supplements are necessary and if they don’t keep your iron status in check, some women end up getting an iron transfusion to bump it up quick smart!
Some research has shown that severe and ongoing iron deficiency anaemia can result in a low birth weight baby, so it should be managed early on and rectified ASAP when identified.
How do I get enough iron in my diet?
If you’re an omnivore, including lean red meat a few times a week and lots of non-haem sources daily to help you reach your daily target of 18 mg a day.
If you are relying mostly on non-haem sources of iron, these are more sensitive to other elements of food and nutrients that can either help or hinder its absorption.
Key inhibitors of non-haem iron absorption include:
- Calcium: like iron it is a positive divalent ion, which just means it competes for absorption in the body. Avoid calcium-rich foods such as dairy and calcium supplements with or around mealtimes.
- Tannins: found in tea & coffee, sipping on a cuppa 30 minutes after your lentil soup won’t help you absorb iron
- Phytates: a type of antioxidants found in wholegrains, legumes, nuts & seeds (i.e. where you find lots of non-haem iron), again little you can do about this one. Some people “activate” things like nuts by soaking to reduce phytate content but honestly I would not pay the extra for “activated” anything!
- Zinc: often found in similar foods to iron-rich foods is also another positive divalent ion that competes for absorption in the body! There is often not much you can do about this one!
However, there is hope to help you absorb that non-heme iron!
- Vitamin C (or ascorbic acid): found in capsicums, tomatoes, broccoli, citrus, kiwi, strawberries and lots of other fruits and veggies helps with the absorption of non-haem iron.
- Other organic acids such as citric acid: can also help with absorption. This could mean adding some vinegar or lemon or other citrus juice to your leafy greens to aid with the iron absorption.
Should I take an iron supplement?
Iron supplements are very handy! Especially in situations where your iron is already low, you don’t eat red meat, or you’re pregnant (or planning on being so very shortly!) it can be very challenging to achieve this in a timely manner with food alone.
However, a commonly reported side effect of talking iron supplements is constipation. This is because excess unabsorbed iron can irritate the gut and lead to constipation. So doing your best to get as much as possible from your diet and taking much smaller doses of iron may be helpful. Alternatively, looking into “gentler” versions of iron supplements such as “iron (as amino acid chelate)” can also help dodge that horrid bowl side effect! The dosages are often lower so if you are already low, speak to your doctor about dosage. There re also other prescription iron supplements that you can ask your doctor about too.
Follow your doctor and dietitian recommendations for dosage and type of iron to supplement, but let them know if you are experiencing side effects!
Stefanie Valakas is a leading women’s health and fertility dietitian and nutritionist based in Australia. She specializes in preconception nutrition, and is passionate about helping couples who are trying to conceive optimize their diet–and chances of conceiving! She helps women facing PCOS, endometriosis, hypothalamic amenorrhoea, thyroid issues, and early menopause.
Want to learn more about your fertility and optimize your chances of conceiving? Try our new Trying to Conceive Program in the Baby2Body App today!