Let's talk about iron deficiency

 

Since iron deficiency is the most common nutritional deficiency in the world, and it’s prevalent amongst menstruating females, it’s important to understand a few key facts and myths on correcting low iron levels and iron deficiency.

What are some common signs and symptoms of iron deficiency? Fatigue, irritability, headaches and cramps, are a few of the common symptoms.

One of the important minerals I get all patients to check each year is their iron. Not just ferritin though, I get a full iron studies done so we can see exactly what your iron stores are and how your body is transporting it around to different tissues and organs.

Testing your iron

To accurately assess your iron, you want to ensure your blood test includes:

  • FBC - including hemoglobin

  • CRP - this is a good indicator of systemic inflammation

  • Full iron studies, including:

    • Ferritin (this is the stored iron in the body). We call this the “iron waiting at the depot”.

    • Transferrin (the transportation of the ferritin). We call this the “taxi” service. Transferrin is responsible for the delivery of iron to the tissues and organs that need it, like the thyroid. Typically the lower number of taxis - the more satiated your body is with the current iron stores. The higher the taxi number - the hungrier your body is for iron.

    • Transferrin saturation - We refer to this as “how many passengers are in the taxi”. Usually 20-30% is the ideal number of iron passengers. An elevated level can suggest iron overload. It’s interesting to note, that a level over, may benefit from a haemochromatosis gene test. Lower saturation levels can suggest a need for iron.

      • 98% of patients with fasting transferrin saturation over 45% will be homozygous for C282Y HFE mutation, which is why it’s worth doing a gene test for hemochromatosis with high levels.

A few things to note:

  • Best to do a blood test for iron studies in a FASTED state - ideally no food for 10-12 hours before your test (otherwise it can contribute to higher iron levels than you actually have). Water is fine to drink leading up to your blood test. Most patients find it easier to do their blood test first thing in the morning before breakfast.

  • 48 hours before your test please stop all iron containing supplements

  • 24 hours before your test refrain from strenuous and endurance exercise (gentle exercise like walking and yoga is fine)

Also, women on the oral contraceptive pill, pregnant or post-menopausal will naturally have altered iron results, for example during third trimester we tend to see a natural drop in ferritin and saturation, and an increase in transferrin for most women.

If I had to pick the best indicator for most women of what really reflects their iron storage + usage it would be transferrin.

Here’s a little video on understanding iron and why I do a few key things with patients that have low iron or iron deficiency. Watch the video

What does the research say?

You should NOT be taking high doses of iron (over 50 - 60 mg of iron per day), or taking iron every day. This will not give you the BEST results when it comes to addressing low iron and iron deficiencies.

“Iron supplements at doses of 60 mg or higher increase hepcidin for up to 24 hours and are associated with lower iron absoprtion on the following day”. PMID: 26289639.

Keep in mind that over-the-counter iron supplements like Ferro-grade C and Maltofer are 100mg/dose, which does not address low iron.

If you’re keen to check out your iron levels and get some personalised naturopathic support, you can book in a consultation with me here.

 

You can read more about the importance of alternate day iron dosing (NOT daily iron dosing) here

 
 
 
Olivia McFadyen