Image Credit – Tomato MRI, Alexandr Khrapichev, University of Oxford

Iron is an essential mineral that the body needs to energize your cells and keep you feeling strong and vibrant. Iron deficiency is the most common mineral deficiency worldwide. You may be familiar with some of the signs – fatigue, brain fog, trouble focusing at work or school, or frequent colds – but may have dismissed them as just part of life’s usual stresses. 

Other less well known symptoms of iron deficiency include skin bruising, restless leg syndrome, and hair shedding. Mood changes such as depression or anxiety and sensitivity to the cold, especially hands and feet, may also indicate low iron. 

The body regulates iron through a complex system that balances iron absorption, storage, and recycling. This regulation is crucial because both too little and too much iron can lead to serious health problems. Your iron status can also be influenced by other factors such as pregnancy or times of increased growth and development, especially teenagehood. Excessive blood loss due to heavy periods, endometriosis, fibroids, intestinal polyps or trauma can also cause iron deficiency. 

Dietary sources of iron come in two forms – heme iron (from animal foods) and non-heme iron (from plant foods). The body absorbs heme iron more efficiently than non-heme iron. Your overall gut health is crucial in the absorption of iron. Adequate stomach acid is essential for breaking down the food matrix to release iron molecules, as well as converting the iron to a soluble form that can be absorbed by the small intestine. The gut microbiome also influences iron availability and uptake by reducing gut inflammation and reducing intestinal permeability (leaky gut). 

Iron for Fertility and Pregnancy

Ensuring your iron is at optimal levels before you get pregnant will help support fertility for both partners. It may also prevent the development of iron deficiency during your pregnancy. 

During pregnancy, the body’s need for iron significantly increases to support the growth and development of the baby and placenta. Iron deficiency in pregnancy can negatively impact the baby’s neurodevelopment, with potential long term effects on their cognitive and psychological development.  The baby also needs iron for their own blood supply and storage of iron to last through the first few months of life.

Pregnancy is a period of higher susceptibility for iron deficiency and anemia due to the increased iron demands. Morning sickness and food aversions in pregnancy can also contribute as you may be eating less iron containing foods. Iron deficiency anemia in pregnancy is associated with several poor outcomes, including increased risk of preterm delivery, low birth weight, and increased bleeding during birth. It can also compromise the baby’s iron stores, potentially affecting their development. Your iron status will be monitored by your midwife or obstetrician, and supplementation is recommended if you are found to be low. 

Heavy Bleeding Impacts Your Iron

Periods are a significant source of blood and iron loss, especially if they are heavy, prolonged or if you have short cycles. Endometriosis, fibroids and adenomyosis can cause heavy bleeding, but sometimes the underlying cause is never found. Heavy periods can be improved with treatment, which can reduce their impact on your life, and iron status. 

Strategies for Supporting Iron Levels

A holistic approach with these 3 steps can improve your iron levels, prevent anemia and help you feel great again.

~ Ensure Adequate Intake

Making sure you are eating enough iron containing foods is the first step to ensuring optimal levels. Red meat is a good source of iron, but shouldn’t be eaten every day. When choosing plant sources of iron, combining with foods containing vitamin C and betacarotene can increase absorption. 

Certain components found in food and drinks, such as tannins (in tea and coffee), and phytates (in whole grains and legumes) can inhibit iron absorption. While you don’t need to avoid these entirely, having them a few hours apart from iron-rich meals can help. Soaking, sprouting, or fermenting grains and legumes can reduce phytate levels and improve iron absorption. Calcium rich foods can interrupt iron absorption – have these at a different meal where you can. 

Cooking acidic foods (like tomato sauce) in cast iron cookware can increase the iron content of the food. The acidity helps to leach iron from the cookware into the food, thereby increasing your iron intake.

~ Prioritise Gut Health to Support Absorption

A happy gut is the foundation for good nutrient absorption. If your gut is damaged or inflamed, your ability to break down foods and absorb the iron they contain will be compromised. Long term use of some medications such as PPIs can also impair your absorption of iron. Some lifestyle factors can affect your gut health, and should be addressed as part of your iron deficiency treatment. Chronic stress, excessive exercise and poor sleep can lead to slow gut motility, low stomach acid and microbial dysbiosis. These in turn can contribute to poor iron absorption. 

~ Reduce Blood Loss 

For people with heavy periods, reducing the amount of blood lost each month will help to stabilise their iron levels. Heavy periods can be improved with treatment, including with Chinese medicine, targeted supplementation and lifestyle changes. Specific blood disorders such as clotting disorders or thalassemia can lead to increased turnover of iron. Optimising iron absorption and recycling is essential to keep iron stores high and prevent anaemia. 

Should I Take an Iron Supplement?

Iron can be harmful at high doses so have your levels checked with a blood test before deciding to supplement. Your GP may suggest a high dose over the counter iron supplement. However many of these products cause digestive upset and constipation. Iron infusions are an alternative to oral supplements, but can also be inflammatory and cause side effects such as head and body aches.  Working with a natural medicine practitioner before an infusion can reduce the potential impacts of the procedure. 

A holistic approach to optimizing iron levels includes supporting all stages of the iron cycle – intake, absorption, and loss – and addressing any underlying issues including stress and inflammation. 

Chinese medicine connections 

The strength and elegance of Chinese medicine is in its view of the body as a whole system. Illness is never isolated to one blood test or diagnosis, but is seen as a disruption to the interconnected energy of the body. 

Iron is a component of red blood cells, and in Chinese medicine iron deficiency is viewed as a Blood deficiency. Blood is produced by the Spleen Qi (digestion), and the essence and Qi of the Kidneys (bone marrow). To nourish Blood, treatments are focused on these two main organ systems, supporting the capacity of the body to produce Blood. 

Emotional balance is also important for Blood stores in Chinese medicine. Too much worry or overthinking can damage the digestion, consuming Blood and reducing the body’s capacity to produce it. Stress can cause Qi stagnation, which in turn limits the capacity of the Spleen to generate Blood. 

Iron is an essential mineral and maintaining good levels is imperative for health and vitality. Whilst supplements and infusions can help, addressing the underlying causes of low iron is the best long term approach for overall vitality. If you are struggling with low iron, Chinese medicine can help to reduce blood loss, support gut health and improve absorption, helping you return to your energetic best.