- Iron-Deficiency Anemia: How to Increase Your Iron Absorption
- Treat What’s Causing Your Iron-Deficiency Anemia
- Eat Smart to Increase Your Iron Absorption
- What to Know About Taking Iron Supplements
- Foods to Fight Iron Deficiency
- Iron Deficiency
- Sources of Iron
- High-Risk Populations
- How to Prevent Iron Deficiency
- Boosting iron absorption: A guide to for the science-minded
- A healthy diet is the key to getting the iron you need – Harvard Health Blog – Harvard Health Publishing
- Iron stores
- Keeping the reservoir full
- Good sources of iron
- Boost Your Iron – Before You Donate!
- Top Iron-Rich Foods List
- Iron supplementation: When less is really more
- Iron & Oral Supplements for Anemia: Types & Benefits
- What are the symptoms of anemia?
- Who is most ly to develop iron-deficiency anemia?
- How is anemia diagnosed?
- How is anemia treated?
- What foods are high in iron?
- What is oral iron supplementation?
- What dose of iron is usually prescribed for the treatment of iron deficiency anemia?
- When will I start to feel better?
- How long will I have to take an oral iron supplement?
Iron-Deficiency Anemia: How to Increase Your Iron Absorption
If you’ve been diagnosed with iron-deficiency anemia, you may be relieved to learn what’s been causing your symptoms.
Iron is an essential mineral that, in addition to helping maintain healthy hair, skin, and nails, aids in the production of hemoglobin, a protein in red blood cells that helps transport oxygen throughout the body.
People who are deficient in iron (or who have iron-deficiency anemia) have trouble producing enough healthy red blood cells, which can cause fatigue, shortness of breath, and more.
But don’t start piling your plate full of spinach, Popeye-style, just yet. Here’s what to know about iron-deficiency anemia and how to boost your iron levels.
Treat What’s Causing Your Iron-Deficiency Anemia
Knowing the reason why you’re deficient in iron is an important first step in controlling your condition, says Sioban Keel, MD, a hematologist and an associate professor of hematology at the University of Washington School of Medicine.
For example, women who have heavy periods are particularly at risk for the condition, according to the American Society of Hematologists (ASH); some women may need to take an iron supplement or talk to their gynecologist about birth control options that could lessen the bleeding, Dr. Keel says.
Or, says Cristina Sutter, MHSc, RD, from Vancouver, Canada, “if you’re an athlete, and you’re losing extra iron through sweat, or a vegetarian who’s short on [iron], just being aware [of your low iron] and remembering to take your supplement and eat a well-balanced diet can make all the difference.”
Eat Smart to Increase Your Iron Absorption
What you eat — and when you eat it — can impact iron absorption. Here are a few ways to work more of this mineral into your diet.
- Eat meat. The best source of iron is heme iron, which comes from animal-based foods including red meat, poultry, and seafood, according to the National Institutes of Health Office of Dietary Supplements (ODS). While tofu, legumes, and spinach do contain iron, plant-based (or non-heme) iron isn’t as readily absorbed as iron from meat. “Only about 2 to 20 percent of non-heme iron makes its way from your digestive tract into your blood, compared with 15 to 35 percent from animal foods,” says Cynthia Sass, MPH, RD, author of Slim Down Now.
- Add vitamin C to your diet. “Pairing vitamin C with your meal gives non-heme iron a boost, upping its absorption,” Sass says. In addition to eating more fruits such as oranges, kiwfruiti, and grapefruit, you can get a healthy dose of vitamin C from bell peppers, broccoli, and cauliflower.
- Cook in a cast-iron skillet. “Using iron cookware transfers some of the iron into your food,” Sass says. “This especially works for acidic foods that have a higher moisture content, such as tomato sauce.” According to a small study done in children, published in December 2013 in the Indian Journal of Pediatrics, cooking a cast-iron pot increased the iron content of the food by about 16 percent.
- Reschedule your coffee and tea times. Separate coffee and tea (including decaf, though herbal is okay) from iron-rich meals and supplements. “Tannins, which are found in tea and coffee, interfere with absorption, so if you’re trying to build your body’s iron stores, drink tea and coffee at least a few hours before [or after] an iron-rich meal,” Sass adds.
- Space out your iron intake. Your body can absorb more iron when its consumed in several smaller doses rather than one large one, says Sass.
What to Know About Taking Iron Supplements
Because the amount of iron in food is so small compared with the amount that someone with an iron deficiency might need, “it’s unly they’d drastically improve their iron levels through diet,” says Sutter.
Although foods liver and shellfish have high amounts of iron — with pork liver coming in at about 15 milligrams (mg) per 3 ounce (oz) serving and 3 oz of oysters containing about 8 mg, according to the U.S.
Department of Agriculture and the ODS, respectively — they aren’t commonly available or even recommended for daily consumption, due to high cholesterol levels.
According to ASH, even if you’ve identified the of cause of your iron deficiency (and are treating your condition), you may still need to take iron orally or intravenously. Iron supplements are usually taken three times per day, with most people needing to take 150 to 200 mg of elemental iron, according to ASH. To help maximize how your body uses these supplements:
- Don’t take them at the same time as calcium supplements, if you take both. Calcium may interfere with iron absorption, the ODS says.
- Take them on an empty stomach or with orange juice to improve absorption, adds Sutter.
Note that most iron supplements have some side effects such as constipation, nausea, and upset stomach. Taking them after dinner and before bed could help offset some of your queasiness.
Foods to Fight Iron Deficiency
Colin & Linda McKie/iStock/Thinkstock
You may pump iron at the gym a few times a week, but your body pumps it continuously through the bloodstream every day.
Iron is needed to make hemoglobin, a part of red blood cells that acts a taxicab for oxygen and carbon dioxide.
It picks up oxygen in the lungs, drives it through the bloodstream and drops it off in tissues including the skin and muscles. Then, it picks up carbon dioxide and drives it back to the lungs where it's exhaled.
If the body doesn't absorb its needed amount of iron, it becomes iron deficient.
Symptoms appear only when iron deficiency has progressed to iron deficiency anemia, a condition in which the body's iron stores are so low that not enough normal red blood cells can be made to carry oxygen efficiently. Iron deficiency is one of the most common nutritional deficiencies and the leading cause of anemia in the United States.
- Pale skin and fingernails
- Glossitis (inflamed tongue)
Sources of Iron
The body absorbs two to three times more iron from animal sources than from plants. Some of the best animal sources of iron are:
- Lean beef
Although you absorb less of the iron in plants, every bite counts, and adding a source of vitamin C to vegetarian sources of iron will enhance absorption. Some of the best plant sources of iron are:
- Beans and lentils
- Baked potatoes
- Dark green leafy vegetables such as spinach
- Fortified breakfast cereals
- Whole-grain and enriched breads
The following populations are at a higher risk for developing iron deficiency.
Women Who Are Pregnant: Increased blood volume requires more iron to drive oxygen to the baby and growing reproductive organs. Consult your doctor or registered dietitian nutritionist before taking an iron supplement.
Young Children: Babies store enough iron for the first six months of life. After six months, their iron needs increase. Breast milk and iron-fortified infant formula can supply the amount of iron not met by solids.
Cow's milk is a poor source of iron. When children drink too much milk, they crowd out other foods and may develop “milk anemia.
” The American Academy of Pediatrics recommends no cow's milk until after one year, at which point it should be limited to no more than 4 cups per day.
Adolescent Girls: Their often inconsistent or restricted diets — combined with rapid growth — put adolescent girls at risk.
Women of Childbearing Age: Women with excessively heavy menstrual periods may develop iron deficiency.
How to Prevent Iron Deficiency
Eat a balanced, healthy diet that includes good sources of iron to prevent any deficiencies. Combine vegetarian sources of iron with vitamin C in the same meal. For example: a bell pepper-bean salad, spinach with lemon juice, or fortified cereal and berries.
If treatment for iron deficiency is needed, a healthcare provider will assess iron status and determine the exact form of treatment — which may include changes in diet or taking supplements.
Boosting iron absorption: A guide to for the science-minded
Iron absorption in anthropological perspective
Back in the Paleolithic, iron deficiency was probably uncommon (Eaton et al 1999).
That’s because the Paleolithic diet included
• animal muscle tissue (from mammals, birds, fish, and/or shellfish)
• plant-based sources of iron (e.g., green leafy vegetables), and
• foods rich in vitamin C (which can triple the bioavailability of iron)
Today, many people around the world are iron deficient. They can improve their iron status by changing their diets. But how does this work? Here is an overview of iron absorption–the factors that enhance it and the substances that inhibit it.
Heme versus nonheme iron
The bioavailability of iron depends on several factors. People who are iron-replete absorb iron less easily than people who are iron-deficient.
In addition, absorption depends on the specific form that iron takes.
Heme iron is the most readily absorbed form of iron, and it’s found in shellfish, red meat, poultry, and fish (see the chart in this article about iron rich goods). On average, people absorb between 15-35% of the heme iron they consume (Insel et al 2003).
Nonheme iron is found in plant foods, as well as in eggs, milk, and meat.
Compared with heme iron, it’s less easily absorbed by the body.
Moreover, sources of nonheme iron often contain phytates, which bind to iron and carry it through the digestive tract unabsorbed.
As a result, the foods with high iron content aren’t necessarily the best sources of iron. By weight, soybeans have roughly twice the iron of beef. But only about 7% of the iron in soybeans is absorbed. Spinach is also high in iron, but less than 2% of the iron in cooked spinach is absorbed (Scrimshaw 1991).
Iron absorption enhancers
Nonheme iron is harder to absorb. But this doesn’t mean it’s unimportant. What’s needed is a way to improve the body's absorption of nonheme iron, and you can do this by adding one or more of these iron absorption enhancers to your meals:
• Vitamin C (Teucher et al 2004; Fidler et al 2009)
• Beef (Johnson and Walker 1992; Englemann et al 1998)
• Poultry (Hurrell et al 2006)
• Salmon (and, presumably, some other kinds of fish: Navas-Carretero et al 2008)
• Pork (Engle-Stone et al 2005)
• Citric acid (Hallberg and Rossander 1984)
How much difference do these additives make?
Vitamin C may be particularly effective. One study reported that adding just 63 mg of vitamin C to a meal rich in nonheme iron yielded a 2.9-fold increase in iron absorption (Fidler et al 2009).
Meat can also make a big difference. Experiments suggest that adding 50 to 85 grams of meat to a meal results in a 1.5- to 4-fold increase in iron absorption (Baech 2003; Baynes and Bothwell 1990; Cook et al 1976; Engle-Stone et al 2005; Navas-Carretero 2008).
Beef may more effective than other meats. In one experiment, beef protein enhanced iron absorption 80% better than did chicken protein (Hurrell et al 2006).
Iron absorption inhibitors
The flip side of the coin are substances that inhibit the absorption of iron:
• phytic acid (found in grains, legumes, and other plant foods)
• egg protein (from both the white and the yolk)
• minerals that compete with iron for absorption: calcium, zinc, magnesium, and copper
• tannic acid (in tea)
• certain herbs, including peppermint and chamomile
Notice that many nutritious, healthful foods contain iron absorption inhibitors. It’s not desirable to cut these your child’s diet–your child needs calcium, zinc, phosphorus, and fiber.
However, if your child is iron deficient, it might be helpful to avoid some of these foods just before, during, or after a meal that contains iron rich foods.
For instance, experiments have demonstrated that people absorb much less iron from bread when their meals include egg protein, tea, peppermint, chamomile, or coffee (Hurrell et al 1999; Hurrell et al 1988).
Similar experiments have demonstrated that calcium interferes with the absorption of iron (Hallberg 1998; Perales et al 2006).
What about phytic acid? Phytates, which are found in most plant foods, can reduce iron absorption by up to 80%. But vitamin C—consumed along with a meal–can counteract the effect.
In one study, preschoolers with iron deficiency anemia were given vitamin C supplements twice a day—100 mg at each of two phytate-rich meals.
After two months, most of the kids were no longer anemic (Seshahdri et al 1985).
This underscores the importance of vitamin C. Many grains and legumes (including soy) can be good sources of iron–if you consume them with vitamin C.
Iron-fortified foods really can help. Iron-fortified cereals–consumed with vitamin C–can be an effective way to improve your child’s iron status. So can iron-fortified soy sauce (Chen et al 2005).
Cooking with iron cookware can add iron to your diet, particularly if you cook acidic foods at high temperatures (Kuligowski and Halperin 1992).
Although egg protein inhibits the absorption of iron, a few egg yolks might not hurt. In a study of healthy, iron sufficient weanling infants, researchers fed 6-month-old babies egg yolks from eggs enriched with n-3 fatty acids.
Babies ate 4 cooked yolks a week for 6 months. At the end of the treatment, their iron status was similar to that of controls (Makrides et al 2002). The study didn’t describe whether the eggs were eaten alone or in the context of a meal.
Learn more about iron-rich foods
For more information about improving iron absorption, see this article about iron rich foods.
Baech SB, Hansen M, Bukhave K, Jensen M, Sørensen SS, Kristensen L, Purslow PP, Skibsted LH, and Sandström B. 2003. Nonheme-iron absorption from a phytate-rich meal is increased by the addition of small amounts of pork meat. Am J Clin Nutr. 77(1):173-9.
Baynes RD and Bothwell TH. 1990. Iron deficiency. Ann. Rev. Nutr. 10:133-148.
Chen J, Zhao X, Zhang X, Yin S, Piao J, Huo J, Yu B, Qu N, Lu Q, Wang S, and Chen C. 2005. Studies on the effectiveness of NaFeEDTA-fortified soy sauce in controlling iron deficiency: a population-based intervention trial. Food Nutr Bull. 26(2):177-86; discussion 187-9.
Cook JD and Monsen ER. 1976. Food iron absorption in human subjects. III. Comparison of the effect of animal proteins on nonheme iron absorption. Am J Clin Nutr 29:859–67.
Eaton SB, Eaton SB 3rd, and Konner MJ. 1999. Paleolithic nutrition revisited: a twelve-year retrospective on its nature and implications” European Journal of Clinical Nutrition 51 (4): 207–16.
Engle-Stone R, Yeung A, Welch R, and Glahn R. 2005. Meat and ascorbic acid can promote Fe availability from Fe-phytate but not from Fe-tannic acid complexes. J Agric Food Chem. 28;53(26):10276-84.
Engelmann MD, Davidsson L, Sandström B, Walczyk T, Hurrell RF, and Michaelsen KF. 1988. The influence of meat on nonheme iron absorption in infants. Pediatr Res 43:768–73.
Fidler MC, Davidsson L, Zeder C, and Hurrell RF. 2004. Erythorbic acid is a potent enhancer of nonheme-iron absorption. Am J Clin Nutr. 2004 Jan;79(1):99-102.
Hallberg L. 1998. Does calcium interfere with iron absorption? Am. J. Clin. Nutr. 68: 3-4.
Hallberg L and Rossander L. 1984. Improvement of iron nutrition in developing countries: comparison of adding meat, soy protein, ascorbic acid, citric acid, and ferrous sulfate on iron absorption from a simple Latin American-type of meal. Am J Clin Nutr 39:577–83.
Hurrell RF, Reddy MB, Juillerat M, Cook JD. 2006. Meat protein fractions enhance nonheme iron absorption in humans. J Nutr. 136(11):2808-12.
Hurrell RF. 2004. Phytic acid degradation as a means of improving iron absorption. Int J Vitam Nutr Res. 74(6):445-52.
Hurrell RF, Reddy M, Cook JD. 1999. Inhibition of non-haem iron absorption in man by polyphenolic-containing beverages. Br J Nutr. 1999 Apr;81(4):289-95.
Hurrell RF, Lynch SR, Trinidad TP, Dassenko SA, and Cook JD. 1988. Iron absorption in humans: bovine serum albumin compared with beef muscle and egg white. Am J Clin Nutr 47:102–7.
Insel, PM, Turner RE, and Ross D. 2003. Nutrition. 3rd edition. Jones and Bartlett.
Ishikawa SI, Tamaki S, Arihara K, Itoh M. 2007. Egg yolk protein and egg yolk phosvitin inhibit calcium, magnesium, and iron absorptions in rats. J Food Sci. 2007 Aug;72(6):S412-9.
Kollipara UK and Brittin HC. 1996. Increased iron content of some Indian foods due to cookware. J Am Diet Assoc. 96(5):508-10.
Kuligowski J and Halperin KM. 1992. Stainless steel cookware as a significant source of nickel, chromium, and iron. Arch Environ Contam Toxicol. 23(2):211-5.
Navas-Carretero S, Pérez-Granados AM, Sarriá B, Carbajal A, Pedrosa MM, Roe MA, Fairweather-Tait SJ, and Vaquero MP. 2008. Oily fish increases iron bioavailability of a phytate rich meal in young iron deficient women. J Am Coll Nutr. 27(1):96-101.
Perales S, Barberá R, Lagarda MJ, and Farré R. 2006. Fortification of milk with calcium: effect on calcium bioavailability and interactions with iron and zinc. J Agric Food Chem. 2006 Jun 28;54(13):4901-6.
Rutzke CJ, Glahn RP, Rutzke MA, Welch RM, Langhans RW, Albright LD, Combs GF Jr, and Wheeler RM. 2004. Bioavailability of iron from spinach using an in vitro/human Caco-2 cell bioassay model. Habitation (Elmsford). 2004;10(1):7-14.
Scrimshaw NS. 1991. Iron deficiency. Sci Am. 265(4):46-52.
Seshadri S, Shah A, and Bhade S. 1985. Haematologic response of anaemic preschool children to acsrobic acid supplementation. Hum. Nutr. Appl. Nutr. 39A: 151-154.
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Content last modified 1/14
Image of red blood cells by OpenStax College, Anatomy &Physiology, Connexions website. http://cnx.org/content/col11496/1.6/,Jun 19, 2013.
A healthy diet is the key to getting the iron you need – Harvard Health Blog – Harvard Health Publishing
An article in this week’s Journal of the American Medical Association (JAMA) focuses on what happens to iron stores in the body after donating blood.
As many as one-third of regular blood donors have too little iron in their bloodstreams.
According to the article, it can take up to six months to replenish the body’s iron after donating a unit of blood—significantly longer than the recommended 8-week waiting period between deposits at the blood bank.
The article made me wonder about the basics of iron health. How much of this stuff do we need? How do we get it? If you always feel pooped, how ly is “iron poor blood” to blame?
One-quarter of the world’s population is anemic, meaning they don’t get enough iron to produce the red blood cells and oxygen-carrying hemoglobin needed to nourish their myriad cells.
In developed nations the United States, iron-poor blood is uncommon. Anemia attributable to iron deficiency affects perhaps 1% to 2% of American adults. “Because our country usually has a problem of eating too much, most adults meet the minimum requirements for iron intake,” says nutrition researcher Howard Sesso, an associate professor of epidemiology at Harvard Medical School.
In the United States, blood loss is the main cause of iron deficiency and anemia. Among women, heavy menstrual periods and childbirth account for this. Among those age 65 and older, the causes of iron deficiency and anemia are ly to be internal bleeding, difficulty absorbing iron and other nutrients, and eating a less varied diet.
The average American man harbors about 3.5 grams (one-eighth of an ounce) of iron in his body. The average woman has about 2.5 grams.
Where do we keep this iron? Roughly 60% of it is held by the oxygen-carrying hemoglobin protein in red blood cells. The next largest storehouse is ferritin, a protein that latches onto iron and sequesters it in the liver, spleen, and bone marrow. When the body needs to draw on its iron account, it comes the ferritin bank.
Without enough stored iron, an individual can develop anemia. Symptoms include fatigue, loss of stamina, shortness of breath, weakness, dizziness, and a pale, unhealthy complexion. So precious is iron for your health that the body uses a protein called transferrin a scrap metal collector to scrounge iron from old red blood cells before they are destroyed.
Keeping the reservoir full
Most of us get the iron we need from food. Proponents of the Paleo or “cave man” diet should be cheered to know that red meat, poultry, and fish contain the most easily absorbed form of dietary iron—called heme iron. This is iron attached to the hemoglobin protein. The body absorbs heme iron more easily than the iron found in plants.
“In the typical American diet, the main sources of iron tend to be animal products,” Sesso says. “Typical meat consumption in the United States is usually more than adequate to meet one’s iron requirements.”
In plant foods, iron is not attached to such a protein. The body doesn’t absorb non-heme iron from fruits, vegetables, beans, and other plant foods as easily as it absorbs heme iron.
That means those who eat little or no meat must take in more iron from leafy greens, legumes, whole grains, mushrooms, and other iron-rich plant foods.
They also need to get enough vitamin C, which helps the body absorb iron from food.
The USDA recommends that women between the ages of 19 and 50 get 18 mg of iron a day, while women ages 51 and older and men 19 years and beyond need 8 mg a day.
Moderate amounts of meat plus fruits and vegetables can provide that amount, helped along by the many foods fortified with iron and other vitamins and minerals, milk, flour, and breakfast cereals.
And half of all Americans get some iron from a daily multivitamin.
One caution about iron: If you don’ think you are getting enough iron, or feel pooped out and assume it’s your “tired blood,” you may be tempted to pop an iron supplement as insurance. But beware.
The body does not excrete iron rapidly. That means it can build up over time and, in some people, becomes toxic.
The genetic disorder hemochromatosis causes iron to build up in organs, causing heart failure and diabetes.
So don’t just prescribe yourself an iron supplement on a whim; ask your doctor if you need it.
Good sources of iron
|Food||Portion||Iron content (milligrams)|
|Fortified cold breakfast cereal||3 ounces||30 to 60|
|Spirulina seaweed||3 ounces||28|
|Soybeans, cooked||1 cup||9|
|Cream of Wheat||1 serving||9|
|Pumpkin seeds||3 ounces||8|
|Spinach, boiled and drained||1 cup||7|
|Lentils, cooked||1 cup||7|
|Soybeans, cooked||1 cup||5|
|Kidney beans, cooked||1 cup||4|
|Beef, ground||4 ounces||3|
|Turkey, ground||4 ounces||3|
|Source: USDA National Nutrient Database for Standard Reference|
Boost Your Iron – Before You Donate!
It is important to increase your iron intake in the weeks before you donate. Low hematocrit or low hemoglobin are the most frequent reasons those wanting to donate are disqualified, and both are tested prior to blood donation. Low hematocrit or hemoglobin can be related to a low iron level. The great news is that it is usually temporary!
How to help your body absorb iron:
– Add fruits and vegetables high in Vitamin C. Vitamin C can enhance the iron absorption by as much as 20 times.
– Refrain from tea drinks since tannic acid can interfere with iron absorption.
Recommended daily dietary iron intake:Females 19 to 50 – 18 mgFemales 50 and over – 8 mg
Males 19 and over – 8 mg
Depending on which location you visit, we will test hematocrit or hemoglobin.
What is hematocrit?
Hematocrit is the percentage of blood volume that is red blood cells. According to the U.S. Food and Drug Administration (FDA), women must have a hematocrit of at least 38% and men a hematocrit of at least 39%. This is to protect donors from becoming anemic by donating blood.
What is hemoglobin?
Hemoglobin is a special protein inside red blood cells that carries oxygen. According to the FDA, to donate blood, men must have a hemoglobin of at least 13 g/dL (grams per deciliter) and women a hemoglobin of at least 12.5 g/dL. This is to protect donors from becoming anemic when they give blood.
Common reasons for low hematocrit or hemoglobin (a possible sign of low iron) are:– A low-iron diet- Menstrual blood loss
– A diet low in folate, vitamin B6 or B12
People with chronic illnesses such as arthritis, diabetes, and kidney disease may also have low readings. Some health conditions are not readily apparent but may cause a low hematocrit or hemoglobin and possible low iron levels in your body.
What can I do if my diet seems to be the only reason for my low hematocrit or hemoglobin?
Eat more of these high-iron foods:– Red meat (especially liver), pork, chicken, turkey- Fish and shellfish (oysters, clams, shrimp, scallops)- Dried fruit (raisins, apricots, prunes, peaches)- Green, leafy vegetables- Beans, peas, nuts
– Iron-fortified breads and cereals
Eating foods rich in vitamin C (citrus fruits, broccoli and tomatoes) helps in iron absorption. Avoid drinking tea while eating high-iron foods. Coffee, milk, fiber and soy protein may also block the absorption of iron. Over-the-counter iron supplements can be taken after consulting with a doctor to determine the exact cause of low hematocrit or hemoglobin.
Following these steps may help raise your percentage just a few points within just a few days.
YOUR COMMITMENT TO BEING A LIFE-SAVING BLOOD DONOR IS IMPORTANT.
- Blood donation can’t wait.Learn more about this developing situation.
- Blood donation is safe and critically important, despite concerns surrounding coronavirus (COVID-19)….// Read More
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Top Iron-Rich Foods List
Spinach may not give you superhuman strength to fight off villains Popeye's nemesis Bluto, but this leafy green and other foods containing iron can help you fight a different type of enemy — iron-deficiency anemia.
Iron-deficiency anemia, the most common form of anemia, is a decrease in the number of red blood cells caused by too little iron. Without sufficient iron, your body can't produce enough hemoglobin, a substance in red blood cells that makes it possible for them to carry oxygen to the body's tissues. As a result, you may feel weak, tired, and irritable.
About 20% of women, 50% of pregnant women, and 3% of men do not have enough iron in their body. The solution, in many cases, is to consume more foods high in iron.
When you eat food with iron, iron is absorbed into your body mainly through the upper part of your small intestine.
There are two forms of dietary iron: heme and nonheme. Heme iron is derived from hemoglobin. It is found in animal foods that originally contained hemoglobin, such as red meats, fish, and poultry (meat, poultry, and seafood contain both heme and non-heme iron). Your body absorbs the most iron from heme sources. Most nonheme iron is from plant sources.
Very good sources of heme iron, with 3.5 milligrams or more per serving, include:
- 3 ounces of beef or chicken liver
- 3 ounces of clams or mussels
- 3 ounces of oysters
Good sources of heme iron, with 2.1 milligrams or more per serving, include:
- 3 ounces of cooked beef
- 3 ounces of canned sardines, canned in oil
Other sources of heme iron, with 0.6 milligrams or more per serving, include:
- 3 ounces of chicken
- 3 ounces of cooked turkey
- 3 ounces of ham
- 3 ounces of veal
Other sources of heme iron, with 0.3 milligrams or more per serving, include:
- 3 ounces of halibut, haddock, perch, salmon, or tuna
Iron in plant foods such as lentils, beans, and spinach is nonheme iron. This is the form of iron added to iron-enriched and iron-fortified foods. Our bodies are less efficient at absorbing nonheme iron, but most dietary iron is nonheme iron.
Very good sources of nonheme iron, with 3.5 milligrams or more per serving, include:
- Breakfast cereals enriched with iron
- One cup of cooked beans
- One-half cup of tofu
Good sources of nonheme iron, with 2.1 milligrams or more per serving, include:
- One-half cup of canned lima beans, red kidney beans, or chickpeas
- One cup of dried apricots
- One medium baked potato
- One cup of cooked enriched egg noodles
- One-fourth cup of wheat germ
- 1 ounce of pumpkin, sesame, or squash seeds
Other sources of nonheme iron, with 0.7 milligrams or more, include:
- One-half cup of cooked split peas
- 1 ounce of peanuts, pecans, walnuts, pistachios, roasted almonds, roasted cashews, or sunflower seeds
- One-half cup of dried seedless raisins, peaches, or prunes
- One medium stalk of broccoli
- One cup of raw spinach
- One cup of pasta (cooked, it becomes 3-4 cups)
- One slice of bread, half of a small pumpernickel bagel, or bran muffin
- One cup of brown or enriched rice
Some foods can help your body absorb iron from iron-rich foods; others can hinder it. To absorb the most iron from the foods you eat, avoid drinking coffee or tea or consuming calcium-rich foods or drinks with meals containing iron-rich foods.
Calcium itself can interfere.To improve your absorption of iron, eat it along with a good source of vitamin C — such as orange juice, broccoli, or strawberries — or eat nonheme iron foods with a food from the meat, fish, and poultry group.
If you have trouble getting enough iron from food sources, you may need an iron supplement. But speak to your health care provider about the proper dosage first and follow his or her instructions carefully.
Because very little iron is excreted from the body, iron can accumulate in body tissues and organs when the normal storage sites — the liver, spleen, and bone marrow — are full.
Although iron toxicity from food sources is rare, deadly overdoses are possible with supplements.
Mayo Clinic: “Iron deficiency anemia.”
MedlinePlus: “Iron deficiency anemia.”
The University of Chicago Medical Center: “Iron Deficiency Anemia.”
National Institutes of Health Office of Dietary Supplements: “Dietary Supplement Fact Sheet: Iron.”
University of Colorado, Denver: “Here’s how to increase iron in your diet!”
Northwestern University: “Nutrition Fact Sheet: Iron.”
© 2018 WebMD, LLC. All rights reserved.
Iron supplementation: When less is really more
Anemia is often the result of an iron deficiency. In such cases the patients, who are typically female, will be prescribed iron supplements to be taken daily. In cases of severe deficiency, the dosage is increased to several tablets a day.
A new study recently published in the medical journal Blood reveals that it may be difficult for the body to absorb iron in quantities that are necessary and desirable when the supplement doses are administered in 24-hour intervals.
This may be due to a small, protein- molecule with the name of hepcidin. As soon as iron enters the body, hepcidin production begins in the liver.
This tiny protein, which is composed of just 25 amino acid building blocks, then is released into the bloodstream and reaches the intestine, where one of its functions is to regulate the amount of iron absorbed into the body through the cells of the gastrointestinal tract.
A group of researchers working with Diego Moretti, senior assistant to ETH Professor Michael B. Zimmermann, has now shown how hepcidin inhibits the absorption of iron supplements in the intestine more profoundly than previously thought.
Hepcidin has an inhibiting effect
In their study, the scientists observed over 50 young women whose iron reserves were depleted but who did not yet suffer from anemia. The women received a daily dose of at least 40 milligrammes of iron, as is commonly prescribed in cases of iron deficiency.
Afterwards, the researchers measured how the hepcidin concentration developed, and quantified its effect on the absorption of subsequent doses of iron. They found that the hepcidin reached its peak concentration after six to eight hours, but even 24 hours after the first dose of iron it was still present in high enough quantities to markedly reduce absorption of the second dose.
The body was only partly able to absorb this second dose of iron, which was given either on the same day or 24 hours after the first dose.
Are half measures best?
Traditional iron supplementation is often associated with undesirable side effects such as gastrointestinal complaints. Such issues are closely related to the dosage of iron given, and they are also one of the reasons why many patients stop taking supplements.
If absorption efficiency were to be improved, it would be possible to achieve a greater biological effect from a smaller dose of iron while also reducing side effects. “To improve the percentage of iron absorbed, it would ly be more efficient to wait longer between doses,” says Moretti.
However, he does concede that two limitations of the study: the participants in the study were all healthy young women without anemia, and their iron absorption was observed only over a two-day period.
The behaviour of the hepcidin concentration over the course of an iron supplementation regimen lasting several weeks will be the subject of a follow-up study, preparations for which are already underway.
Here, the scientists are studying iron supplementation over periods lasting two and four weeks.
To analyse iron reabsorption, the researchers used stable iron isotopes as indicator substances. These substances have a modified ratio of stable iron isotopes. Iron-56 is the most frequent naturally occurring stable iron isotope (91.7 percent), followed by iron-54 (5.
8 percent) and iron -57 (2.1 percent). Iron-58 occurs only in trace amounts. For their analysis, the scientists used tablets with increased quantities of iron-57, iron-54 and iron-58.
The researchers were able to measure endogenous iron absorption by observing isotope ratio changes within the body.
Worldwide there are hundreds of millions of individuals who suffer from iron deficiency. The most common causes are elevated iron loss, such as through bleeding (particularly in menstruating women), as well as imbalanced diets low in vitamin C and meat products.
Foods with a high iron content include meat, legumes and wholegrain items, liver, black pudding. In large quantities iron supplements can be toxic, however, which is why the body naturally actively regulates iron absorption.
On average there are 5 to 7 grammes of iron in the human body, of which 60 percent is found in the red blood pigment, or haemoglobin.
Materials provided by ETH Zurich. Original written by Peter Rüegg. Note: Content may be edited for style and length.
Iron & Oral Supplements for Anemia: Types & Benefits
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)
What are the symptoms of anemia?
There are several symptoms that may occur in all types of anemia. They are:
- Feeling tired
- Difficulty breathing
- Fast heartbeat
- Feeling cold (including the sensation that your hands or feet are colder than usual)
- Infections (caused by problems with the immune system)
Who is most ly 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 ly 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.
Oral iron supplements can cause the following side effects:
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.
Last reviewed by a Cleveland Clinic medical professional on 10/05/2018.
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