Functions of Iron in the body?
Oxygen transport, and use,
Amino acid metabolism,
CARNITINE synthesis
COLLAGEN synthesis,
THYROID hormone Synthesis
Some Enzymes that iron is involved in
Catalase (anti-oxidant defense)
Cytochromes (mitochondria for ENERGY)
myeloperoxidase,
thryopeproxidase,
lysine/proline dioxygenases,
PEPCk
Symptoms
●Fatigue
●Restless legs syndrome
●Headache
●Exercise intolerance
●Exertional dyspnea
●Weakness
●Dry or rough skin
IRON FACTS
Absorbed in Small intestine- Duodenum
Things that cause us to be deficient
#1 heavy menstrual bleeding
Pregnancy
Gut issues- Celiac, PPIs, Gastritis, H. pylori, SIBO
Exercise induced loss - (probably causing a GI issue)
Q: Sources of Iron nutritionally-
Top 3-5 Animal (Clams, Oysters, Liver, Red Meat, Dark Chicken)
Top Plant Sources- (Spirulina, Molasses, Chickpeas, lentils, Spinach,)
Q: Who's at risk for Iron Deficiency?
Any menstruating female
A low iron diet- Vegan, Vegetarian
Any GI disease process that impacts absorption (CELIAC, IBD, Surgery)
Q: How do we define Iron Deficiency?
Lavs vs. optimal Reference range
Iron expert Dr. Michael Auerbach MD uses a cutoff of 30 ng/mL.
Normal ferritin concentration ranges from 30 to 200 mcg/L
Iron Deficiency on Labs
Serum ferritin <30 ng/mL
Transferrin saturation <19 percent
Different Reference ranges in different countries,
Also different clinics have different ranges, ie GI clinic.
Problems w/ Insurance
Iron Infusions
Supplements we love and WHY?
IV Infusions
Enhancers of absorption:
Acids (ascorbic acid/vitamin C) - brush-border enzyme DCYTB (duodenal cytochrome B) reduces ferric to ferrous iron
Meat, fish, poultry (MFP) – cys residues bind and help solubilize ferric iron, amino acids and peptides improve iron bioavailability and absorption Nutrients 2017 PMID: 28617327
Iron deficiency (low iron status)
Inhibitors:
Competitors for transport
Zinc, manganese, calcium
" zinc-DMT1/FPN1 axis is a critical determinant of zinc-deficiency-induced changes in iron homeostasis and helps understand the mechanism of iron and zinc interactions.” 2019 Nutrients, PMID: 31412634
Mechanism of calcium inhibition is more short-term and no long term effects, don’t eat in same meal
Formers of insoluble complexes
oxalic acid (dark leafy greens like spinach and chard, nuts, grains, legumes)
phytic acid (unsprouted/unfermented grains, legumes and nuts) Phytic acid, an abundant secondary metabolite of plant foods, chelates dietary iron, and limits its intestinal absorption. Since phytic acid also inhibits the zinc absorption, higher risk of zinc deficiency is expected in populations with high prevalence of anemia
tannins (teas, wines, beer, chocolate, berries, legumes, nuts, grains)
Physiological states
Reduced stomach acidity
To support healthy iron levels:
Animal sources of (heme) iron are bio-available whereas plant sources (non-heme) are extremely hard to convert and absorb.
Include red meats (beef, bison, lamb, game meat) at least 3x/wk. Preferably from grass-fed sources.
If possible include liver 1-2x/wk: either in capsule form (Vital Proteins Liver Capsules or Paleovalley Organ Complex) or hidden into ground meats. Use a 4:1 ratio (1lb ground meat to 1/4 lb ground liver) when making meatloafs, meatballs, patties, or meat sauce.
Plant sources include 1 tbsp molasses, spinach, spirulina, dried apricots or lentils. Though portions necessary to reverse deficiency or maintain levels are difficult to obtain solely from plants so supplementation may be necessary.
Other tips:
Cook your food in a cast iron skillet or use the "lucky iron fish" in your cooking
Always pair your plant-based-iron foods with vitamin C foods to help enhance absorption, such as bell pepper, citrus, kale, strawberries, or rosehip tea.
Avoid having plant-based iron with other calcium or zinc-rich foods/supplements (like dairy or grains) or absorption inhibitors like tea or coffee.
Prevalence
For females, iron deficiency anemia was present in nearly one in five!
Women are at a greater risk, so get tested
Vegan’s/Vegetarians are at a greater risk
Where does Iron go in the body?
●RBCs – Approximately 2 g goes to the RBCs
●Iron proteins (eg, myoglobin, cytochromes, catalase) - 0.4grams
●Plasma iron bound to transferrin – 3 to 7 mg
●Storage iron in the form of ferritin or hemosiderin – about 1 gram for men and 0.5 grams for women
Sources
5mg /3oz Liver
2 mg/3 oz Hamburger,
1 mg/3 oz white turkey chicken, 2 mg for dark meat turkey
Clams- 12/3 oz, oysters 8mg/3oz
Spinach 3.7mg/cooked per half cup
Avg American gets 10-14mg/per day
RDA-
8mg MEN
18 mg Women
28 mg if Pregnant
SOURCES-
Causes and diagnosis of iron deficiency and iron deficiency anemia in adults
Author:Michael Auerbach, MD, FACP
Literature review current through: Apr 2020. | This topic last updated: Apr 15, 2020.