Guide to iron

Iron is an essential mineral which is needed to make haemoglobin, the pigment in red blood cells that carries oxygen around the body.

A lack of iron can lead to iron-deficiency anaemia, which causes an unusual tiredness as well as shortness of breath, heart palpitations and a pale complexion. Supplements can support red blood cell formation and reduce tiredness.

The latest UK National Diet and Nutrition Survey found iron levels were especially low among females aged 11 to 64 years. The findings revealed 46 per cent of girls and almost one in four women have low iron intakes.

Dr Sarah Brewer says: ‘Iron is a nutrient which we simply can’t live without, yet significant numbers of people have low levels. Signs that you could have iron-deficiency anaemia include: tiredness and fatigue; shortness of breath; dizziness; headache; coldness in your hands and feet; pale skin; and muscle weakness. In extreme cases, it can also cause angina chest pain when low haemoglobin levels mean the blood can’t supply enough oxygen to hard-working heart muscle cells.’

What does iron do?

Most of the iron in the body is found in either haemoglobin, the oxygen-binding protein of red blood cells which transports oxygen to the tissues from the lungs, or myoglobin, a protein found in muscle cells which stores and releases oxygen in the muscles.

Iron is also vital for energy production in our cells. Our bodies carefully monitor our iron status, absorbing more of the mineral when demand is high and less when stores of it are adequate.

Anaemia

Iron-deficiency anaemia is an extremely common condition. However, it is easily treated with diet and/or supplements.

Causes include: bleeding in the gut caused by either stomach ulcers, cancer or the side effects of Non-Steroidal Anti-inflammatory Drugs (NSAIDs); menstrual bleeding; not eating enough iron-rich foods or being unable to absorb iron from food.

Other common symptoms include: soft, curved nails with a dip in them; brittle nails; muscle fatigue; skin itching; cracking in the corners of the mouth; brittle hair and hair loss; insomnia; and dizziness. Iron deficiency can also be a cause of restless legs syndrome (RLS), a common condition which causes an overwhelming urge to move the legs.

According to the World Health Organisation (WHO), iron deficiency is the most common nutritional disorder in the world. Two billion people – almost 30 per cent of the world’s population – are anaemic. An increase of iron intake in food and supplements is recommended.

Immunity

Low levels of iron, even if not severe enough to cause anaemia, can affect the immune system, making you more vulnerable to infections. A study of 92 women by the Hormozgan University of Medical Science, found that iron-deficient anaemia played a role in the recurrence of thrush.

Getting iron from your diet

There are two types of iron: haem iron (from animal sources); and non-haem iron (from plant sources).

Haem iron is much more easily absorbed and can be found in liver, red meat, poultry, fish, and shellfish such as oysters and mussels.

Non-haem iron can be found in beans, nuts, dried fruit and most dark-green leafy vegetables, including kale and spinach. It isn’t absorbed easily and so vegetarians are more at risk of iron deficiency. Vitamin C improves the absorption of iron from plant sources, so combine eating iron-rich foods with a glass of orange juice or by taking an iron and vitamin C supplement.

Safety

Taking too much iron can have side-effects such as constipation, nausea, vomiting and stomach pain. A supplement intake of 17mg a day would not be expected to produce adverse effects, according to the Expert Group on Vitamins and Minerals.

Iron is highly toxic for children and supplements should be kept out of their sight and reach.

Iron supplements should also be avoided if you have inflammatory bowel disease, diverticulitis (small pouches that protrude from the wall of the intestine and become inflamed) or peptic ulcers.

Correct dosage

The recommended daily allowance EU RDA/NRV of iron is one 14mg tablet a day for adults. Women who suffer with heavy blood loss during monthly periods may need to take an iron supplement.

Look for a supplement which uses the more stomach-friendly bisglycinate form of iron, preferably where it is combined with vitamin C to boost absorption.

Nothing beats a healthy, balanced diet to provide all the nutrients we need. But when this isn’t possible supplements can help. This article isn’t intended to replace medical advice. Please consult your healthcare professional before trying supplements or herbal medicines.

Iron is a nutrient which we simply can’t live without, yet significant numbers of people have low levels. Signs that you could have iron-deficiency anaemia include: tiredness and fatigue; shortness of breath; dizziness; headache; coldness in your hands and feet; pale skin; and muscle weakness. In extreme cases, it can also cause angina chest pain when low haemoglobin levels mean the blood can’t supply enough oxygen to hard-working heart muscle cells.

Dr Sarah Brewer
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