The importance of iron
Iron is a workhorse nutrient: It makes your cells work properly, sharpens your concentration and memory, drives your body’s energy supplies, helps form hemoglobin in your red blood cells that carries oxygen to every part of your body, and may even ward off depression. Yet millions of Canadian women of reproductive age don’t have enough. “Probably 20 percent of menstruating North American women are deficient in iron,” notes Dr. William Ehman, an assistant professor in the faculty of medicine at the University of British Columbia, and a family physician in Nanaimo, B.C., who regularly sees iron-deficient women in his practice. “The biggest misconception is that iron deficiency is always related to a poor diet, when the reality is, most women need to work to keep their iron levels up.” For example, if you menstruate heavily, your doctor might recommend birth control such as the pill or an IUD to lessen overall menstrual bleeding. Read on to discover the surprising facts about iron deficiency and how you can get-and keep-enough in your body.
Lots of women-not just vegetarians and pregnant women-find it hard to get enough iron.
“During pregnancy, your body needs more iron, but it’s hard to meet your increased needs through diet alone,” notes Dr. Nan Schuurmans, an Edmonton obstetrician and co-author of the book Healthy Beginnings. Your healthcare provider may prescribe an iron supplement that you will need to take along with your prenatal vitamins.
As for vegetarians, because they do not eat meat (which is rich in iron), Dietitians of Canada recommends that they eat greater amounts of iron-containing fruit, vegetables, grains, nuts and beans in order to get adequate amounts of the nutrient. “However, vegetarians who make proper food choices don’t have a higher incidence of iron deficiency compared to non-vegetarians,” says Vesanto Melina, a registered dietitian in Langley, B.C., who specializes in vegetarian and vegan nutrition, and is co-author of a joint position paper on vegetarian diets from the Dietitians of Canada and the American Dietetic Association.
But you’re not home-free if you’re not in either of the above groups. Here are some other common causes of iron deficiency:
Poor iron absorption: This could be due to not eating enough iron-rich foods, or eating foods that can hinder the way your body absorbs this essential mineral. “Because iron is absorbed in the gut, faulty absorption could also be due to a digestive issue such as untreated celiac disease or colitis,” says Ehman. A 2010 study published in the International Journal for Vitamin and Nutrition Research suggested that people who are obese may not be able to absorb iron well. And absorption can be blocked for those taking large amounts of antacids such as ranitidine, or a proton-pump inhibitor (PPI) medication such as omeprazole or esomeprazole.
Too-vigorous workouts: If you are training extra-hard-for a half-marathon, for example- “you can lose small amounts of iron through sweat and urine,” explains Alex Paton, a Winnipeg registered dietitian who specializes in sport nutrition. Running can also cause minor GI bleeds (that the runner may not even notice) simply because the body is being jostled and shaken, she adds.
Another factor is foot strike-literally, red blood cells bursting in the feet when they hit the ground. (You might experience foot pain or extreme fatigue if this is the case.) “Running shoes with firm insoles decrease the amount of blood loss through foot strike,” notes Kamal Janakiraman, a researcher and physiotherapist who co-authored a 2011 study in Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology.
Giving blood: Canada Blood Services screens donors for low iron levels and turns down anyone whose levels are below a certain amount. Blood donation causes a temporary drop in hemoglobin, but your body makes new red blood cells to replace those lost. It’s a good idea to eat iron-rich foods for a few days after donation, and space out your donations if your levels are in the low-normal range.
Looking pale and feeling faint are not the only signs of iron deficiency.
The symptoms of iron deficiency can be vague, says Ehman. “Women come into my office talking about feeling fatigued and not being able to exercise the way they used to.” He adds that restless leg syndrome can also be a sign. Other possible symptoms are a red, inflamed tongue; dizziness; headache; difficulty maintaining body temperature; shortness of breath; brittle nails; irritability; and rapid or irregular heartbeat. In mild cases, you might not notice any symptoms at all. Your doctor can order blood tests to check your iron levels.