How Much Iron Is Safe To Take While Pregnant

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Are you wondering how much iron is safe to take while pregnant? At times, it can be confusing and difficult to know exactly what is going on with your body. When you are carrying a child, it is very important to always have the right amount of vitamins and minerals so that neither you nor your baby will have any health problems.

Are you planning on becoming a parent in the near future? Congratulations! Becoming a mom or dad is one of the most important and exciting events in your life. One thing that might scare–or worry you, is the fact that pregnant women need to watch their iron intake. So how much iron is safe to take while pregnant?

How Much Iron Is Safe To Take While Pregnant

Why is iron important during pregnancy?

It might seem counterintuitive that you need more iron during pregnancy, considering 70 percent of iron is found in red blood cells — and you’re no longer losing blood each month during your menstrual cycle. But iron needs jump during pregnancy to deliver oxygen to your growing baby and because your body actually produces more blood since you’re growing, too. Iron is also important in fetal brain development. Having low iron levels can put you at risk for anemia, especially during the second half of your pregnancy.

How much iron do pregnant women need?

Pregnant women need 27 milligrams of iron per day (compared to 18 milligrams for adult women 19 to 50 who are not expecting). Most prenatal vitamins include enough iron to cover that increase, but iron-deficiency anemia is common in pregnancy due to the increased demand for blood production. Luckily, it’s easy to prevent by filling your plate with plenty of iron-rich foods and, if your practitioner recommends one, with the help of a daily iron supplement.

Understanding the Iron Deficiency

Anemia from iron deficiency is the most common anemia type  and may derive from inadequate intake (e.g., poor diet quality), malabsorption (e.g., gastritis, celiac disease, gastritis, gastrointestinal resection, iron refractory iron deficiency anemia), increased physiological requirement (e.g., growth, menses, pregnancy), or pathological blood loss (e.g., internal bleedings, menorrhagia, intravascular hemolysis). The nutritional iron deficiency is the most common cause of iron deficiencies and is mainly triggered by increased needs not fully guaranteed by dietary intakes . This condition is eventually associated with a detectable change in different laboratory tests.

In 2007, a joint assessment of the WHO and the Centers for Disease Control and Prevention (CDC) indicated ferritin as a primary measure of the martial status at the population level and the soluble Tf receptor (sTfR) as a second promising parameter that warranted continued evaluation .

These two biomarkers are useful to categorize the anemia type as both mirror the intracellular iron homeostasis. As abovementioned, small quantities of ferritin are present in the serum reflecting the amounts deposited in cells. Similarly, small amounts of sTfR derive from the extracellular cleavage of the Tf receptor, and increased serum levels mirror negative iron homeostasis.
Nevertheless, ferritin is also an acute-phase protein involved in the inflammatory response against pathogens therefore being of limited use during infective and inflammatory conditions, but also in case of liver disease, tumor, hyperthyroidism, and heavy alcohol intake. If not properly assessed, the prevalence of iron deficiency may be underestimated, as ferritin increases during inflammatory conditions irrespective of the martial status.
Consequently, it has been suggested to rise the cut-off value from 12 to 30 μg/L since an adjustment of ferritin values according to the individual’s inflammatory status has found no consensus yet. The sTfR is less influenced by inflammation, but other acute-phase mechanisms, such as hypoxia or iron-limited erythropoiesis, are known to possibly affect its circulating levels. Regardless of the etiology, frank anemic conditions represent risk factors for bad conditions, especially in fragile individuals undergoing orthopedic surgery, and specific diagnostic algorithms are available to categorize the type to properly tailoring the intervention.
What is dietary iron?

The human body cannot make iron on its own. For this reason, people must obtain the mineral through their diet. When iron makes its way into the body through a person’s diet, it is known as dietary iron.

Research has identified two primary forms of dietary iron. The first is known as nonheme iron, which is present in plant- and animal-derived foods. The second form is heme iron, which is only present in foods derived from animals.

Heme iron has a higher bioavailability, and the body can absorb it more easily. Nonheme iron is the most important dietary source of iron for vegans and vegetarians. However, it has a lower bioavailability, and there are more factors affecting it’s absorption.

Food Sources

Meats, poultry, and seafood are richest in heme iron. Fortified grains, nuts, seeds, legumes, and vegetables contain non-heme iron. In the U.S. many breads, cereals, and infant formulas are fortified with iron.

Heme iron is better absorbed by the body than non-heme iron. Certain factors can improve or inhibit the absorption of non-heme iron. Vitamin C and heme iron taken at the same meal can improve the absorption of non-heme iron. Bran fiber, large amounts of calcium particularly from supplements, and plant substances like phytates and tannins can inhibit the absorption of non-heme iron.

Sources of heme iron:

  • Oysters, clams, mussels
  • Beef or chicken liver
  • Organ meats
  • Canned sardines
  • Beef
  • Poultry
  • Canned light tuna

Sources of non-heme iron: 

  • Fortified breakfast cereals
  • Beans
  • Dark chocolate (at least 45%)
  • Lentils
  • Spinach
  • Potato with skin
  • Nuts, seeds
  • Enriched rice or bread
When it comes to diet and pregnancy, the list of what not to eat can seem to go on forever. But equally important is the list of things you should eat.

Not only are you providing nutrients for your baby during their extended stay in your womb, but your body is working on overdrive to support all the changes of pregnancy.

While eating for two doesn’t mean that you will need double what you needed pre-pregnancy, you will need to increase your intake of calories and certain minerals and vitamins.

One important mineral you will need to increase during pregnancy is iron.

Your body doesn’t naturally make iron. Iron can only be obtained through your diet or through supplements. That’s why increasing your intake of iron-rich foods can be important, especially during pregnancy.

Should you take iron supplements during pregnancy?

An iron-containing prenatal vitamin in combination with sufficient dietary sources of iron throughout the day can provide many pregnant women with adequate amounts of the mineral. But iron-deficiency anemia is common, particularly after week 20 of pregnancy, and some moms-to-be do need a daily iron supplement in addition to their prenatal.

A blood test can check your iron levels and determine if you might need to take iron tablets during pregnancy that go beyond what’s supplied in your prenatal. Anyone can develop anemia, but vegans and vegetarians have a higher risk, as do women carrying multiples, or those who have had back-to-back pregnancies or severe morning sickness. If you fall into one of those categories and notice symptoms (such as feeling fatigued, dizzy or breathless), ask your doctor if you might need an iron supplemen.

Iron supplements typically contain 30 milligrams of the mineral. Because iron can cause nausea and constipation, your practitioner may suggest slow release capsules that are easier on the stomach. If your doctor has also recommended supplementary calcium, keep in mind that you shouldn’t take more than 250 milligrams at the same time as an iron supplement, since calcium can interfere with iron absorption (you should also take these supplements two hours apart).

The bottom line: For most women, iron supplementation is safe during pregnancy. However, not every mom-to-be needs extra iron, especially since the mineral is already in most prenatal vitamins and can be found in certain foods. As always, talk to your practitioner before adding any new supplements to your diet.

The Martial Status Biomarkers during Iron Deficiency
The depletion of storages, iron-deficient erythropoiesis, and iron-deficient anemia are the increasingly severe consequences that arise upon iron deficiency, with the affection of erythroid cell development and feature being acknowledged by impaired RBCs homeostasis but even intracellular iron-containing proteins. Although the measurement of blood parameters relies on well-established and widely used analytical methods, many concerns persist regarding the pre-analytical phase management and assay comparability/standardization.

  • Iron storage depletion. During the first phase of iron depletion, the deposits in the bone marrow, liver, and spleen are becoming exhausted (no stainable bone marrow iron), but no consequences on erythropoiesis are detectable yet. This early depletion is characterized by low ferritin (<35 μg/L), but normal Hb and other martial status indices. The bone marrow is a major site for iron storage, but all the local metal is used for erythropoiesis, easily impairing RBC generation upon iron depletion at this site. The absence of stainable iron in the bone marrow is the gold standard for iron deficiency diagnosis, but it is used only in certain circumstances due to the invasive nature of the procedure. It is based on the Prussian blue staining of aspirates to detect both hemosiderin in macrophages and iron granules in sideroblasts. The analysis requires an experienced observer and careful attention to detail. The serum fraction of ferritin represents a portion of the total body pool that is stored in cells specialized in storing the metal and processing heme (e.g., hepatocytes and macrophages). In healthy individuals, the normal concentrations range between 15 and 300 μg/L, with lower values in children vs. adults, in women vs. men, and in fertile vs. post-menopausal women. Normally, 1 μg/L of serum ferritin corresponds to 8–10 mg of stored iron as a direct proportion. Values comprised between 12 and 15 μg/L indicate a depletion of iron stores. The ferritin measurement is widely available, standardized, and methodologically robust, and is based on colorimetric/fluorescent enzyme-linked immunoassays (ELISA) or on chemiluminescent immunoassays (CLIA) ran on automated analyzers. The serum is the best matrix for a proper ferritin measurement, although plasma is also suitable depending on the analytical method.

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