You Don't Have to be Anemic to be Iron-Deficient

June 27, 2002—Women suffering from poor endurance may have an underlying deficiency of iron even if their blood count is normal, according to a report in the American Journal of Clinical Nutrition (2002;75:734–42).

This new study examined 41 women between the ages of 18 and 33 who were found to have a marginal deficiency of iron but who were not anemic. Women who took a supplement containing 16 mg per day of iron for six weeks showed a significant improvement in both their iron levels and their endurance during exercise.

Iron deficiency is the most common nutritional deficiency in the world, affecting 20 to 50% of the world’s population, although it occurs less frequently in the United States. The most common cause of iron deficiency is inadequate intake of iron, but malabsorption and loss of iron from bleeding are significant factors in some cases. Premenopausal women are at risk of becoming iron-deficient, because of the blood loss that occurs every month during menstruation.

Doctors often screen for iron deficiency by testing for anemia. However, individuals who have a mild deficiency of iron may not be anemic, since blood counts do not typically drop until iron stores in the body are almost completely depleted. The new study demonstrates that a normal blood count does not necessarily rule out iron deficiency and that more specific tests are necessary to better evaluate iron status. Other symptoms that can result from iron deficiency (with or without anemia) include fatigue, mood swings, and difficulty concentrating.

Prior to taking supplemental iron, women should be tested by a doctor to make sure this action is appropriate. Although supplemental iron may help those who are deficient, too much iron may cause adverse side effects, including stomach and intestinal cramps, nausea, and constipation. In addition, a small proportion of the population has a genetic disorder (hemochromatosis) that causes them to accumulate iron. In those individuals, taking extra iron could cause serious problems, including diabetes and liver disease. A simple blood test is available to determine whether a person has hemochromatosis.

The optimal intake level of iron may vary depending on the degree of the deficiency, but some physicians recommend taking between 50 to 100 mg of elemental iron per day until the deficiency is corrected, and lower amounts thereafter. The absorption of iron is increased by taking it with about 100 mg of vitamin C. Iron supplements should not be taken at the same time as coffee, tea, soy, or calcium supplements (and possibly milk), since these substances interfere with the absorption of iron. Good food sources of iron include red meat, dark greens (kale, chard, etc.), molasses, beans, Brewer’s yeast, and eggs.

It is important for anyone with iron deficiency to see a physician to determine the cause.

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Darin Ingels, ND, MT (ASCP), received his bachelor’s degree from Purdue University and his Doctorate of Naturopathic Medicine from Bastyr University in Kenmore, WA. Dr. Ingels is the author of Garlic and Cholesterol: Everything You Need to Know (Prima, 1999) and Natural Treatments for High Cholesterol (Prima, 2000). He currently is in private practice in Southport, CT, where he specializes in environmental medicine and allergies. Dr. Ingels is a regular contributor to Healthnotes and Healthnotes Newswire.

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