Iron Deficiency

Iron deficiency is on of the most prevalent deficiencies I see in my practice. This is not unique to women or to adults. In fact 40% of children worldwide are iron deficient. This number is dramatic. We need to ask ourselves; Why is iron deficiency so prevalent?

Iron is paramount for red cell function and oxygenation of our blood. This directly affects brain function and energy levels resulting in poor memory, fatigue, anxiety and poor cognition when deficient or even inadequate. Iron is also important for immune function.

• Deficiency is usually defined as a ferritin (stored iron) of <30.
• Inadequate iron stores are defined as a ferritin of between 30-100.

Causes of iron deficiency

• Malabsorption (gastrointestinal conditions such as coeliac disease, IBS, gut dysbiosis or inflammatory bowel disease mean that iron is not that easily absorbed from the gut)
• Poor nutrition (the rise of vegan/vegetarian diets has led to inadequate consumption of iron rich foods)
• Heavy periods (many women suffer with heavy menstrual periods which result in iron deficiency)
• Certain genetic polymorphisms which affect transportation and absorption of iron.

Symptoms and presentation of iron deficiency

Textbook presentations of iron deficiency suggests patients will present with conjunctival pallor, spoon shaped nails and fatigue. In reality the presentation can be very different. Many patients will present with feeling tired, increasing stress levels, brain fog, being forgetful, bruising easily, anxiety, palpitations, dark circles under their eyes, poor sleep quality and even recurrent infections.

Children may present with behavioural issues and emotional dysregulation. They may have typical symptoms of feeling tired and appearing pale. Parents may report fussy eating as an issue.

If iron deficiency is suspected it is important to see your doctor for a blood test to assess your iron studies and not just ferritin alone. It is important to also look at a full blood count to assess whether the iron deficiency is causing an anaemia. If iron deficiency is found then it is important to find the cause of the deficiency for longer term management. It is important to be aware that unexplained iron deficiency can be a sign of an underlying sinister cause. This is important to establish by your doctor.

Management of iron deficiency

This needs to be a three pronged approach with supplementation and increasing the consumption of iron rich foods as well as supporting the absorption of iron.

Iron rich foods

• Beetroot
• Dates
• Dark leafy greens eg. Spinach/Kale
• Red Meat
• Liver
• Eggs

Foods to avoid

• Caffeine hinders the absorption of iron
• Foods high in phytates such as legumes
• Foods rich in calcium will chelate iron

Foods rich in vitamin C increase the absorption of iron.

Iron supplements should be taken alternate days for better absorption.

Iron can be replaced intravenously if oral supplementation is not affective or with patient choice. We recommend having a thorough consultation with your doctor or provider to make an informed decision.

Iron is such a vital mineral for quality of life. If you suspect you may have iron deficiency, we highly recommend seeing your doctor. 

This blog is not intended to diagnose or treat anyone and is not intended as individual medical advice.