You often feel tired and listless, regularly receive feedback: “Oh dear, you are pale”? And it certainly cannot be a hangover? Joking aside: Maybe you have problems with your iron intake. Iron deficiency is a widespread phenomenon, especially among women, where both mental and physical fitness suffer.
But what are the causes of iron deficiency, how is it diagnosed and treated correctly? With the help of the Munich haematologist Prof. Dr. Stefan Eber, we clarify the most important questions on the subject of “iron deficiency”. For more than 30 years he has been dealing with the so-called iron deficiency anaemia, both in studies and in daily practice.
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In this article:
- Why is iron so important for the body?
- Causes of iron deficiency
- Symptoms of iron deficiency anemia
- What is my daily iron requirement?
- Why are women so often affected by iron deficiency?
- Do sportswomen need more iron?
- What helps with iron deficiency?
- Animal vs. vegetable iron
- Which foods contain a lot of iron?
- These foods promote iron absorption
- Do all vegans suffer from iron deficiency?
- iron deficiency during pregnancy
- Iron supplements make sense?
- Are there side effects from an iron overdose?
What is iron deficiency?
For your body to function smoothly, it is not only dependent on a daily supply of carbohydrates, protein and fat, but also on a large number of so-called “micronutrients”. One of these is iron. This is an essential (vital!) trace element. If there is too little iron in the body, this is called iron deficiency or – as it is called in the technical jargon – iron deficiency anaemia.
It is estimated that between 20 and 25 percent of people worldwide are affected by this form of anaemia, especially women and children.
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Why is iron so important for the body?
There are about 3 to 5 grams of iron in your body, much of which is needed for blood formation. This is because iron is an integral part of the blood pigment haemoglobin. Haemoglobin, in turn, is part of our red blood cells. The blood cells can only bind oxygen with the help of the iron and transport it via the bloodstream to all body cells. “In the case of an iron deficiency, all organs are therefore affected”, explains Prof. Dr.
Eber, “because without iron, less haemoglobin is formed and this in turn is missing for the transport of oxygen”.
By the way, the same applies to the muscles, because iron is also a component of the so-called “muscle haemoglobin”, i.e. the dye myoglobin, and thus supplies your muscles with oxygen. Iron is also involved in various metabolic functions, the formation of messenger substances (enzymes) and signal transmission between nerve cells. In short: without iron, there are quite a few places where iron is missing.
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By the way: Incidentally, the red blood cells are “renewed” about every 120 days. However, the iron is not lost in the process, but is used again to form haemoglobin – a really clever recycling system from Mother Nature, isn’t it?
What causes can iron deficiency have?
Malnutrition and heavy blood loss, also during menstruation, lead to iron deficiency. © Irina Bg/ Shutterstock.com
Iron deficiency can have various causes: “Most often it is due to food intake, or more precisely malnutrition, in which not enough iron is absorbed through food,” the expert says. Since the body itself is not able to produce the important trace element, it is dependent on you feeding it iron-rich foods on a daily basis.
Anemia can also develop due to an increased need for iron, where the amount ingested is insufficient even with a balanced diet. Pregnant women, for example, have an increased need for iron, as do athletes and older people. It also becomes problematic if your intestines cannot absorb the iron properly due to a disease and excrete it unused. This also applies to severe diarrhoea.
Even severe blood loss, such as after an accident, during an operation or birth, can quickly lead to a deficiency. This is because our blood contains the largest amount of iron in the body and is lost along with it.
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What are the symptoms of iron deficiency anaemia?
Since the problem with iron deficiency is the lack of oxygen ALLER body cells, anemia affects the whole body accordingly and can manifest itself in a number of different symptoms:
- Fatigue and tiredness
- Headaches and dizziness
- Cold feeling
- Nervousness / inner restlessness
- Lack of concentration
- reduced physical and mental performance
- Paleness of the skin (and mucous membranes)
- brittle hair and fingernails
- torn corner of the mouth
- Hair Loss
Dr. Eber advises you to have your doctor check the concentration of iron stored in your body by means of a blood count at the latest when these signs appear. It is, by the way, rather unknown that anaemia can also affect the mood and even be the cause of depression.
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What is my daily iron requirement?
The normal iron requirement for women is 15 milligrams per day. After the menopause it drops to about 10 milligrams. This in turn corresponds to the normal daily dose for men. However, there are exceptional situations in which your body needs more. These include breast-feeding and pregnancy, where the requirement increases to 20 to 30 milligrams a day. The amount required also increases during heavy menstrual periods and sport, but this varies from woman to woman.
Why are women so often affected by iron deficiency?
Women suffer particularly often from iron deficiency due to their periods. © Aleshyn_Andrei / Shutterstock.com
Statistically speaking, anaemia is a women’s problem, because the female sex suffers from it significantly more often. You owe this primarily to your monthly period. This is basically nothing more than a bleeding, in which all 4-week-old cells are rejected. “Women with heavy menstrual periods are particularly affected by iron deficiency”, says Prof. Dr. Eber. Of course, the greater the blood loss, the higher the amount of iron lost.
The more this is, the more difficult it becomes to compensate for the missing iron through diet.
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That is why the haematologist recommends: “If you have a particularly heavy period, have your storage iron checked by your doctor more often. The iron depots of your body are called storage iron.
But how do you even find out if your period is not “normal” but strong? The doctor has some advice on this too: “There are tests on the Internet which, with the help of a few questions about the use of your tampons and bandages during your period, give a good estimate of your period strength. If you’re unsure, you’d better see your doctor again.”
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Tip: On the website www.mens-test.de you can enter your data directly online. In addition to the menstruation test, which helps you to estimate the strength of your period, there are additional tips and tricks to deal with it.
Iron deficiency and sports: Do sportswomen need more iron?
Athletes have an increased iron requirement. © nd3000 / Shutterstock.com
Higher, faster, further: In order to achieve best performance in sports, a good oxygen supply is absolutely necessary. Because the better your body cells are supplied with oxygen, the more you can get out of your training.
This is exactly where iron comes into play, because: “Iron binds oxygen in haemoglobin and transports it through the bloodstream to the muscles, where it is then needed to perform accordingly,” the expert explains. “That’s why athletes strive for a high haemoglobin level.” By the way, female athletes have a more than twice as high risk of iron deficiency as male athletes, simply because of their menstrual periods.
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But regardless of whether you are a man or woman: the more active you are, the more iron your body needs. By the way, endurance and extreme athletes (such as marathon runners) must pay particular attention to their iron requirements.
What helps with iron deficiency?
Unfortunately there is no patent remedy. The treatment of anemia depends entirely on how severe the anemia is. Normally, you can compensate for the deficiency with a balanced, iron-rich diet.
“This is the first thing I recommend to my patients,” says the iron expert. “However, if the need is increased, for example due to heavy menstrual periods or during pregnancy, it can be quite sensible to resort to iron supplements”. In addition, there are also serious cases that can only be treated with the help of infusions.
Iron-rich diet: animal vs. vegetable iron
There are animal and plant foods that serve as iron suppliers. © Wasu Watcharadachaphong / Shutterstock.com
Iron deficiency anaemia can usually be easily compensated for through diet. But not all iron is the same. Although the vital trace element is found in both animal and vegetable foods, it differs in one important respect: in meat, fish and eggs (especially egg yolk) it is found as bivalent iron, also known as haem iron. This means that it is present in a compound with haemoglobin, which ensures good usability.
Iron from vegetable foods, such as legumes or oatmeal, on the other hand, cannot be optimally absorbed or utilized by your body – in fact, 5 to 10 times less than haem iron from animal products. In addition, some vegetables, soya and whole grain products contain certain “inhibitors” that further complicate iron absorption (more on this below).
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What kind of food has lots of iron in it?
Iron from animal foods can be optimally utilized by the body. Meat is the best supplier, especially offal, but it is honestly not to everyone’s taste. But fish and eggs (especially egg yolk) are also excellent sources of iron. In addition, there is a wide variety of vegetables that have high iron values but can only contribute to a small extent to covering daily requirements. Because the beautiful appearance is clouded by the poor usability and various inhibitors.
Which foods are really suitable as sources of iron and behind which there is rather only hot air, we have compiled for you here:
What should I eat if I have iron deficiency?
We have already mentioned it briefly: Some foods make it very difficult for your body to get the iron from food. Others are the key to getting the best out of it:
Vitamin C promotes iron absorption
The all-purpose vitamin C not only strengthens your immune system, but also supports the body in dissolving iron from food. The acid creates the best basis for transporting the iron via the intestines into the bloodstream. Already with a glass of orange juice with your meal (e.g. to the bowl of oatmeal in the morning), you can easily improve the usability of vegetable iron.
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These foods complicate the absorption of iron
Substances in red wine inhibit the body’s ability to absorb iron. © ouh_desire / Shutterstock.com
Milk and dairy products are good sources of calcium and calcium is – just like iron – an important micronutrient. But calcium inhibits the absorption of iron and magnesium in the intestines.
Red wine, coffee and black tea also make it difficult for the body to absorb iron from food. This is due to secondary plant substances (polyphenols) which bind the iron itself, so that it can no longer be absorbed and utilised by the intestines. Whole grain products, spinach, legumes and rhubarb also contain oxalic or phytic acid, which also act as iron blockers. The only problem is that many of these “inhibitors” are themselves relatively good sources of iron.
The secret is the right combination of ferrous foods. Eat rather poorly digestible, vegetable products together with vitamin C-rich vegetables such as peppers or broccoli. Or try your oatmeal with orange juice instead of milk.
Do all vegans suffer from iron deficiency?
It is almost impossible for vegetarians and vegans to cover their iron requirements from food alone. “Especially vegans in most cases show deficiency symptoms”, explains Dr. Eber. “This is due to the lack of animal iron suppliers. The problem with a purely plant-based diet is that iron from vegetables, grains and seeds is much more difficult for the intestines to absorb. In order to cover your daily requirements, you would have to eat really extremely large amounts.”
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Vegetarians can absorb some iron at least through dairy products. However, since milk belongs to the “iron inhibitors”, this is also a difficult matter. Therefore the expert recommends: “Vegans should absolutely let examine their blood values, because the renouncement of animal food is a malnutrition for the body, which should be balanced then by iron preparations”.
Iron deficiency in pregnancy: What do I have to watch out for?
During pregnancy, your blood volume increases (more blood is only available with more iron) to form the placenta and to supply the baby at the same time. Prof. Dr. Eber emphasizes: “During pregnancy, regular checks of your blood iron concentration are part of your routine. Only with sufficient iron can the child develop optimally”.
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That is why the daily iron requirement of pregnant women doubles to a proud 30 milligrams. This is a rather considerable amount, which you can unfortunately hardly cover with food alone. Deficiency symptoms due to iron deficiency not only affect you, but also the development of your child. Therefore, the following applies:
1. Make sure you eat an iron-rich diet during pregnancy. This will at least lay a good foundation.
2. Have your iron levels checked during prenatal care. Normally this is a matter of course. A doctor should then advise you which dietary supplement is best for you.
Which tablets should I take for iron deficiency?
Iron preparations are often essential in cases of permanent iron deficiency. © Irina Bg / Shutterstock.com
The most common means of treating or preventing iron deficiency are vegetable fruit juices that are mixed with iron and are slightly reminiscent of blood due to their typical red colour. There is only one catch: just as with vegetable foods, the iron in the juices is difficult for the body to absorb. In order for them to be effective nevertheless, they contain a particularly large amount of iron. In addition, the juices contain vitamin C, which further boosts the absorption capacity.
Iron supplements in the form of capsules and tablets, on the other hand, have the advantage that they contain the bivalent haem iron and therefore enter the bloodstream much more easily. When it comes to efficacy, Prof. Dr. Eber believes they are definitely the better choice. “Unfortunately, these iron preparations do not taste very good. They are also difficult to tolerate and can lead to stomach problems.
In short: Best case scenario, you’d rather cover your iron needs with food. If this is not enough, it is best to consult your doctor about which form of supplementation is best for you.
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Are there side effects from an iron overdose?
As is so often the case with iron: A lot doesn’t always help a lot. Because if you give your body high doses of iron over a longer period of time (this only works with dietary supplements), at some point it no longer knows where to put it and deposits it in the organs. “This slowly leads to the organs no longer working properly,” warns the haematologist, “although the quantity must be very large for this to happen.
Normally, however, the body reacts quite cleverly to too much iron and regulates its absorption in the intestines with the help of a protein. However, the problem arises when this process is disturbed. The overdose of iron can then lead to joint pain, skin changes and, in the worst case, even liver failure.
So, to sum up: Iron is vital, iron deficiency is a common problem. Women in particular are often affected by deficiency symptoms due to their monthly menstruation. You should therefore see your doctor to have your blood values checked – especially if you are very active in sports and/or pregnant. With the right diet you can prevent iron deficiency well, so that problems do not even occur.