The Trouble with Iron: Iron Deficiency vs. Iron Overload

How much iron do you really need? And what are the dangers of too much or too little?

By Susan Ince
  • The Women’s Health Initiative showed that there was no heart benefit to women from taking estrogen. That makes sense if iron buildup, rather than lack of estrogen, increases the risk of heart disease.
  • Taking aspirin appears to benefit the heart, and taking aspirin daily causes enough bleeding from the gastrointestinal tract to lower a woman’s level of ferritin (a protein linked to iron storage) quite significantly over time.
  • Artery-clogging plaque contains much more iron than a healthy artery wall.
  • The blood vessels of frequent blood donors are healthier than those of occasional donors.

If Sullivan’s right, should heart-savvy women line up for the bloodmobile now? It’s not a bad idea to donate blood if you’re qualified. And don’t worry about anemia — each time you hit the blood bank, you’ll be monitored.

Get the Iron You Need

From Food

Women require about 18 milligrams of iron a day (27 when pregnant) until menopause, when the amount drops to about 8 milligrams.

Good sources of iron are lean red meats (such as beef, venison, and lamb), organ meats, oysters, clams, beans, whole grains, and cooked greens. (There are 13 milligrams of iron in 3.5 ounces of cooked chicken liver; a cup of kidney beans has 5.) In addition, many types of food naturally low in iron (such as breads and cereals that are not whole grain) are iron-fortified.

With a few exceptions, for every 20 milligrams of iron you consume, only one is absorbed into your bloodstream (unless you have hemochromatosis). Iron from animal sources is two to three times more absorbable than iron from plants or fortified foods. To boost iron absorption from plant sources, include fruit (such as citrus or papaya) or raw vegetables high in vitamin C (broccoli, brussels sprouts, green peppers, leafy greens) in the same meal. To lower iron absorption, pair iron-rich foods with those that contain calcium (dairy products), tannins (tea), and phytates (wheat bran and flaxseed).

From Supplements

Don’t assume you need an iron supplement, as overload is a possibility. Women over 40 should ask their doctors before taking a multivitamin that contains iron. But if you do need to take iron, here are some suggestions for good results.

  • Consider Proferrin (from Colorado Biolabs), made from easily absorbed heme iron (which is found only in meat, poultry, and fish). The risk of its causing digestive problems is low, so you can take it with or between meals. Vegetarians, beware: It’s made from the red blood cells of cows.
  • Try supplements made from non-heme iron (found in plant-based and iron-fortified foods). These include ferrous fumarate, ferrous sulfate, and ferric iron; they’re less expensive and more widely available than those made from heme iron. They can, however, cause gastrointestinal disturbance and constipation, although products designed to dissolve in the intestine rather than the stomach may have fewer side effects. Ferrous sulfate (sold as Feosol and Slow Fe) is the most easily absorbed non-heme iron.
  • Take iron between meals (preferably paired with some vitamin C) and at least two hours before or after other medications, as one may reduce the effectiveness of another.

Is Your Iron in Balance?

If you have too much iron, you may experience:

  • Swollen, stiff, or painful joints, especially the hips, knees, and ankles
  • Fatigue
  • Abdominal pain
  • Irregular heart rhythm
  • Diabetes
  • Infertility
  • Hair loss

If you have too little iron, you may experience:

  • Fatigue
  • Foggy thinking, memory loss
  • Headaches
  • Restless legs syndrome
  • Hair loss
  • Sensitivity to cold
  • Shortness of breath
  • Urge to eat ice

Originally published in MORE magazine, February 2008.

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