Iron deficiency anemia is a condition where your blood lacks healthy red blood cells. Red blood cells are important because they transport oxygen to your body’s tissues.
Approximately 2 billion people in the world are anemic, and more than half due to low iron. The World Health Organization has deemed iron deficiency anemia a public health condition of epidemic proportions. Iron deficiency anemia can lead to many health problems and 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
*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
Obtaining iron in your diet is extremely important. The foods you eat are a main source to get iron in your body. Meat contains heme, which is an iron-rich molecule readily absorbed by humans. Individuals who avoid meat altogether have reduced heme-iron and B12 concentrations. I’m a firm believer of a low animal-based diet. However, we must exercise caution when trying to radically change habits. When you’re raised eating meat, a sudden elimination of these nutrients from your intestines may potentially lead to dysbiosis. Gut microbes need time to adjust to a meatless environment. Adding burden to injury, finding non-heme iron rich foods is a challenging feat.
There is a high risk for micro-nutrient deficiencies when going vegan. This may be due to a lack of knowledge, misinformation, or improperly combining nutrients, such as iron and other minerals.
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, leading 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. With CKD, there’s another component that affects iron absorption; hepcidin. Hepcidin is cleared by the kidneys, and 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
Tannins, which are found in coffee and tea, block iron absorption. Coffee and tea are popular among many of our patients and it may be difficult to eliminate them completely. However, it may be easier to change the timing or amount of consumption. 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.
Stress in excess amounts has deleterious effects in your body. Increased stomach acid production due to prolonged stress can affect absorption of minerals and vitamins. Additionally, it an potentially lead 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
- obscure parasitic infections or colon cancer (after bypass or other weight loss surgeries)
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
- proton pump inhibitors and H2 blockers
- calcium supplements
- iron binding medications
Isolation from the Elements
Earth’s core is made predominately of iron. Sadly, we are not in contact with Mother Nature and do not know where iron comes from. 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.
Other Causes of Low Iron
- Blood loss due to menstruation – Women with heavy periods may have an iron deficiency because they lose blood during menstruation.
- Blood loss from chronic nosebleeds
- Frequent blood donations
- Pregnancy – Hemoglobin is needed for the growing fetus and iron is needed for the mother’s increased blood volume.
Steps to Restore Iron Level
- 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.
- 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.
- 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. A doctor can diagnose iron deficiency through blood tests. Give us a call and book your appointment for a thorough evaluation and treatment if necessary.
Iron deficiency Anemia cannot be ignored.