How much iron should i take daily for iron deficiency? Do you have to take iron pills for a condition called iron deficiency? What are some questions you should ask your doctor before deciding to take iron supplementation?
Iron deficiency is common and can cause a range of symptoms including fatigue, trouble breathing and dizziness. But how much iron should you take to treat iron deficiency? And are some iron supplements better than others?
How Much Iron Should I Take Daily For Iron Deficiency
Oral Iron Supplementation
What is iron?
Iron is one of the minerals in the human body. It is one of the components of hemoglobin, the substance in red blood cells that helps blood carry oxygen throughout the body.
If you do not have enough iron, your body cannot make hemoglobin, and you may develop anemia. This is known as iron-deficiency anemia, the most common type of anemia.
Factors that can lower your body’s supply of iron include:
- Blood loss (caused by ulcers, some cancers, and other conditions; and, in women, during monthly periods)
- A diet that doesn’t have enough iron in it
- An increase in the body’s need for iron (for instance, in women during pregnancy).
Factors which Affect Iron Absorption and Retention
- The most important factor is your existing iron level. A low iron level will increase absorption, while a high iron level will decrease absorption. In general, you absorb 10-15% of the iron from foods. (1)
- Meat proteins will increase the absorption of non-heme iron. (1)
- Vitamin CÂ will increase the absorption of non-heme iron by as much as 85%. (1,4)
- Tannins, oxalates, polyphenols, and phytates found in tea and coffee can reduce the absorption of non-heme iron by up to 65%. Black tea reduces absorption more than green tea and coffee. (1,4,5)
- The following teas and beverages also inhibit iron absorption: Peppermint tea, cocoa, vervain, lime flower, chamomile, and most other herbal teas containing polyphenols. (5)
- Calcium, polyphenols, and phytates found in legumes, whole grains, and chocolate can reduce absorption of non-heme iron. (1) Further milk and antacids can inhibit absorption of iron supplements. (6)
- Some proteins from soy products may inhibit non-heme iron absorption. (1)
- High fiber foods, such as whole grains, raw vegetables, and bran can inhibit absorption of iron supplements. (6)
- Foods or drinks containing caffeine can inhibit absorption of iron supplements. (5,6)
Causes of Iron Deficiency
- Menstruating WomenÂ – Due to blood loss during menstruation, women are at risk of iron deficiency. The greater the blood loss the greater the risk. (1)
- Individuals with Kidney FailureÂ – People with kidney failure, and especially those on dialysis, are at high risk of iron deficiency anemia. This is due to an inability of the kidney to create adequate amounts of the hormone erythropoietin which is necessary for red blood cell creation, and therefore, retaining iron. (1)
- Pregnant and lactating womenÂ – A developing fetus requires a high amount of iron, likewise, there is a high amount of iron lost through breast milk after birth. (1)
- Older infants and toddlersÂ – Infants and toddlers require a lot of iron as they grow and so are at risk of iron deficiency. (1)
- People with low levels ofÂ Vitamin AÂ – Vitamin A helps move iron from storage in the body. Without adequate amounts of vitamin A, the body cannot regulate iron leading to an iron deficiency. (1)
- People with gastrointestinal disordersÂ – Diarrhea, ulcers, and other gastrointestinal disorders and diseases can lead to an inadequate iron absorption. (1)
- CancerÂ – 60% of patients with colon cancer are iron deficient. 29-46% of patients with other cancers are also deficient in iron. (1)
- People with Gastrointestinal DisordersÂ – People on a restricted diet, or who have problems absorbing nutrients are at risk of iron deficiency. This includes people after bypass surgery. (1)
- People with Heart Failure – Around 60% of people with heart failure are iron deficient.
Iron deficiency anemia is a common type of anemia — a condition in which blood lacks adequate healthy red blood cells. Red blood cells carry oxygen to the body’s tissues.
The Three Stages Of Iron Deficiency
Iron deficiency in general describes not having enough stored iron in your body.
Anemia refers to a low hemoglobin ( the protein in your blood that contains most of your body’s iron and carries oxygen) level.
Iron Deficiency Anemia refers specifically to anemia (low hemoglobin) caused directly as a result of low iron body stores.
Now this is where things get a bit more complicated.
Iron deficiency technically progresses over three stages.
Stage 1 – Storage Depletion – Lower than expected blood ferritin levels. Ferritin is the storage form of iron, and low ferritin levels are the first sign that the body’s iron stores are compromised.
Stage 2 – Mild Deficiency- During the second stage of iron deficiency, transport iron ( known as transferrin) decreases. This is often accompanied by a reduction in size of red blood cells even though hemoglobin levels remain normal.
Stage 3 – Iron Deficiency Anemia – Hemoglobin begin to drop in the final stage which, depending on other blood work, may formally be defined as IDA. At this stage your red blood cells are fewer in number, smaller and contain less hemoglobin.
Who is most likely to develop iron-deficiency anemia?
Anyone can develop iron-deficiency anemia, although the following groups have a higher risk:
- Women: Blood loss during monthly periods and childbirth can lead to anemia.
- People over 65, who are more likely to have iron-poor diets.
- People who are on blood thinners such as aspirin, Plavix®, Coumadin®, or heparin.
- People who have kidney failure (especially if they are on dialysis), because they have trouble making red blood cells.
- People who have trouble absorbing iron.
How is anemia diagnosed?
Your healthcare provider can perform blood tests to tell if you have anemia. The type and number of blood tests will depend on what type of anemia your doctor thinks you might have.
The blood tests will measure your hemoglobin and how much iron is in your body. If these levels are low, the doctor can make a diagnosis of anemia.
How is anemia treated?
Your healthcare provider will decide on the proper treatment, depending on the type of anemia and what is causing it.
Your doctor must first find out if the anemia is being caused by a poor diet or a more serious health problem. You can then be treated for both the anemia and its cause.
Iron-deficiency anemia is treated by eating foods that are high in iron, or with oral (taken by mouth) iron supplements.
What foods are high in iron?
The following foods are good sources of iron:
- Kidney beans
- Beef liver
- Beef (chuck roast, lean ground beef)
- Turkey leg
- Whole wheat bread
- Peanut butter
- Leg of lamb
- Brown rice
- Raisin bran (whole grain-enriched cereals)
- Blackstrap molasses
What is oral iron supplementation?
In addition to eating foods that are rich in iron, you may have to take oral iron supplements. There are many different types of oral iron supplements, including pills, capsules, drops, and extended-release tablets. The purpose of oral iron supplementation is to treat your symptoms by increasing the levels of iron and hemoglobin in your body.
You don’t need a prescription to buy iron supplements. Working with your doctor, you can choose which type is best for you.
The iron in your body is called “elemental iron.” Oral iron supplements contain different amounts of elemental iron. When you choose a supplement, be sure to check the label to see how much elemental iron it contains; a greater amount means that more iron will be absorbed by your body.
What dose of iron is usually prescribed for the treatment of iron deficiency anemia?
Your doctor will tell you how much iron you need to take every day. For the treatment of iron deficiency anemia in adults, 100 to 200 mg of elemental iron per day has been recommended. The best way to take the supplement so that you absorb the greatest amount of iron is to take it in two or more doses during the day. However, extended-release iron products may be taken once a day.
Please note the following:
- Although the supplements work best on an empty stomach, you may want to take them with food so that they don’t upset your stomach.
- You shouldn’t take iron supplements with milk, caffeine, antacids, or calcium supplements. These can decrease the amount of iron that is absorbed.
- Try to take your iron supplement with vitamin C (for example, a glass of orange juice) to increase absorption.
When will I start to feel better?
When you should start to feel better depends on your particular situation. Normally, it may take from a week to a month (after you start your iron supplement) before you start to feel better. Continue to watch your symptoms and take note of side effects that might be caused by the supplements. If you have any questions or concerns, talk to your healthcare provider.
What are the side effects of oral iron supplements?
Oral iron supplements can cause the following side effects:
- Dark stools
- Upset stomach
- Constipation (you may need to take a stool softener)
How long will I have to take an oral iron supplement?
Your doctor will let you know how long you will have to take the iron supplement. Usually, after your hemoglobin and iron levels are back to normal, you will continue to take the iron supplement for another six months. Afterward, you will have regular blood tests to measure your iron level.