As discussed in my previous blog post many women deal with anemia or iron deficiency anemia. It is by far one of the most common nutrient deficiencies and in some people can be hard to correct. There are certain steps that should be taken if you think you may be low in iron:
1. Get tested
· The first step to fixing your fatigue/dizziness/cold hands and feet, etc. is to see if you actually are deficient in iron. Iron supplementation usually isn’t recommended without confirming it is needed. Common blood tested used include:
o Complete blood count (AKA a CBC): This takes an in depth look at red blood cells to see how many there are, if they are big or small, if they are dark or light, and more. This test is important for determining if anemia is occurring and can provide clues about what type.
o Ferritin: This is a protein produced by the liver which helps to store iron. If the CBC is normal and ferritin is low then this indicates iron deficiency. A higher than expected ferritin can also indicate inflammation is occurring. Note that naturopathic doctors often interpret this lab differently than medical doctors do.
o Vitamin B12: This isn’t necessarily related to iron deficiency but is another common nutrient deficiency that can contribute to anemia.
o Iron panel (Iron/TIBC): This test looks at how much iron in circulating in the blood stream and the ability of proteins to bind to iron. This test also helps determine what type of anemia is occurring.
2. Fix your diet
· Let’s say you’ve had the appropriate testing done and it shows you need some iron. The next step is optimizing your diet to help increase levels. The primary source of iron is in any type of meat (Beef, poultry, fish, shellfish, pork, and liver) – these contain the heme-iron form which is considered to be the easiest to absorb. Non-meat sources include beans, lentils, spinach/kale/chard, molasses, tofu/tempeh, various nuts and seeds, dried fruits, and some grains. These are in the non-heme form which makes them harder to absorb. As mentioned in my previous blog post I also like to recommend cooking with cast iron pans or an iron fish to help boost iron levels in food.
3. Add in a supplement
· Diet usually isn’t enough to cause significant changes in labs and symptoms.
o How to take it: Ideally iron supplements should be taken away from food to maximize absorption. However, sometimes this isn’t possible due to causing an upset stomach or constipation so then it needs to be taken with food. Another option is to supplement every other day which can decrease side effects and help with absorption.
o Other considerations: Try to avoid swallowing iron supplements which certain liquids. Cow milk, coffee, black tea, and green tea can all decrease iron absorption. It is best to only drink water in the hour before and after taking the supplement. I also like supplements which combine iron with B vitamins (Support energy and blood building) and vitamin C (Help to improve absorption).
· Work with your MD or ND to determine an appropriate dose and form of iron for you.
4. Follow-up testing
· As discussed in my previous post there are many other things that can contribute to iron deficiency/anemia. If you experience heavy period then salivary hormone testing and/or thyroid bloodwork can be performed. If you experience digestive symptoms then you can work with an ND to determine which testing is appropriate. These may include SIBO breath testing, bloodwork for celiac and IBD markers, or IgG food sensitivity testing.
· Repeating the tests done in step one is also going to be important to make confirm improvements are happening. It takes a long time for labs to show changes so testing should be done at most every 4-6 months.
Dr. Kelsey Murray, ND