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Iron Deficient? Or Iron Overloaded?

Why you need to know the difference

Iron deficiency is one of the most common nutritional deficiencies in the world. What many people aren’t aware of though is that iron overload is also extremely common.

Learn what causes iron deficiency and iron overload, and why it’s essential you know the difference.

Why is iron important?

Iron is an important mineral for oxygen transportation; without iron, the body cannot produce haemoglobin, the part of red blood cells that carry oxygen to the body’s tissues. Iron is also required for growth and development, to support the immune system to fight off pathogens and assist the body to make certain hormones.

What causes iron deficiency?

Iron deficiency occurs when the body doesn’t have sufficient iron stores. This can be due to numerous factors, including:

  • Poor diet and insufficient intake of iron-rich foods. Diets that are high in sugar, refined carbohydrates (pasta, bread, pastries) and processed/junk food contain little in the way of nutrition and essential nutrients, including iron.
  • Pregnancy: a woman’s irons stores often become depleted as blood volume increases to accommodate the growing baby.
  • High intensity and endurance-type exercise can contribute to iron loss, especially if there is heavy sweating. Red blood cells break down quicker and are excreted out of the body.
  • Blood loss through menses (especially women with heavy periods), during childbirth or from internal bleeding, for example from a peptic ulcer or colorectal cancer.
  • Chronic inflammation reduces iron availability and also changes the way the body metabolises iron.
  • An inability to absorb iron due to intestinal disorders such as coeliac disease or leaky gut (where the gut wall becomes inflamed and permeable), and surgical removal of the part of the intestines.

Women, children and teenagers (due to their growing bodies), vegetarians and frequent blood donors are more at risk of iron deficiency.

Symptoms of low iron

  • Extreme fatigue and weakness, especially on exertion
  • Apathy
  • Pale skin
  • Feeling cold and cold hands and feet
  • Headaches
  • Dizziness or feeling lightheaded
  • Shortness of breath
  • Rapid heartbeat or heart palpitations
  • Brittle nails and hair loss
  • Swollen or sore tongue
  • Poor concentration or an inability to concentrate
  • Dark circles under the eyes
  • Cravings for dirt, ice or clay (known as pica)

High iron levels: what you need to know

Having high iron levels is just as problematic as having low iron levels. There is a hereditary iron-loading condition called haemochromatosis where the body absorbs more iron than usual from food, causing an excessive build-up of iron in the body.

The body stores this excess iron in various tissues including the liver, heart and pancreas which is incredibly dangerous. Iron is a pro-oxidant (the opposite to an antioxidant) and too much of it can damage your tissues and cause health issues such as liver scarring (cirrhosis), diabetes, congestive heart failure, impotence and Alzheimer’s disease.

Iron is also a bacterial growth factor – it helps bacteria to grow and proliferate. Having too much iron in your body can lower your immune system and make you more susceptible to infections.

Haemochromatosis is often under-diagnosed as the symptoms experienced are similar to other conditions including iron-deficiency anaemia. Symptoms include extreme fatigue, weakness, joint pain, loss of body hair, lowered sex drive, menstrual issues and abdominal pains.

This is why it’s essential you get your iron levels checked if you are experiencing any of these symptoms, especially fatigue. Never supplement with iron or increase your intake of iron-rich foods without having a blood test first.

Factors that affect iron absorption

Iron absorption depends on individual factors like age, sex, a person’s health status and whether they have any health conditions such as hemochromatosis or anaemia. The dietary source of iron can also impact absorption. There are two types of iron in food: haem and non-haem. Haem iron is only found in animal foods including red meat, poultry and seafood (oysters, clams and mussels). Non-haem iron comes from plant-based foods.

Haem iron absorbs more efficiently than non-haem iron; however, eating too much meat or animal-derived foods is not good for your health as they are very acidic and inflammatory.

Factors that affect iron absorption include:

  • Calcium can impact haem-iron absorption so eating dairy-based foods (milk, cheese, yoghurt), canned fish that contain tiny bones (pink salmon, sardines) and calcium-fortified foods and drinks such as shop-bought orange juice, bread and dairy-alternative milk, at the same time as iron-rich foods may reduce the amount of iron you absorb.
  • Eggs have been known to reduce iron absorption by up to 30% as they contain a compound called phosphoprotein which binds up iron.
  • Phytic acid is a substance found in many plants including beans, legumes, grains, nuts and seeds. When consumed, phytic acid combines with other minerals to create phytates. The human body does not have the required enzymes to break down phytates so nutrients are poorly absorbed. Soaking beans, legumes and nuts overnight before eating, sprouting or fermenting these foods helps to remove phytic acid to aid absorption. Eating garlic and onion at the same meal can increase mineral absorption of iron and zinc.
  • Tea and coffee contain tannins, a naturally-occurring substance that inhibits the absorption of iron. Tea also contains oxalates which is a compound in plants that binds up minerals, preventing them from being absorbed in the body. Avoid eating iron-containing foods or taking iron supplements with a cup of tea as your body won’t absorb the iron well.

Vitamin C enhances the absorption of non-haem iron, so eating foods that are high in vitamin C at the same time as (non-haem) iron-rich foods will increase the amount of iron your body absorbs. However, if you have hemochromatosis, this is something you need to be aware of.

Fruits and vegetables are high in vitamin C, especially citrus fruits, kiwi fruit, berries, pineapple, broccoli, cabbage, cauliflower, peppers, tomatoes, sweet potatoes, leafy greens and fresh herbs like parsley and thyme.

B12 and folic acid are important co-factor nutrients that assist in the absorption and metabolism of iron. Food sources of B12 include nutritional yeast, eggs, meat and fish. If eating animal-derived foods, always opt for organic where possible. Folic acid-rich foods include broccoli, leafy green vegetables (spinach, kale, cabbage), Brussels sprouts, kidney beans and lentils.

Iron-rich foods

The best food sources of plant-based iron include:

  • Dark leafy greens (spinach, kale, rocket, parsley)
  • Broccoli
  • Pine nuts
  • Sunflower seeds
  • Pumpkin seeds
  • Apricots
  • Black strap molasses
  • White beans, pinto beans and kidney beans
  • Chickpeas and lentils
  • Spirulina
  • Wheat germ

What to do if your iron levels are too high

  • Reduce your intake of iron-rich foods and avoid iron-fortified foods such as breakfast cereals and bread.
  • Regularly donate blood to reduce the amount of iron in your body. You lose between 220-250 mg of iron every time you donate blood.
  • Avoiding supplementing with vitamin C, especially if you are eating foods that contain iron.
  • Intermittent fasting is very beneficial for the body and has shown to reduce concentrations of iron in blood serum as well as decrease stored iron levels. Fasting also downregulates inflammation and improves the way the body responds to insulin.
  • Drink green tea and add rosemary to your food as both of these herbs contain compounds that block iron absorption.
  • Curcumin, which is found in turmeric, is an antioxidant that helps clear iron out of the body. Add turmeric to your food with some black pepper (which aids absorption) or it can be taken as a tea, capsule or liquid herbal.
  • Avoid using iron cookware as when it’s heated, the iron from the cookware will transfer to the food you’re cooking (and subsequently eating).

Be aware of your iron status

Iron is an important mineral needed for growth and development, to oxygenate cells and to make certain hormones in the body. An imbalance of iron levels, whether that be too high or too low, can lead to a host of health issues. If you are experiencing any symptoms associated with iron deficiency or iron overload, ensure you speak to your healthcare practitioner and get an iron blood test as soon as possible.

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Blog/Article content reflects the author's research and diverse opinions, not necessarily CNM's views. Items may not be regularly updated, so represent the best available understanding at the time of publication.

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