Let’s talk about Iron

Karen Thorley

• January 16, 2022

Low iron, particularly Ferritin which is our iron storage, is becoming more common today.  There are a few factors that can impact iron and supplementing is not always the answer.  

The purpose of iron (Fe) is to maintain oxygenation of all the cells and all the tissues of the body. 

Fe metabolism is tightly regulated, as both deficiency and excess have health implications. 

Fe requires an acidic environment for absorption which is perfect in your stomach where hydrochloric acid is produced as part of the digestive process.

Fe requires ascorbic acid (Vit C) to aid absorption so consuming iron rich foods in the first part of your meal and including vitamin C rich foods as well will support effective absorption.  It is important to note that drinking during the meal, dilutes acid which will inhibit effective absorption so limit water and other drinks to an hour before meals and 2 hours after.

Our red blood cells (RBC) require between 30-40mg of Fe to make the required 6g of haemoglobin needed daily.  We produce 2milion – 3million RBC per minute.  How clever is our body!!  When we provide the nutrients in the form of whole foods, our body knows exactly what to do with them. 

RBC function as well as Fe metabolism together regulate Fe absorption, recycling and trafficking.  Without this teamwork of tight regulation, deficiencies will result in anaemia and excess will result in reactive oxygen species (ROS) causing tissue injury and organ failure. 

RBC normally live about 120 days (4 months).  When they get old (or damaged) macrophages which are a part of our immune system, remove them from circulation through a process called phagocytosis.  The most important part of the RBC is preserved.  And, just in case you didn’t guess it, the most important part is the haemoglobin.  Why?  Because this is the chemical that allows the RBC to carry oxygen around the body.  This explains why we can go a long time before noticing that our Fe stores are getting low. 

Fe is released from the haemoglobin and stored as ferritin.  A chemical known as ferroportin exports the ferritin back to the bloodstream when needed.  It is also responsible for transporting dietary Fe that has been absorbed in the small intestinal cells out and into the bloodstream.  You could say that ferroportin is the gatekeeper, controlling Fe entry into the bloodstream both from ferritin stores as well as dietary Fe.

You may have heard of haemochromatosis?  This is also known as ferroportin disease which is a rare genetic disorder characterised by the abnormal accumulation of Fe in the body.  The gatekeeper allows too much Fe into the blood stream.  When Fe exceeds the carrying capacity of transferrin which is like the transport carrier, this excess Fe can be taken up in organs such as the liver, pancreas and heart where it can lead to organ damage.

So, what are some of the things that lead to Fe disorders or just abnormal pathology markers?  

• Parasites

• Lack of dietary iron

• Gut inflammation

• Internal bleeding

• Chronic inflammation

• Chronic infection

• Acute trauma / blood loss from surgery or accidents

• Pregnancy

• Heavy menstruation

• Some medications such at Proton-pump inhibitors which are used to treat ulcers and reflux. 

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Symptoms of Fe deficiency

• Low energy / fatigue

• Decreased physical performance and quality of life

• Cell cycle and DNA replication issues leading to hair loss, nail abnormalities and mouth ulcers

• Restless leg syndrome

• Altered drug metabolism

• Brain fog / decreased function

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How can you ensure you get enough Fe?

Legumes contain Fe which is readily released during cooking. 

Leafy vegetables contain Fe which is considered poorly absorbed due to phytate and phenolic compounds.  This can be overcome by consuming vitamin C rich foods at the same time. 

Vitamin D plays a role in Fe absorption.  Mushrooms left upside down in the sun contain more Vitamin D than you can get from any supplement safely.  Get as much sun exposure as you can without burning.

Keep inflammation to a minimum with sensible diet and lifestyle choices. 

The brightest coloured foods are high in vitamin C. Capsicum, citrus fruits, strawberries and other berries for example.

 :  Fresh cow’s milk has a pH between 6.5 – 6.7 which is acidic.  It contains calcium however the body needs to counteract the acidity so will take the calcium straight from the milk to the bones.  The thought that cow’s milk will give you strong bones is incorrect because the calcium does not go to the bones.