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Ironing out your diet

Iron deficiency
It’s not uncommon in today’s fast-paced world to feel weak, tired, or low in energy. What you might not know is that your sluggish mood may be due to something missing in your diet, not just your hectic schedule. A diet low in iron may lead to a condition called iron deficiency anemia, which can cause fatigue, weakness, pale skin, an increased risk of infection and reduced concentration. The World Health Organization reports that 5 – 20% of people in developed countries, like the United States, are consuming diets low in iron. Globally, iron deficiency is the number one nutritional disorder, affecting approximately 75% of the world’s population. The good news is that iron deficiency may be easy to avoid if you know the facts.

Iron is an important mineral because it’s an essential part of hemoglobin, which helps move oxygen throughout the body. It also assists with brain development and supports a strong immune system.

Causes of iron deficiency
While there may be other causes, one cause of iron deficiency is poor nutrition. Anyone not meeting their daily needs may be at risk for iron deficiency anemia. However, certain individuals are more likely to develop low iron stores due to increased needs, such as vegetarians, women with heavy menstrual periods, and pregnant women, whose bodies work to compensate for increased blood production to the fetus. Infants, toddlers and teenage girls may also be at risk if they are regularly eating a diet low in iron. Men and women who participate in intense exercise routines may also have increased iron needs.

Recommended dietary allowances for iron (mg/day)

All iron is not created equal
Iron is found in our diets in two forms. The first is heme iron which is found only in animal products and is most efficiently absorbed by our bodies. Beef, oysters, turkey, chicken and tuna are all good sources of heme iron. Non-heme is the other form of dietary iron, and it’s found primarily in plant products like beans, spinach, tofu, raisins and iron-fortified cereals and grains. It is the most abundant form of iron in our diets, however, it is more difficult for our bodies to absorb. Vitamin C increases the absorption of iron in non-heme sources. Excellent sources of Vitamin C include oranges, strawberries, green and red peppers, tomatoes, broccoli and spinach.

*Read the food label. The % Daily Value of iron is based on a recommendation of 18 mg/day. If a product lists "Iron 10%", it contains 1.8 mg.

Discuss treatment with your physician
If you are iron deficient, it’s important to first discuss your best treatment choice with your doctor. Iron supplements may be recommended when diet alone cannot restore the body’s iron stores in a reasonable amount of time. Your doctor will likely rule out other causes of low iron stores, such as uncontrolled internal bleeding, ulcers or aspirin use. Unfortunately, iron supplements may cause unpleasant side effects such as nausea, vomiting, constipation, diarrhea, dark colored stools and/or abdominal pain. As with all medications, iron supplements should be kept out of reach of children to prevent accidental ingestion leading to harmful iron toxicity.

Too much of a good thing
Because too much iron can be a problem, iron supplements should not be taken by everyone and not without first speaking with a physician. Adult men and postmenopausal women lose very little iron on a regular basis, and therefore iron deficiency in these individuals is fairly uncommon. Supplementation in these populations may lead to a harmful condition known as iron overload. Over time, excess iron can be stored in organs, such as the liver and heart, and can cause serious damage. Individuals with the genetic disorder hemochromatosis absorb iron very efficiently and can easily reach toxic amounts stored in organs. These patients are therefore advised to avoid supplementation their diet with iron.

If you are in a high risk group
If you are in a high risk group for iron deficiency or think you may not be consuming enough iron, talk to your doctor before making any changes. She or he can suggest possible tests to determine your iron status and work with you to come up with an appropriate treatment plan. Until then, continue to eat a well-balanced diet including an assortment of iron-rich foods from all the food groups.

The Yale-New Haven Nutrition Advisor is created by registered dietitians and dietetic interns who staff the Nutrition Clinic at Yale-New Haven Hospital. For information, contact the Nutrition InfoLine at (203) 688-2422.

For more information on this topic, see

Iron Deficiency Anemia, Mayo Clinic

Nutrition for Everyone: Iron Deficiency, Centers for Disease Control and Prevention

Iron-Deficiency Anemia Is Preventable, American Dietetic Association

Last revised: January 18, 2006 (mv)

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All information is intended for your general knowledge and is not a substitute for medical advice or treatment for specific medical conditions. You should seek prompt medical care for any specific health issues and consult your physician before starting a new fitness regimen.