While we need iron, excess iron in the body is a health risk. Thus, for a healthy person, the best way to get iron is through your diet, and then to support your intake with quality supplements as needed. Here are some common iron nutrition questions I get about this mineral:
1) How do I know if my iron levels are ok? Annual labs will reveal if your body has healthy stores of iron as well as if iron is doing its job(s) properly. For life stage changes (planning to be or pregnant, menopause), and training for or performing a significant physical event, are times to check your levels, and your practitioner will check if you report any conditions (blood in stool, fatigue, etc).
2) What does iron do? Iron is part of your better energy team. Hemoglobin, an iron-containing protein of your red blood cells, picks up and delivers oxygen throughout the body. Metabolism, the breaking down of nutrients into usable energy, requires iron. Your immune system also benefits from iron.
3) How can I have too much iron? Earlier in life, and during periods of growth (pregnancy as well as intense exercise) the body will use iron to support these efforts. Throughout life, for women, we also lose iron monthly via menstruation. The body can accumulate too much iron from excess intake (typically more of a risk from supplements and fortified foods, not foods, unless one is mono-eating iron rich foods in high quantities). The body can also hold on to iron or not use it when something is not functioning properly.
4) What is the risk of too much iron? Excess body stores of iron, as well as “free floating” iron, increases risk of major diseases from cancers to heart and diabetes, as well as concerns of worsening cognitive diseases like Alzheimer’s and Parkinson’s and even speeding up cellular aging (makes sense when we understand what iron does).
5) How should I get my iron? From whole food first, and from plants first. This can be controversial as there are two types of iron – heme (animal) and non-heme (plants). Over the decades, nutritionists have advised against non-heme sources for absorption concerns. But today we know a few things:
The overall health benefits of plant-based diet.
That other animals get their iron from plants.
That vitamin C and other plant nutrients aid absorption of iron. That, perhaps, the absorption issues of non-heme are a built in protection against too much iron.
Now, that doesn’t mean you can’t enjoy quality animal sources of iron but you don’t need to eat meat to get sufficient iron. Second, during growth phases, as mentioned above, or along with being monitored by your practitioner, during intense periods of fitness and muscle exertion, you can and likely should supplement your iron intake. Third, when lab values are concerning, your practitioner will recommend a supplement. This is not meant to be a lifelong, taking iron daily prescription and you should request follow up lab checks. For women, consider taking the supplement only during your period to see if you achieve normal levels that way.
6) What foods are best for iron? Your pulses (lentils, chickpeas, beans etc), hemp hearts, cooked spinach (Popeye!!) and other dark leafy greens, as well as olives, pumpkin and sesame seeds. Whole grains like bulgur, barley and quinoa contain nice amounts of iron (1-2mg per serving, typically 1 cup) and cereals made from these will contain iron as well. However, flour-based cereals are often fortified with iron, one serving can deliver an adult daily dose of iron or more and I like these less (we often eat more than one serving and we hopefully get other sources of iron in the same day). When eating animal sources of iron such as pork liver and mollusks like oysters top the list joined by beef (and beef liver), as well as quality fish like wild salmon. You can also get extra iron by preparing your food in a cast iron pan.
7) I’m eating iron rich foods and taking a supplement but my levels aren’t getting better. What can I do? First, I recommend working with your doctor and a dietitian. There are factors that can interfere with iron absorption like foods and supplements (coffee, calcium in foods as well as supplements and medications).
8) My iron supplement is making me constipated, I can’t keep taking it. This is really common. There are some supplements that work to address this with herbs which also include vitamin C which in addition to promoting better iron absorption can also help address constipation. I often add magnesium to improve motility when adding an iron supplement to the diet as well.
Here’s a favorite iron-rich recipe: Quinoa Medley Bowl