• The Lowdown on Low Iron

     Approximately 2 billion people in the world are anemic, and more than half due to low iron.  The World Health Organizations has deemed iron deficiency anemia a public health condition of epidemic proportions.  Iron deficiency anemia is associated with:

    • poor pregnancy outcome (20% of all maternal deaths)
    • impaired physical and cognitive development
    • increased risk of morbidity in children 
    • reduced work productivity in adults 
    • Iron deficiency affects people in affluent communities equally as frequent as those with limited access 
    iron infusion santa monica

    Hundreds of patients have obtained IV iron infusions at Seaside Medical Practice for management of low iron states.    

    Here are the trends we observed:

    Veganism and Low Iron

    vegan iron foodsMeat contains heme, a form readily absorbed by humans, and individuals who avoid meat altogether have reduced heme-iron and B12 concentrations.  I’m a firm believer of a low animal-based diet, though we must exercise caution when trying to radically change habits.  When you’re born and raised on meat, and suddenly cut off a major nutrient in your intestines, there’s potential for gut dysbiosis. Gut microbes need time to adjust to a meatless environment.  Add burden to injury, finding non-heme iron rich foods is a challenging feat.  Whether it is a lack of knowledge, misinformation, or not combining nutrients properly, there is a high risk for micro-nutrient deficiencies, including iron and other minerals when going vegan.

    Heavy Exercise and Low Iron

    Heavy exercise promotes inflammatory cytokines, namely IL-6.  High IL-6 turns on hepcidin, the master regulator of iron absorption leadinexercise iron loss g to decreased serum iron availability.  This is indeed the basis of chronic disease anemia, as seen in conditions such as chronic kidney disease (CKD) or cancer.   In CKD, there’s a another component that affects iron absorption; hepcidin is cleared by the kidneys, therefore there’s more in circulation to shut down iron absorption.

    Next, with strenuous exercise comes a lot of sweat, thereby accounting for a small percent of iron loss. Physical stress also causes hemolysis and thermohemolysis.   One study found 27% of athletes had iron deficiency, and 70% had functional iron deficiency.  Restoring iron stores in such individuals aides in oxygen carrying capacity and improved VO2 max.

    Excess Coffee and Tea

    coffee iron deficiencyTannins block iron absorption.  One thing I am not able to readily convince patients to quit is their coffee, but they are easily accepting to changes in amount or timing of their coffee or tea intake.   Drink your caffeinated beverages at least an hour apart from main meals

    GI Loss and Low Iron 

    Gastrointestinal losses account for a substantial proportion of iron deficiency by multiple mechanisms.gi loss of anemia

    Stress in excess amount has deleterious effects in your body.  Increased stomach acid production due to prolonged stress can affect absorption of minerals and vitamins in addition to potentially leading to microscopic bleeding if ulcers develop.

    Helicobacter Pylori is a bacteria resident on the stomach lining thought to be related to dysbiosis of intestinal mucosa.


    Other less common causes of GI loss include, autoimmune gastritis, celiac disease or gluten sensitivity, after bypass or other weight loss surgeries, obscure parasitic infections or colon cancer.

    Chronic Inflammation and Low Iron

    Chronic inflammatory conditions such as rheumatoid arthritis or cancer are obvious causes of iron deficiency state. An often missed albeit very important cause is sleep debt.  A pillar of good health, one systematically ignored by more than 80% of the population is adequate sleep. Research shows deficient sleepers have elevated IL-6 levels, the molecule which promotes hepcidin release.

    Medications that cause low iron

    •   antacids
    •   proton pump inhibitors and H2 blockers
    •   calcium supplements
    •   antibiotics
    •   iron binding medications

    Isolation from the Elements 

    Earth’s core is made predominately of iron, sadly we are not in contact with Mother Nwhere does iron come from ature.  We walk in shoes on cement or covered flooring, and we rarely get our hands ‘dirt-y’.  The concept of grounding is gaining popularity for this and other similar reasons.

    low iron

    Steps to Restore Iron Level

    1. Enrich diet with iron containing foods and stop heavy iron loss from the body when possible. See our comprehensive list of iron rich foods, in both vegan and non-vegan diets.

    2. Restore iron with oral supplements.

    Slow release iron formulations taken with vitamin C 1-3 times per day as tolerated. More than 50% of us require medication to relieve constipation or bloating on oral regimens. If severe GI side effects occur, stop oral iron immediately and go to next step.

    3. IV Iron Infusion.

    The best method of restoring iron deficiency, functional iron deficiency and iron deficiency anemia is infusion of intravenous iron. Some may skip step 2 and proceed directly to IV iron upon the recommendation of their doctor.

    If you suspect you may have iron deficiency, don’t wait another minute.  Give us a call and book your appointment for a thorough evaluation and treatment if necessary.

    Iron deficiency Anemia cannot be ignored.

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