Do You Need an Iron Boost?

If you’re feeling sluggish, turn first to certain foods (hint: Popeye was definitely on to something!).

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If a person’s blood contains a lower- than-normal number of red blood cells, they have a condition called anemia. The most common cause is a lack of iron, a mineral that’s vital to the creation of hemoglobin (the protein in red blood cells that transports oxygen from the lungs to various tissues). This is called iron deficiency anemia (IDA), and about 13% of the world’s population has it at any given time.

The term “anemic” is often used to describe weakness in general, and that’s fitting, because a lack of energy and a feeling of overall exhaustion are IDA’s signature symptoms. Other symptoms include shortness of breath, dizziness, chest or stomach pain, headache, pale skin, and rapid or irregular heartbeat. These occur mainly because the heart must work harder to compensate for the reduced oxygen-carrying capacity of the blood.

Why Do You Have IDA?

One major reason for IDA is blood loss, which can be due to heavy menstrual periods, internal bleeding, injury, or surgery. It may also be caused by low intake of dietary iron or problems with absorbing the mineral, possibly from inflammatory bowel disease or a genetic predisposition. After an IDA diagnosis, a physician may use scanning (such as CT) to see if there’s a potentially dangerous underlying condition such as internal bleeding.

How to Add More Iron to Your Diet

Often the best and safest therapeutic response is simply to eat foods that contain more iron. Heme iron, found mostly in meat and other animal foods, is easily absorbed. Good non-meat sources of heme iron include oysters, clams, tuna, shrimp, and eggs. Non-heme iron comes from plant-based foods, and good sources of it are beans (kidney, lima, navy), tofu, lentils, molasses, spinach, and brown rice.

To increase iron absorption, especially from non-heme sources, eat these foods with others that are rich in vitamin C, such as red peppers and tomatoes, or with a vitamin C supplement (200 mg). In my view, iron supplementation is rarely necessary, but if your doctor thinks it’s appropriate, an absorbable form called iron gluconate, taken with vitamin C, is likely the best choice.

Could You Be Getting Too Much Iron?

While too little iron is indeed a problem, too much has its own dangers. Our thinking about iron has changed since the 1970s, when supplementing with the mineral was a common recommendation for “tired blood” and fatigue.

An estimated 16 million Americans have some degree of iron overload, triggered by overconsumption, hereditary disposition, or both. Excess iron ends up in the liver, heart, and endocrine organs, which can lead to liver disease, heart failure, elevated blood glucose, and, rarely, neurodegenerative diseases. The best treatment for the problem, aside from reducing dietary intake, is therapeutic phlebotomy—basically, donating blood every two weeks until your level of ferritin, a blood protein that contains iron, returns to normal.

This article originally appeared in the October 2020 issue of Prevention.

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