If you often feel tired or run down despite getting adequate sleep, it’s time to consider the possibility of iron deficiency. Iron deficiency is one of the most common nutrient deficiencies in the world, and one that is fairly easy to diagnose and treat. But do not reach for an iron supplement just yet; self-diagnosis and treatment are seldom a good idea, especially when it comes to iron.
Iron is an important part of hemoglobin in red blood cells and myoglobin in muscle tissue, essential for the transport and storage of oxygen. If you do not have enough iron in your body, cells will not get enough oxygen, causing iron deficiency and leaving you feeling exhausted, weak and irritable. Other common symptoms of iron deficiency include dizziness, shortness of breath, headaches, restless leg syndrome, paleness, unusual cravings, hair loss, and/or decreased physical abilities, such as reduced exercise capacity. These symptoms could be the result of something other than iron deficiency, though, so an accurate diagnosis is important.
Diagnosis of iron deficiency can be done with a simple blood test. Low serum ferritin, the storage form of iron, indicates the beginning stage of iron deficiency, and can cause symptoms even with a normal hemoglobin level. A low hemoglobin level reflects a later stage of iron deficiency and possibly anemia.
Treatment of iron deficiency depends on its severity. With extreme symptoms and low hemoglobin, an iron supplement is usually the best solution. Purchase one over the counter, checking the label to be sure it contains only 100% of the RDA (8-18 mg for women and 8-11 mg for men, depending on age). Do not continue taking it indefinitely, as excess iron can be harmful, increasing your risk for heart attack, diabetes and cancer. A good rule of thumb is to take a daily iron supplement for three months and then have your blood tests repeated; if iron stores are still low, repeat the process.
Treatment for low ferritin, and a sustainable approach to prevent future deficiency, is to improve the quality of your diet. Iron-rich foods should be on the menu daily. These include lean meat, poultry, seafood (especially cooked oysters), beans, lentils and tofu as well as dark leafy greens and fortified cereal. Be sure to include a food source of vitamin C with your iron sources, as vitamin C helps with iron absorption. Good food sources of vitamin C are citrus fruits, strawberries, kiwi, bell peppers, broccoli and tomatoes.
Knowing your risk of iron deficiency can help you be even more motivated to eat an iron-healthy diet. Individuals with digestive issues (such as celiac or inflammatory bowel disease), cancer or heart failure are all at increased risk, as are pregnant women, women with heavy periods, vegetarians and ultra-endurance athletes. If any of these describe you, talk to a dietitian to optimize your diet and wellbeing.
Melissa Wdowik, PhD, RDN, FAND, is an assistant professor at Colorado State University in the Department of Food Science and Human Nutrition, and director of the Kendall Reagan Nutrition Center.