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IRON DEFICIENCY: Addressing The Most Common Nutritional Disorder On The Planet

In today's article we are going to talk about iron deficiency. You may not think this affects you, but you could be wrong! This is a remarkably prevalent problem worldwide. In fact the WHO states on it's website;

"Iron deficiency is the most common and widespread nutritional disorder in the world. As well as affecting a large number of children and women in developing countries, it is the only nutrient deficiency which is also significantly prevalent in industrialized countries." (1)

Why Iron Is Important To Learn About

Iron is an essential mineral to almost all life on the planet - animals and plants, specifically. Plants require iron to make chlorophyll, the molecule that allows the plant to turn light into energy. Animals require iron to make hemoglobin, the red blood cell molecule in our blood stream that takes in the oxygen from the air we breathe. Animals also use iron in a molecule called myoglobin, which stores oxygen for use in your muscles.

We all need iron to live.

Some Definitions

Before we get into it, please note that there is a difference between "iron deficiency" and "anemia". Iron deficiency implies your body doesn't have enough iron overall. Anemia means that you do not have enough red blood cells. "Iron deficiency anemia" is when you do not have enough iron to make enough red blood cells. This means you can have iron deficiency without anemia, and more severely, it means that iron deficiency left unchecked can progress to the point of anemia. This is a common point of confusion for the lay-reader, as both conditions are often addressed together and given much of what's written online either outright confuses the two or is worded very carefully.

Iron deficiency runs a spectrum from mild/simple deficiency to outright anemia.

While doctors are very capable of picking up overt iron deficiency anemia on a complete blood count (CBC), many patients with a simple iron deficiency get either missed or sometimes misdiagnosed.

Signs and Symptoms

While the severity of the symptoms and signs can range from unnoticeable to severe depending on the severity of the deficiency, those with iron deficiency often complain of the following:

  • fatigue or extreme tiredness
  • paleness
  • shortness of breath
  • headaches and dizziness (in particular they frequently get dizzy standing up quickly)
  • tachycardia / heart palpitations (sometimes misinterpreted as anxiety)
  • restless legs
  • poor ability to maintain temperature control (are often cold in warm environments)
  • poor immune function
  • poor cognitive function
  • chronically dry hair and skin
  • brittle or spoon shaped nails

Note that most with simple iron deficiency don't experience all of these, but often just 2 or 3. The more severe and extensive your symptoms the more likely you are to fall on the iron deficiency anemia aspect of this spectrum.

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Who Gets Iron Deficiency and Why?

While anyone could have an iron deficiency, most likely populations include;

  • Women (particularly pregnant women and those with difficult/heavy periods)
  • Children
  • Elderly
  • Vegetarians/Vegans
  • Endurance Athletes
  • People with GI disorders
  • African American /Hispanic ethnicity

The most common causes of iron deficiency are either due to not enough intake/absorption, or too much demand from the body. Key reasons for each include:

  • Increased Demand: blood loss (eg. menstruation, GI bleeding, or too frequent blood donations, surgeries/accidents), pregnancy, uterine fibroids, medications/supplements, alcohol abuse, 
  • Poor Intake/Absorption: vegetarian/vegan diets, medications that inhibit absorption (most commonly proton pump inhibitors!), GI conditions ranging from IBS to celiac disease to chron's disease, autoimmune disease, and hormone imbalances.

Confirming If You Have Iron Deficiency

If you think you might be one of the 1 in 3 people that have iron deficiency, it's important to speak with your medical or naturopathic doctor. He or she can run a couple of simple blood tests to confirm your iron status with you. These tests should at a minimum include:

  • Complete Blood Count (CBC) - to rule out overt anemia
  • Serum ferritin - a measure of your iron stores

If you are found to have an iron deficiency, typical treatment involves iron supplementation and a list of high iron foods to include in your diet. There are more invasive therapies for more severe deficiencies as well. Whatever treatment is offered to you, be prepared for it to take upwards of 6 months of consistent treatment to replenish your iron stores.

Rebuilding Your Iron Stores

According to the US RDA's, most of us need between 8 and 12 mg of iron per day of intake from food or supplements. Pregnant women are advised to aim for much more at 27mg/day.

Most of this ingested iron will not be absorbed... in normal healthy GI tracts, about 90% of it will be excreted in the feces. So, of the 8-12mg you are recommended to eat, only about 1-1.5mg will actually be absorbed. In addition, a normal healthy body will use/excrete about 1-1.5mg/day. Under normal healthy circumstances, this means you iron intake and output is balanced and this is a good thing. :)

If you need to rebuild your stores, your doctor will advise you as to the appropriate intake per day for your situation. Necessarily, this requires further investigation and treatment of the root causes for your deficiency listed above. Without the root cause for your deficiency being identified and corrected, it will be very hard to replenish your iron stores, even with iron supplementation.

Next Steps

If you know or suspect that iron deficiency is a concern for you, I'd be honoured to help. As a Naturopathic Doctor, I help patients with this problem all the time. Once we've identified and started correcting the root cause of iron deficiency, the recovery process begins to proceed smoothly and efficiently. What's really great to see is that my patients symptoms often improve almost right away. With iron, I often continue treatment beyond symptom relief until we achieve optimal ferritin stores and ensure it doesn't return.

If you'd like to get started working together, please Book An Appointment today!

As always, I hope this information has served and helped you. Thank you for reading.


Laura Nurse, BBA, ND

Naturopathic Doctor


Other episodes you might enjoy :

4 Things Your Fingernails Can Tell You About Your Health

Making Up For Deficiencies In Our Food Supply

You Don't Get Enough Vitamins In Your Food

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