A lot of mums wonder how much iron is needed in pregnancy, but the simple fact is that there isn’t a magic number. As a growing fetus needs more and more iron to support the development of various organs. But the amount varies from pregnancy to pregnancy because while one foetus may need 40 milligrams (mg) of iron per day, another may need 80mg per day.
How Much Iron Is Needed In Pregnancy
Iron deficiency anemia affects an individual’s ability to perform physical activities and impairs growth and learning in children. In general, iron imbalance leads to either iron deficiency anemia or hemosiderosis; both are disorders with potential adverse consequences.
Diet and socioeconomic factors have an important role in iron deficiency, and, as a result, it is more commonly observed in people of various racial backgrounds living in poorer areas of the world.
Chronic iron deficiency anemia is rarely a direct cause of death; however, moderate or severe iron deficiency anemia can produce sufficient hypoxia to aggravate underlying pulmonary and cardiovascular disorders.1
Pharmacists have an important role in consulting with patients about different OTC iron products and can refer patients to a clinician to further diagnose the underlying causes if signs and symptoms of severe anemia are observed.
Iron deficiency develops in several stages. In the first stage, body iron requirement exceeds iron intake, causing progressive depletion of bone marrow iron stores. As iron reservoirs decrease, compensatory increases in absorption of dietary iron occur. During later stages, deficiency is severe enough to impair red blood cell biosynthesis, leading to anemia. Iron deficiency, if severe and prolonged, may cause dysfunction of iron-containing cellular enzymes, which may contribute to fatigue and loss of stamina via mechanisms independent of the anemia itself.Â 2
Iron deficiency anemia must be differentiated from other types of microcytic anemia, such as anemia caused by deficient erythropoiesis or decreased red blood cell production due to other underlying causes. If tests exclude iron deficiency in a patient with microcytic anemia, then anemia of chronic disease, structural hemoglobin abnormalities (e.g., hemoglobinopathies), and congenital red blood cell membrane abnormalities are considered. Clinical laboratory studies of hemoglobin electrophoresis and HbAÂ 2, as well as genetic testing (e.g., alpha-thalassemia), may help distinguish these entities.2
When iron deficiency anemia is suspected in patients with chronic blood loss or microcytic anemia, complete blood count (CBC), serum iron, iron-binding capacity (transferrin), and serum ferritin are measured. Serum iron concentration is typically low in patients with iron deficiency or chronic diseases and elevated in patients with hemolytic disorders and iron-overload syndromes. Usually, serum iron and iron-binding capacity are both tested, because their relationship is important; iron-binding capacity increases in iron deficiency. Iron deficiency in the absence of anemia is asymptomatic.2
Among healthy individuals, serum iron levels are 75 to 150 mcg/dL in men and 60 to 140 mcg/dL in women; total iron-binding capacity is 250 to 450 mcg/dL. Patients taking oral iron may have normal serum iron despite a deficiency; in these cases, a valid test requires cessation of iron therapy for 24 to 48 hours. Serum ferritin concentrations closely correlate with total body iron stores. The normal range in most laboratories is 30 to 300 ng/mL; the mean serum ferritin level is 88 ng/mL in men and 49 ng/mL in women. Low concentrations (<12 ng/mL) are specific for iron deficiency
Iron is also used for improving athletic performance and learning problems, and treating attention deficit-hyperactivity disorder (ADHD), restless legs syndrome (RLS), and canker sores. Some people also use iron for Crohn’s disease, heart failure, breath-holding attacks in children, growth in children, depression, fatigue, improving thinking, and the inability to get pregnant.
Women sometimes take iron supplements to make up for iron lost in heavy menstrual periods. Iron-rich foods, such as pork, ham, chicken, fish, beans, and especially beef, liver, and lamb are also used.
How does it work?
Iron helps red blood cells deliver oxygen from the lungs to cells all over the body. Once the oxygen is delivered, iron then helps red blood cells carry carbon dioxide waste back to the lungs to be exhaled. Iron also plays a role in many important chemical reactions in the body.
RedÂ blood cell transfusionsÂ may be given to patients with severe iron-deficiency anemia who are actively bleeding or have significant symptoms such as chest pain, shortness of breath, or weakness. Transfusions are given to replace deficient red blood cells and will not completely correct the iron deficiency. Red blood cell transfusions will only provide temporary improvement. It is important to find out why you are anemic and treat the cause as well as the symptoms.
In some cases your doctor may recommend intravenous (IV) iron. IV iron may be necessary to treat iron deficiency in patients who do not absorb iron well in the gastrointestinal tract, patients with severe iron deficiency or chronic blood loss, patients who are receiving supplemental erythropoietin, a hormone that stimulates blood production, or patients who cannot tolerate oral iron. If you need IV iron, your doctor may refer you to a hematologist to supervise the iron infusions. IV iron comes in different preparations:
- Iron dextran
- Iron sucrose
- Ferric gluconate
Large doses of iron can be given at one time when using iron dextran. Iron sucrose and ferric gluconate require more frequent doses spread over several weeks. Some patients may have an allergic reaction to IV iron, so a test dose may be administered before the first infusion. Allergic reactions are more common with iron dextran and may necessitate switching to a different preparation. Severe side effects other than allergic reactions are rare and include urticaria (hives), pruritus (itching), and muscle and joint pain.
Iron is commonly associated with animal protein, but if the thought of meat turns your stomach (thanks, morning sickness) or if you’re a vegetarian or vegan, don’t worry. Iron can be found in a variety of foods.
There are two types of iron: heme and non-heme.
- Heme iron. You can get this type from consuming meat, fish, and other sources of animal protein. It’s quickly digested by your body.
- Non-heme iron. This is found in grains, beans, vegetables, fruits, nuts, and seeds, and takes a little longer for your body to convert into a substance it can use.
While all animal proteins contain heme iron, some sources may be better options during pregnancy than others.
You’ll also want to avoid eating raw meat and fish, as that could increase your risk for bacterial infection, which can be especially dangerous during pregnancy.
Red meat is the best source of heme iron. One 3-ounce serving of lean sirloin beef contains about 1.5 milligrams (mg)Trusted Source of iron.
But before you throw that steak on the grill, have your meat thermometer handy. Consuming undercooked or “rare” meat isn’t recommendedTrusted Source during pregnancy due to the risk of bacterial contamination.
Is your beef fully cooked?
Beef is considered fully cooked once it’s reached an internal temperature of 160°F (71°C). If you’re eating out while pregnant, ask for your burger or steak to be served well-done. That will increase the chances that the meat you’re eating has been fully cooked.
Chicken contains 1.5 mgTrusted Source of iron per 8-ounce serving. It’s safe to eat chicken during pregnancy, but, just like with beef, you’ll want to make sure it’s cooked all the way through at 165°F (73.8°C) to avoid consuming dangerous bacteria, like Listeria.
Salmon is relatively rich in iron — 1.6 mgTrusted Source for a wild-caught, half-pound filet of Atlantic salmon. Salmon is safe to consume during pregnancy as long as it’s fully cooked to an internal temperature of 145°F (62.8°C).
In addition to being a source of heme iron, salmon is also packed with omega-3 fatty acids and other nutrients that may contribute to a healthy pregnancy.
Salmon is also lower in mercury than some other types of fish, such as tuna and swordfish, which may make it safer to consume when pregnant.
Try to get two or three servings of fish per week as a way to boost iron as well as protein. Other fish that are considered safe during pregnancy are:
- light tuna
If you don’t eat meat or if the thought of meat turns your stomach, there are several plant-based sources of iron you can try. Keep in mind that non-heme iron is harder for your body to absorb and takes longer to metabolize.
If non-heme iron is your primary iron source, talk to your doctor about whether they recommend adding in an iron supplement.
Beans and lentils
Bean and lentils are packed with fiber and protein, and their iron content is hard to beat.
A cup of prepared lentils will give you 6.6 mgTrusted Source of your daily iron. And white kidney beans have just as muchTrusted Source per cup, drained and cooked.
Make lentils and beans in bulk if you want to start incorporating them into your diet, and sprinkle some in your salads or heat up a few handfuls as a side dish at dinner.
Spinach and kale
Spinach and kale are rich in antioxidants, vitamins, and iron, too. One cup of cooked kale contains 1 mg Trusted Sourceof iron, and spinach is even better, packing 6.4 mgTrusted Source per 1-cup serving.
These greens are very versatile. You can toss some in with your salad, chop them up into an omelet, or just sauté some in a saucepan. You can also throw them into a smoothie for a sweet, nutritious treat.
Broccoli may be a quintessential kid favorite, but this easy-to-prepare veggie also packs in a lot of nutrients that are beneficial in pregnancy.
This cruciferous veggie boasts just over 1 mgTrusted Source of iron per cup. As a bonus, broccoli contains a hefty amount of vitamin C, which helps with iron absorption.
Broccoli is also fiber-dense and full of nutrients. Since pregnancy can slow down your digestive system (hello, bloating and constipation), adding good sources of fiber to your diet can help relieve these uncomfortable symptoms.
Try roasting it by the head with plenty of olive oil and sea salt, or steam up some broccoli and keep it on hand for a snack.
As an added bonus, broccoli is a good vegetable to have in your parenting arsenal because it’s easy to prepare and often enjoyed by young kids.
Broccoli can have a strong smell when cooked, so proceed with caution if you’re experiencing morning sickness or a lot of aversions to strong odors.