What is Iron Deficiency?
Iron deficiency can be linked to many common complaints that can keep people from living their best lives. Symptom improvement can often be as easy as correcting these low iron levels. When it is not that easy, it is a necessary stepping stone in the right direction. Optimal iron levels have been shown to correlate with increased quality of life and symptomatic improvement.
Iron deficiency is more than just anemia found on a simple CBC. Ferritin levels can be low months before a drop in hemoglobin can be detected. Symptoms can show up well before anemia is found, and since these symptoms are vague and could be associated with many other common health complaints it often goes unnoticed. Optimizing health starts with doing a full assessment of iron status.
Health Impact of Iron (a deeper dive):
Iron is one of the most important elements in the body. It is responsible for oxygen transport through the body. Oxygen is essential for making energy.
Availability of iron is dependent on many factors: absorption, metabolism, and interaction with physiological processes
Functions in the body: oxygen transport, DNA synthesis, and electron transport.
Extremely important for proper brain function. It helps deliver oxygen, produces neurotransmitters, and aides in the electrical wiring that helps us process information (neuron activity).
Reasons for anemia: blood loss (trauma, surgery, GI or menstrual, pregnancy), low nutritional intake of iron, deficiency of other nutrients (vitamin A, B2, folate, and B12), chronic inflammation, infections (malaria,parasites, yeast, Lyme), medications (acid blockers and PPIs), kidney disease, alcoholism, genetic disorders (thalassemia, sickle cell, aplastic, and hemolytic)
Inhibitors of iron absorption: phytic acid, polyphenols, calcium, and peptides from partially digested proteins, milk, eggs, milk, and soy
Enhancers of iron absorption: ascorbic acid, citrate, amino acids, meat, fish poultry, genes (hemochromatosis)
Competitors for iron absorption: lead, cobalt, strontium, manganese, zinc
Ferritin numbers are affected by inflammation and infection and can be deceivingly elevated. By assessing multiple results in the total iron panel and CBC, we can determine if there is a hidden iron deficiency.
It should be noted that iron overload can have an impact on health as well as deficiency. Increased iron levels can lead to free radical damage and anemia can lead to decreased oxygenation and energy production in cells.
Symptoms of Iron Deficiency
Ringing in the ears
Iron Deficiency Treatment
You can find healthy doses of iron in foods such as meats, seafood, green leafy veggies, beans, and nuts. Dietary interventions are helpful to maintain healthy iron levels in the body, however, if levels are significantly lower, you may need extra assistance in addition to dietary measures. These options are discussed below.
If iron levels are below optimal ranges, oral iron support is the initial treatment. It is important to note that if you have absorption issues associated with intestinal problems then this may not be adequate. Not all iron supplements are created equal. Some forms of iron can be hard on the stomach and aggravate constipation. Adding vitamin C with your iron supplement may maximize absorption when taken together.
IV Iron Treatment
If oral supplementation is not enough and/or there are GI side effects that interfere with proper absorption, IV iron may be warranted. As with oral supplements, not all IV iron formulations are created equal. Here at Texas Center for Lifestyle Medicine, we strive to provide our patients with the safest forms of IV iron that require the least amount of treatments. Currently, we are using Feraheme and Injectafer.
IV iron can be covered through medical insurance in most instances and we work with suppliers on financial assistance if there is a large out of pocket for our patients.