Iron – Good or Bad for You?

Iron plays an important role in the metabolic processes in our body, for oxygen transportation and for the formation of blood. According to a study of the university of Zurich, it is also needed for the information exchange between nerve cells.

It is estimated that approximately 15 to 20% of all women suffer from iron deficiency without anaemia but only 3% have an iron deficiency anaemia. The difference between the two is that in iron deficiency ferritin levels in blood are low, but there are often no other symptoms, whereas in anaemia the blood shows reduced levels of haemoglobin and physical symptoms become apparent.

Ferritin is a protein and is the storage matter for iron in the body. Levels can vary but if they are below 15 ng/ml iron reserves are depleted. Ferritin levels should always be checked with CRP (C-reactive protein), which is used an a general inflammation marker. Acute inflammations and infections raise ferritin levels.


Repeated blood loss as during menstruation is one of the most common causes of iron deficiency. Other causes include chronic inflammatory bowel diseases, regular blood donation and cancer. There is also an increased requirement during pregnancy, breastfeeding and during childhood. While common belief is that vegetarians suffer from iron deficiency, they often live comfortably and symptom-free with low iron levels.


Symptoms depend on the severity and duration of an iron deficiency. Paleness, commonly believed to be the classic symptom, is a very uncertain sign. Studies were not able to show a clear connection between paleness and fatigue. Chronic fatigue can be a sign of many other illnesses such as depression, kidney problems, a dysfunction of the thyroid or chronic hepatitis.

Signs of iron deficiency include muscle weakness, low endurance or stamina, lack of concentration, poor memory, head aches or mood swings. Increased hair loss and brittle nails are often noticed by women as a first sign. Other signs can be dry skin and cracks at the corner of the mouth.


So, when should iron deficiency be treated? When a person is anaemic, i.e. suffers from a low haemoglobin. For women the WHO recommended level is above 12 g/dl, for men above 13 g/dl. For someone with an iron deficiency but without anaemia, treatment only makes sense if they suffer from symptoms.

For treatment, two options are available: iron tablets or iron infusion, where the latter should always be second choice only, as tablets are better tolerated. An iron infusion is indicated id the tablets are not tolerated or if ferritin levels do not increase under oral therapy. Taking iron tablets before meals can help to tolerate them better but has a negative impact on the absorption rate.

Iron infusion have become very popular over the last years, partly, because ferritin levels that require treatment have been corrected to higher levels leading to more patients being diagnosed with iron deficiency. Since iron in high dosages is toxic, the first choice should always be tablets and good nutritional consultation. A course of iron tablets will last several months until ferritin levels are back to normal levels, but symptoms should start to disappear after a few weeks.


Rather than waiting for iron levels to decrease, prevention is essential, especially since once symptoms are apparent, iron deficiency cannot be managed by an iron reach diet anymore but will require medication. The daily iron requirement is approx. 15 mg per day for women, and 10 mg for men.

Iron is quite a complicated substance when it comes to absorption in our digestive tract. It is regulated by many different factors like the actual need and requirements, obviously the amount of iron consumed and the chemical form of this, the absorption rate is influenced in case of increased requirement, red blood cells have an impact, and as mentioned earlier, certain conditions like Coeliac Disease, colitis, gastritis and Crohn’s Disease.

Iron comes in different chemical forms, of which one, the FE2+ is easier absorbed. In animal product, about 40 to 60% of the iron is in this form. The FE3+ form of iron is often absorbed at a less than 5% rate.

Studies have shown that iron is best absorbed when a mix of animal and plant products are consumed together (due to the amino acids in plants).

There are some things that enhance the absorption of iron in your nutrition:

  • Vitamin C and Vitamin A
  • Fructose
  • So called polyoxicarbon acids which are in fruit and vegetables
  • Alcohol (because it increases the secretion of gastric acids, and that itself increases the absorption of iron).

The following on the other hand inhibit absorption of iron:

  • So called phytates, which are found in grains, rice, whole grain and soy products
  • Dietary fibre
  • Tea, coffee and other caffein containing drinks
  • Certain medications such as antacids, blood lipid reducing medications
  • Excessive intake of metal ions like mangan, copper, sink
  • Lack of proteins in the diet

In practical terms, this can be:

  • Eat meat, poultry and fish two to four times per week, as the body can absorb animal iron easier
  • Eat pulses or legumes, vegetables, especially green leafy ones, nuts and grains preferably raw.
  • A small quantity of meat, such as some ham in a soup or a spinach quiche, increases the low plant iron absorption rate.
  • Since Vitamin C increases iron absorption, have a fruit juice or a fresh fruit with a meal to increase the absorption rate. Another good source of vitamin C is Sauerkraut.
  • Calcium counteracts iron absorption, so don’t drink milk or have other dairy products when you eat meat or iron rich vegetables (including the famous spinach in a creamy sauce).

Did you know that using cast iron pots and pans can increase the iron content of food?

And remember, too much iron is not good for your health: it can have a negative impact on the immune system:

  • Too much iron increases the production of free radicals.
  • A study showed that iron medication causes a change in the gut flora and decreased the amount of healthy bacteria in the gut.
  • A Finnish study showed that an increased iron level together with high blood pressure or high cholesterol levels can increase the risk for a heart attack.

So, whether you are a carnivore or a vegetarian, pay attention to a balanced diet, watch what you eat with what and listen to your body. Prevention is key!

For a list of “ferrous foods” click here.

Posted on November 04, 2014 by Luitgard Holzleg

This entry was posted in Blog, News and tagged , , , , , , , , , , . Bookmark the permalink.