The Role of Iron in Women's Health
Iron deficiency occurs in 35-58% of young, healthy women...
Photo credit: Bree Lauren of @madre.mudra - www.madremudra.com
I recently have been developing and perfecting my recipe for my Radiant Woman Iron Syrup, which was created out of my own need for a daily iron supplement. I really strive to get most of my nutrition from my foods by eating a diet rich in phytonutrients and a variety of fresh whole foods, but when it came to Iron my body was just asking for more. So I created an herbal and whole foods based Iron syrup that is easily absorbable, not to mention delicious! As I was working on formulating this Iron syrup I was thinking a lot about the role of Iron in Women’s Health and how deficiency of this nutrient can have such a huge impact on us as women. I commonly see low Iron levels in my Women’s Health practice both on labs as well as symptomatically, so I wanted to shed some light on this topic, how we can identify Iron deficiency as well as support our bodies in making sure they have what they need to thrive.
Iron deficiency is one of the most common nutrient deficiencies in the United States, and studies have shown that some degree of iron deficiency occurs in 35-58% of young, healthy women. When I read that number, I was astounded. More than half the population of healthy young women in the US are deficient in Iron, to me that seems crazy! This is a huge issue, especially because Iron deficiency is the leading cause of anemia which can have serious health implications. The groups that are at highest risk for Iron deficiency are infants under two, teenage girls, women in their fertile years (meaning they are currently menstruating), pregnant women and the elderly. During pregnancy, this number is even higher!
Iron deficiency may be due to an increased iron requirement, inadequate dietary intake, diminished iron absorption, blood loss or a combination of all of these factors. There are many times the body requires more iron such as during growth spurts of infancy or young children, as well as throughout pregnancy and lactation.
First off, what is Iron’s role in the body?
Iron is critical to human life; it is an essential component of the hemoglobin molecule of our red blood cells. It is a red blood cell protein (erythrocyte) and its job is to transfer oxygen from your lungs to your tissues, and carbon dioxide from your tissues to your lungs. Iron also functions in several key enzymes in energy production and supports your metabolism.
Iron is necessary for growth, development, normal cellular function, synthesis of hormones and connective tissue and it's also incredibly important for oxygenation of the brain and cognitive function.
Whew, that’s a lot!
Dietary iron has two main forms -there's the heme form and the non-heme form. Plants and iron fortified foods have the non-heme iron only whereas meat, seafood and poultry contain both heme and non- heme iron. Most of the 3 to 4 grams of elemental iron in our bodies is in our hemoglobin and as part of our myoglobin ( a subunit of hemoglobin). Much of the remaining iron is stored in the form of ferritin in the liver, spleen, bone marrow or myoglobin in the muscle. We typically lose only small amounts of iron in our urine, stool, gastrointestinal tract and our skin. Iron losses are much greater in menstruating women particularly those with heavy blood loss (think heavy flow). Also, think about women here who are having heavy bleeding for other reasons, for example after a miscarriage, after birth, or women with uterine fibroids.
What happens if I don’t get enough iron?
In the short term, getting too little iron does not cause obvious symptoms. The body uses stored iron from the muscles, liver, spleen, and bone marrow first. But when levels of iron stored in the body become low, iron deficiency anemia sets in. Red blood cells become smaller and contain less hemoglobin. As a result, blood carries less oxygen from the lungs throughout the body. Symptoms of iron deficiency anemia include tiredness and lack of energy, GI upset, poor memory and concentration, and less ability to fight off germs and infections or to control body temperature. Infants and children with iron deficiency anemia are at risk for developing learning difficulties. Iron deficiency can occur in people who do not eat meat, poultry, or seafood; lose a lot of blood; have GI diseases that interfere with nutrient absorption; or eat poor diets. Blood loss is the most common cause of iron deficiency in women of childbearing age, most often due to excessive menstrual bleeding.
Low iron is really important to pay attention to because it's an actual indicator of overall poor nutritional status.
If you're low in iron, you really want to make sure that you're looking at your overall diet and all your other nutrient levels as well. Hemoglobin and hematocrit are not as indicative of serum ferritin levels and yet hemoglobin and hematocrit are primarily the only tests that are clinically used in conventional medicine. What this means in a nutshell? Your iron levels that your conventional doctor look at may not be showing them the whole picture; meaning there could be undiagnosed iron deficiency or anemia. Your doctor might say your hematocrit and hemoglobin iron levels are normal, but unfortunately that is not a sensitive enough test for true iron status. Ferritin is how iron is stored in the body and low ferritin is going to be an early indicator of low iron levels in the body.
What is Anemia?
Anemia is a condition in which the blood is deficient in red blood cells, or low in the hemoglobin (the iron containing) portion of red blood cells. There are many symptoms of anemia but some of the main symptoms are weakness and a tendency to become fatigued easily. This is due to the lack of oxygen being delivered to the tissues and a buildup of carbon dioxide. When someone has anemia they usually have low blood volume, a low level of total red blood cells or abnormal size or shape of their red blood cells. Iron deficiency plays a central role in Anemia, especially for women. Iron deficiency anemia occurs when all of the body’s iron stores have been completely depleted.
Some of the symptoms of Iron deficiency anemia include:
Fatigue
Weakness
Loss of appetite
Increases susceptibility to infection
Constipation
Brittle nails
Heart palpitations
Poor scholastic performance
Iron and its Role in Pregnancy
Many women go into their pregnancies already deficient or low in iron and their bodies need for it grows exponentially throughout. During a pregnancy, the blood volume expands by about 35-50% with additional iron required to meet the needs of the fetus, placenta and the increase in maternal tissue. Throughout the second and third trimester the iron requirements for a woman are nearly three times that of a non-pregnant woman! Women who do not supplement iron during their pregnancy are usually unable to maintain adequate iron stores throughout and are at an increased risk for iron deficiency anemia, hypothryoidism and low maternal weight gain. Women who have a history of iron deficiency, low iron stores at the onset of pregnancy or those who tend towards heavy menstrual blood loss are at even further risk for anemia during their pregnancy.
“According to Aviva Romm M.D. women require twice the iron intake of men to maintain normal stores and can expect to lose 500 mg of iron per pregnancy without careful attention to adequate dietary intake and supplementation. Getting too little iron during pregnancy increases a woman’s risk of iron deficiency anemia and her infant’s risk of low birth weight, premature birth, and low levels of iron. Getting too little iron might also affect her infant’s brain development. Iron supplementation can lead to longer gestation rates and higher birth weights as well. Women who are pregnant or breastfeeding should take an iron supplement as recommended by an obstetrician or other health care provider.”
Can iron be harmful?
Yes, iron can be harmful if you get too much. In healthy people, taking high doses of iron supplements (especially on an empty stomach) can cause an upset stomach, constipation, nausea, abdominal pain, vomiting, and fainting. High doses of iron can also decrease zinc absorption. Extremely high doses of iron (in the hundreds or thousands of mg) can cause organ failure, coma, convulsions, and death therefore it is important to keep it out of reach of children.
How much iron do I need?
The amount of iron you need each day depends on your age, sex, and whether you consume a mostly plant based diet or not. Vegetarians who do not eat meat, poultry, or seafood need almost twice as much iron as listed below because the body doesn’t absorb non-heme iron in plant foods as efficiently as heme iron found in animal foods. Calcium can interfere with iron absorption; taking calcium and iron supplements at different times of the day helps to prevent this problem.
Adult Women 19 -50 years: 18 mg
Women 51 years and over: 8 mg
Pregnant women: 27 mg
Breastfeeding women: 9mg
Iron in Whole Food Nutrition
How can we incorporate iron into our diets naturally? By eating a whole foods diet rich in fresh fruit and vegetables, whole grains and grass fed and finished pastured meat and eggs. Iron is found naturally in many foods, so it is possible to get your iron from your food! A carefully planned diet rich in a variety of iron sources can allow vegetarians to meet their dietary iron needs.
You can get your recommended amounts of iron by eating a variety of whole foods, including the following:
•Lean meat, seafood, and poultry (especially organ meats such as liver)
•White beans, lentils, kidney beans, and peas
•Dark leafy greens & spinach
•Nuts & seeds
•Tempeh
•Dried raisins, figs, apricots and prunes
•Eggs
•Molasses
•Spirulina
Iron in food comes in two forms as I stated before; heme iron and non-heme iron. Non-heme iron is found in plant foods and iron fortified food products. Meat, seafood, and poultry have both heme and non-heme iron. Your body absorbs iron from plant sources better when you eat it with meat, poultry, and foods that contain vitamin C, like citrus fruits,strawberries, sweet peppers,tomatoes, and broccoli.
Botanical Sources of Iron
Herbal sources of iron include Nettles, Yellow Dock, Parsley, Dandelion Root, Kelp, Raspberry Leaf and Amaranth greens.
Herbs are a wonderful way to incorporate iron into your daily diet. Susan Weed recommends doing strong herbal infusions, steeped for 4-8 hours to get the most nutrients out of your tea blends. There are so many herbs that include natural sources of iron, and I just listed a few of the most potent ones above. Creating iron rich tea blends, and bringing tea as medicine into your daily practice is a beautiful ritual and nourishes the body, mind and spirit. The combination of iron rich herbal tea blends and whole foods nutrition sets you on a wonderful path of getting the required amount of daily iron without need for supplementation.
Susan Weed's Anemia Prevention Brew:
1/2 oz. dried nettle leaves
1/2 oz. dried parsley leaves
1/2 oz. dried comfrey leaves
1/2 oz. dried yellow dock root
1/2 oz. dried peppermint leaves
Measure all herbs and put them in a glass 1/2 gallon jar. Cover with boiling water and cover tightly. Steep for at least 8 hours. This brew provides excellent herbal sources of iron as well as folic acid and B12. All the green herbs contain vitamin C which aids iron absorption.
Drink freely, up to 4 cups daily, for at least one week each month!
Iron Supplementation
Oral iron supplements or iron syrups are a wonderful, inexpensive way to make sure you are getting enough iron, especially if you have a heavy flow, or are pregnant or breastfeeding. Ascorbic acid increases the absorbability of non-heme or vegetarian sources of iron, so it can be helpful to take 250mg of vitamin C with your iron supplement.
Phytates, oxalates, calcium and tannis found in foods such as cereals, dietary fiber, tea, coffee, eggs and milk can interfere with iron absorption in the body so it is best if the supplement is not taken with food.
There are so many natural ways to incorporate iron into our daily diets, and as women its vitally important that we pay attention to this nutrient and its role in our lives. Now that we know all the ways iron supports our bodies and their natural processes, we can bring more awareness to making sure we are getting our daily recommended dose. Especially if you know you have a heavy flow, are a vegetarian or vegan, or are pregnant or breastfeeding. As women, knowing our physiology, and the ways in which our bodies are working for us can be so empowering. I think the issue of iron deficiency and especially the rise of iron deficient anemia among women, especially young and healthy women, needs to be addressed and talked about. It's important we know the role this nutrient plays in our bodies, so that we can provide our bodies with with what they need to truly thrive; and we can teach our daughters and the next generation so that they may grow up with this deep knowledge and understanding of their bodies.
My iron syrup is is full of whole foods and herbs that contain high amounts of iron, as well as vitamin C for optimal absorption. Made for women of all phases to support the body in building blood and assimilating iron. This syrup is formulated to help regulate women’s cycles, calm the nervous system, and soften painful cycles and pre-menopausal symptoms as well as deeply strengthen and nourish our systems!
Made with Nettle leaf, Raspberry leaf, Alfalfa, Dandelion Root, Yellow Dock, Milky Oats tops, Milk Thistle Seed, Marshmallow Root, Hawthorn Berry, Goji Berry, Rose Hips, Orange Peel, Spirulina, Astragalus infused Raw Honey, Molasses, Pomegranate & Black Cherry Juice Concentrate, Brandy, Spring Water and Love! This delicious witchy green syrup was Made with love on the full moon eclipse!
This will be available in the Apothecary on my next Full Moon release along with other Women's Health focused botanical medicines! Keep an eye out or sign up for my newsletter to stay up to date on all my happenings!
Strong women unite!
Refrences:
Murray, M., Pizzorno, J., & Pizzorno, L. (2005). The Encyclopedia of Natural Medicine (3rd Ed.). New York, NY: Atria Books.
Pitchford, P. (2002). Healing with whole foods. Berkeley, CA: North Atlantic Books
Romm, A. (2018). Botanical Medicine for Women's Health ( 2nd Ed.). St. Louis, MO: Elsevier Inc.