Iron Supplementation

To supplement or not to supplement, that is the question.  Iron is important for the production of hemoglobin in our red blood cells.  Low blood iron leads to low hemoglobin, which leads to poor oxygen carrying capacity, which leads to fatigue.

In children, low iron affects academic performance and can lead to a lower I.Q. 

     Common causes of low iron include a diet low in meat and green vegetables as these are the two most common dietary sources.  If one is eating foods high in iron, blood iron levels can still be low if it is not being absorbed.  People that are not producing adequate levels of hydrochloric acid in the stomach will not acidfy the stomach contents enough to absorb iron from foods or supplements.  If the small intestines are inflamed or chronically irritated as in Crohn's or celiac then absorption of many nutrients as well as iron will be poor.  Finally, chronic loss of blood can also lead to low iron.  Menstruating women or anyone with bleeding anywhere in the body, but most commonly in the gastrointestinal tract can become low in iron

     Before taking supplemental iron it is important to know what your body's iron levels are before taking a lot of this mineral.  Levels of iron higher than normal can actually cause inflammation in the body and lead to damage of organs, especially the heart.  It is highly advisable to ask your family doctor to test your blood level of iron and the ferritin level (how much iron you have in storage) if you suspect you are low.  This will tell you if you truly are low and how low.  This way you have a baseline of where you are in the beginning and on a retest, you have something to compare.

     Often times patients are told that they are anemic.  This means that the total red blood cell count is low.  This can be due to a number of reasons such as a deficiency of folic acid, vitamin B12, or iron, blood loss, or poor blood cell production.   If the cells are small in size and numbers, this is known as microcytic anemia, usually caused by low iron. 

     If either the blood iron or the ferritin is low, it is important to determine why it is low.  Look at the causes listed above and work with your family doctor and with a naturopathic physician to correct the cause.  Usually a combination of diet changes and nutrient supplementation will help correct the problem.  Sometimes iron injections or even intravenous iron may be indicated if one's iron levels are extremely low. 

     Since many forms of oral iron supplements such as ferrous sulphate or ferrous gluconate can be constipating, I like to use iron picolinate in my practice.  This form of iron does not cause constipation.  The dose will depend on if the we can increase dietary sources of iron and how low the blood levels were according to testing. 

     After a couple of months after making healthy changes, retest the iron and ferritin to make sure they are back to normal.  If the levels are improved, but not normal, keep going with the program.  You should notice your energy improving as your iron level normalizes. 

     One caveat, if you are fighting a bacterial infection, stop taking iron until the infection has been successfully fought off.  Iron actually feeds bacteria!  If you are concerned about your iron levels and taking the right amount contact Dr Yim's office.