Let’s Talk about Iron Deficiency - Part II - Treatment Options

In Part I of this article series we talked about what iron does in our body, what are the signs and symptoms of iron deficiency and why you shouldn’t self-diagnose and self-prescribe. Now let’s dive into part II where we will discuss a bit more about treating iron deficiency.

Why it’s important to identify the cause of your iron deficiency, as well as to supplement with iron

Did you know that our body has a remarkable iron recycling system? About 85-90% of the iron required to make new blood cells is derived from the recycling of old blood cells (Slusarczyk & Mleczko-Sanecka, 2021). Therefore, when we experience iron deficiency, it's an indication that something isn't functioning as it should. Have you ever wondered why you've been taking iron supplements for a long time without any improvement in your iron levels? It's likely because the underlying cause of your deficiency has not been addressed. Common reasons for iron deficiency include blood loss from heavy menstruation or gastrointestinal bleeding, poor absorption of iron due to coeliac disease, or inadequate dietary intake of iron and other nutrients essential for iron metabolism. That's why it's crucial to work with a practitioner to determine the root cause of your iron deficiency. A few other factors that can contribute to iron deficiency include a vegan or vegetarian diet, certain medications, chronic inflammation due to severe chronic diseases, or parasite infections.

Why you should take a high dose iron supplement every second day instead of every day.

New research shows that our liver plays a crucial role in regulating iron absorption in our body. It's essential to maintain a balanced amount of iron in our body as excessive iron can lead to severe health problems. The liver produces a protein called hepcidin, which inhibits iron absorption when we consume a high iron diet. This is because the liver perceives an excess amount of iron, more than we usually obtain from our regular diet, and tries to prevent iron overload. Therefore, taking a high dose iron supplement every day can create a vicious cycle, where the liver signals to stop iron absorption. To avoid this, researchers suggest that supplementing with iron every second day can improve the absorption of iron (Stoffel et al., 2020).

An iron supplement option that causes less gastrointestinal side effects.

Iron supplements can often lead to gastrointestinal discomfort, particularly constipation. However, there is a more gentle option available in the form of iron glycinate, also referred to as ferrous glycinate, ferrous bisglycinate, or iron bisglycinate. This type of iron is highly absorbable and tends to cause fewer gastrointestinal symptoms, as supported by research (Ferrari et al., 2012). When choosing an iron supplement, it's also important to look for one that includes vitamin C, methylcobalamin (an activated form of B12), and 5-methyltetrahydrofolate (an activated form of folate). Ethical Nutrients Mega Iron is a brand that can commonly be found in Australian health food stores and contains this optimal combination of iron, vitamin C, B12, and folate. It's worth noting that it's always advisable to consult with a practitioner before taking any iron supplement, as previously mentioned in part I of this article series. Additionally, a naturopath can prescribe other high-quality iron supplements that are tailored to your specific needs.

Summary

To sum it up, it is crucial to work with a practitioner who aims to identify the root cause of your iron deficiency and provide you with a tailored treatment plan accordingly. By taking your iron supplement every other day, you can enhance its absorption. Opting for a more bioavailable type of iron, such as iron glycinate, can also alleviate the unpleasant gastrointestinal symptoms that some supplements cause, such as constipation. Keep an eye out for Part III, where I'll delve into essential dietary considerations for meeting your iron intake, as well as other crucial nutrients that can aid iron utilization in the body. If you require assistance in addressing your iron deficiency, feel free to schedule a naturopathic appointment with me.

References

• Ferrari, P., Nicolini, A., Manca, M. L., Rossi, G., Anselmi, L., Conte, M., Carpi, A., Bonino, F. (2012). Treatment of mild non-chemotherapy-induced iron deficiency anemia in cancer patients: Comparison between oral ferrous bisglycinate chelate and ferrous sulfate. Biomedical & Pharmacotherapy, 66, 414-418. https://www.researchgate.net/profile/Maria-Manca-2/publication/229090686_Treatment_of_mild_non-chemotherapy-induced_iron_deficiency_anemia_in_cancer_patients_Comparison_between_oral_ferrous_bisglycinate_chelate_and_ferrous_sulfate/links/5a95188a45851535bcdb0ffe/Treatment-of-mild-non-chemotherapy-induced-iron-deficiency-anemia-in-cancer-patients-Comparison-between-oral-ferrous-bisglycinate-chelate-and-ferrous-sulfate.pdf

• Slusarczyk, P. & Mleczko-Sanecka, K. (2021). The multiple facets of iron recycling. Genes (Basel, 12(9), 1364. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8469827/#:~:text=Approximately%2090%25%20of%20iron%20needs,(RPMs)%20in%20the%20spleen.

• Stoffel, N. U., Zeder, C., Brittenham, G. M., Moretti, D., & Zimmermann, M. B. (2020). Iron absorption from supplements is greater with alternate day than with consecutive day dosing in iron-deficient anemic women. Haematological, 105(5) 1232-1239. https://pubmed.ncbi.nlm.nih.gov/31413088/