Iron deficiency in food, supplements, anemia
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PrismaticPhoenix
Posts: 65 Member
For most of my life, I've struggled with being anemic whenever I'm not taking some type of iron supplement. It was always just a given that I'd have to take an iron supplement. Now that I'm tracking my food (and have been for some time), I see that I am basically never hitting the RDA% of iron in my diet. Whether or not I'd need to take iron anyway if I was, who knows (I'd need to consult with my doctor again), but the fact is that I'm not. In the last 90 days of logging, I've hit the RDA% 5 times. I'm also struggling with protein (partially because I want to eat less meat), but not to as great a degree, and I feel like I have a better idea of what do with that, how to fix it, and I'm making better progress to improve that (although it isn't working well with my desire to eat less meat). Iron, I'm baffled with. Even things that get listed as "good" sources of iron only seem to have a few percentages. I'm not sure what to do.
Can anyone help me out?
Can anyone help me out?
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Replies
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Heme iron is the best absorbed - comes from animal products - so if you're not eating much of that you're fighting an uphill battle. That being said, combining non-animal sources of iron with vitamin C will improve absorption.2
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I'm mostly carnivore so you might not agree with me but I think you should eat more beef and beef liver not less. They are one of the best sources of iron besides shellfish.1
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MFP, most of which is user entered, is not the best source for micronutrient info, so it's possible that you are getting more than you think.
That said, I eat a pescatarian diet (90% vegetarian + fish once to twice a week). My iron on MFP (with carefully vetted entries) is usually between 50 and 80 percent. Since the amount on MFP is double the recommendation for my age, I am actually getting the correct amount for me. I have eaten between 1200 and 1500 calories and have not found it difficult.
I believe most people with anemia still have to take supplements even with adequate dietary iron. I'm not sure why. Maybe it's like me and vitamin D. No amount of sun exposure and fortified foods seems to be enough to get me adequate Vitamin D blood levels. The high dose supplement is required.5 -
PrismaticPhoenix wrote: »For most of my life, I've struggled with being anemic whenever I'm not taking some type of iron supplement. It was always just a given that I'd have to take an iron supplement. Now that I'm tracking my food (and have been for some time), I see that I am basically never hitting the RDA% of iron in my diet. Whether or not I'd need to take iron anyway if I was, who knows (I'd need to consult with my doctor again), but the fact is that I'm not. In the last 90 days of logging, I've hit the RDA% 5 times. I'm also struggling with protein (partially because I want to eat less meat), but not to as great a degree, and I feel like I have a better idea of what do with that, how to fix it, and I'm making better progress to improve that (although it isn't working well with my desire to eat less meat). Iron, I'm baffled with. Even things that get listed as "good" sources of iron only seem to have a few percentages. I'm not sure what to do.
Can anyone help me out?
So you can start by prioritizing your food consumption around consuming foods highest in iron (good list below).
https://www.healthline.com/nutrition/11-healthy-iron-rich-foods#section13
But if that fails, sometimes what our personal beliefs are have to take a back seat to what is healthiest for our bodies. I know personally you might want to reduce meat (especially red meat), but it might also be the thing that is healthiest for you.
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bold_rabbit wrote: »MFP, most of which is user entered, is not the best source for micronutrient info, so it's possible that you are getting more than you think.
This.I believe most people with anemia still have to take supplements even with adequate dietary iron. I'm not sure why. Maybe it's like me and vitamin D. No amount of sun exposure and fortified foods seems to be enough to get me adequate Vitamin D blood levels. The high dose supplement is required.
And this.
I found MFP hard to use to track iron and often thought mine seemed incorrectly low, even when I was eating a good bit of red meat (much more than I am comfortable with, including for health reasons). I now track at Cron, eating far less red meat or meat generally (I do eat red meat occasionally), and my numbers are good. (I eat lots of greens, am aware that it's not as well absorbed, but I'm also aware that excessive heme iron (the better absorbed kind) isn't ideal. Vit C with greens does help.)
I have never had low iron, and for family history reasons am more concerned about potential high iron, so what works for me may not be relevant to you. I will note that in fact I think a lot of the high iron foods in the US diet are supplemented grain products (like cereals) none of which I eat, but which may be a source (and may not be properly counted) if you eat them.
What I think is the best advice would be to ignore what everyone on the internet says you should or should not eat and talk to a dietitian who will be aware of your specific history and trends and past supplementation, and also could look at your food logs and see if he/she thinks that dietary iron is an issue. You can probably get a referral from your doctor given the past anemia.4 -
I've been fighting my way back from iron deficiency anemia for over a year now. I know iron supplements are no fun, but sometimes they are necessary. Are you currently anemic, or just basing this on a history of anemia? You should be under a doctor's care if you are anemic and following his/her recommendations (requesting a referral to a registered dietician - not a nutritionist - as mentioned in the previous post is a good idea, as well).
Agree with others that the database entries are not always correct for micronutrients like iron. If you're eating more plant-based iron sources than meat, focus on lentils, peas, chickpeas, beans, etc. Vitamin C and folic acid help with absorption of non-heme iron from plants. Dairy consumed with iron sources reduces absorption.
Iron levels and stores can be slow and difficult to raise, especially for menstruating women. Feosol Bifera (a combination of heme and non-heme iron) is the only supplement I've tried that doesn't give me miserable side effects. It's 28mg per tablet (155% rda for a pre-menopausal woman, which I am), and I take 3 a day (on my doctor's recommendation - DO NOT supplement this heavily unless your doctor says you need to) with Vit C and B complex. After 14 months, my total iron and hg are finally acceptable, but my ferritin is still low. I would never be able to make any progress with diet alone.4 -
I'm anemic and need to get almost 400% of the RDA to keep my levels in Low Normal.
The first two types of iron my doctor prescribed did not help with both my iron and energy levels.
Now I take iron bisglycinate, which does not have the side effects people complain about with supplements that use other forms of iron. When I buy from Amazon I get Solgar and when I buy from Emerson I get Thorne. (Using the Amazon link as I doubt many people have access to Emerson.)
For lunch during my period I eat Wellshire Liverwurst; 2 oz = 35% RDA iron. If I can't make it to Whole Foods I get Boar's Head Liverwurst, 2 oz = 25% RDA iron. (For people who want more iron but don't like liver - neither do I; can't stand the stuff, but I do like liverwurst. Wellshire also makes turkey liverwurst. Less iron, but also less fat and calories. Last I checked this brand was exclusive to Whole Foods.)
I also make chicken liver pate but don't really like it, probably because I use way less butter, as a stick seems excessive, but probably improves the taste. However, a whole stick of butter would throw the macros and micros off.
I also mix 1 T of blackstrap molasses into a cup of warm water every morning. That gives me 20% RDA. Here's what I order https://smile.amazon.com/Wholesome-Sweeteners-Organic-Molasses-Pack/dp/B001M0G2PO/ but caution - this brand can leak, so best to not get anything else with that order. It was the cheapest, so I continued to put up with it.
Vitamin C helps with iron absorption and I mix powdered, buffered vitamin C into the molasses "tea" to create a dreadful concoction
https://smile.amazon.com/gp/product/B000I4AIUA/ 2 -
If anyone reading this is tempted to suggest using cast iron pans to get iron levels up, please just don't. Anemia is a serious medical condition. I've become very unwell several times when my anemia was not managed properly, and was using cast iron before, during, and after.
Cast iron pans might provide a little iron bonus, but should not be considered a first line treatment for a serious medical condition.
Additionally, more iron is absorbed from cast iron pans when one is not using cast iron normally - brand new pans, for acidic foods, for applesauce, etc.7 -
I'm glad (well not really, but you know...) to see I'm not alone in needing 400%+ rda. I was starting to think something was seriously wrong when I supplemented at 300% for 6 months and made no progress.kshama2001 wrote: »(snipped)I'm anemic and need to get almost 400% of the RDA to keep my levels in Low Normal.
After a whole battery of gastro tests last summer to rule out GI bleeding, I can only surmise that my periods are heavier than "normal" and I just don't know because it's normal to me. That's a difficult thing to compare.3 -
I'm glad (well not really, but you know...) to see I'm not alone in needing 400%+ rda. I was starting to think something was seriously wrong when I supplemented at 300% for 6 months and made no progress.kshama2001 wrote: »(snipped)I'm anemic and need to get almost 400% of the RDA to keep my levels in Low Normal.
After a while battery of gastro tests last summer to rule out GI bleeding, I can only surmise that my periods are heavier than "normal" and I just don't know because it's normal to me. That's a difficult thing to compare.
Well, apparently 80 ml loss of blood is normal: https://community.myfitnesspal.com/en/discussion/comment/44365249/#Comment_44365249
When I was fighting with the VA to get them to prescribe tranexamic acid it was important for me to be able to quantity my "heavy bleeding". I have a 30 ml capacity menstrual cup and if I empty it 40 times that's 1200 ml, so 15 x the normal amount of 80 ml
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PrismaticPhoenix wrote: »For most of my life, I've struggled with being anemic whenever I'm not taking some type of iron supplement. It was always just a given that I'd have to take an iron supplement. Now that I'm tracking my food (and have been for some time), I see that I am basically never hitting the RDA% of iron in my diet. Whether or not I'd need to take iron anyway if I was, who knows (I'd need to consult with my doctor again), but the fact is that I'm not. In the last 90 days of logging, I've hit the RDA% 5 times. I'm also struggling with protein (partially because I want to eat less meat), but not to as great a degree, and I feel like I have a better idea of what do with that, how to fix it, and I'm making better progress to improve that (although it isn't working well with my desire to eat less meat). Iron, I'm baffled with. Even things that get listed as "good" sources of iron only seem to have a few percentages. I'm not sure what to do.
Can anyone help me out?
You're better off just googling a list of foods higher in iron and prioritizing those.
Reducing meat may not be the healthiest choice for you at the moment since that's what is going to be highest in iron. Vegans and vegetarians often struggle with anemia for this very reason.1 -
I had a severe case of anemia caused by slow bleeds in the stomach. The bleeds were cured by a daily prolosec and eventually by eating better and losing weight. The anemia was fixed by transfusions for the acute stage and high potency supplements for about 9 months after. I have been fine for the last 6 years.
Some of the things I learned about iron from my doctor:- Most people do best by consuming both heme (meat) and non heme (fruits and veggies) based iron
- The body absorbs very little of the iron ingested
- Foods like dairy or supplements that contain calcuim will limit, if not actually block, absorption of iron
- Acid reducers like prilosec will also limit or even block iron absorption
I had to pay attention to my mix of food. I left my dairy for breakfast and bedtime snack and took my prilosec at bedtime. I could take the iron supplement with lunch and eat iron rich foods for lunch and dinner in order to maximize absorption.0 -
Thanks everyone for the suggestions! I'll give some more information for those who wanted it:
I've always struggled with anemia, even when I wasn't doing anything specific with meat in my diet (I was first diagnosed with anemia as a teen and I eating meat heavily then). My doctors' suggestions have always simply been to stick me on a supplement. Right now I'm on a multivitamin and a specific iron supplement, both of which I don't intend to stop taking without consulting my doctor and keeping an eye on what is going on with my iron. I do have extremely heavy periods, so it's possible that my issue isn't a matter of diet, or isn't wholly a matter of diet. The last time I was checked for anemia, it was under control, although I haven't been checked terribly recently.
I don't intend to stop eating meat, at least at this time. However, I do want to cut back and eat more fruits and vegetables instead, partially because I'm not getting enough fruits and vegetables in my diet (particularly vegetables) in addition to other issues.
I went to see either a dietitian or a nutritionist (it was someone at a hospital who I was referred to by my doctor, I wasn't aware there was a difference) twice and it wasn't very helpful.0 -
PrismaticPhoenix wrote: »Thanks everyone for the suggestions! I'll give some more information for those who wanted it:
I've always struggled with anemia, even when I wasn't doing anything specific with meat in my diet (I was first diagnosed with anemia as a teen and I eating meat heavily then). My doctors' suggestions have always simply been to stick me on a supplement. Right now I'm on a multivitamin and a specific iron supplement, both of which I don't intend to stop taking without consulting my doctor and keeping an eye on what is going on with my iron. I do have extremely heavy periods, so it's possible that my issue isn't a matter of diet, or isn't wholly a matter of diet. The last time I was checked for anemia, it was under control, although I haven't been checked terribly recently.
I don't intend to stop eating meat, at least at this time. However, I do want to cut back and eat more fruits and vegetables instead, partially because I'm not getting enough fruits and vegetables in my diet (particularly vegetables) in addition to other issues.
I went to see either a dietitian or a nutritionist (it was someone at a hospital who I was referred to by my doctor, I wasn't aware there was a difference) twice and it wasn't very helpful.
Next time you get checked, try to schedule it for right after your period - if you get checked right before this might reflect a count better than most of the month. And do get checked at least once per year.
Are you having symptoms of iron deficiency? My two most noticeable ones are crippling fatigue and a crazy amount of hair loss.
Now that my anemia has been under control for some time, I have a lot less split ends in my hair than I used to.
https://www.healthline.com/nutrition/iron-deficiency-signs-symptoms2 -
Maybe? I'm very fatigued all the time, but that's pretty usual. I probably ought to make another doctor's appointment but I'm pretty tired of going to the doctor, and I used to go to doctors who got tired of seeing me, so much so that that they told me that I just needed to learn to live with my fatigue. They used to test my thyroid a lot but nothing was ever wrong. My skin gets really dry really easily and that's really unpleasant. My hands also get horrifically cold, so much so that shaking hands with people can be profoundly awkward and I get comments. My hair used to get really bad split ends, but that's at least somewhat better since I started using special shampoo.0
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PrismaticPhoenix wrote: »Maybe? I'm very fatigued all the time, but that's pretty usual. I probably ought to make another doctor's appointment but I'm pretty tired of going to the doctor, and I used to go to doctors who got tired of seeing me, so much so that that they told me that I just needed to learn to live with my fatigue. They used to test my thyroid a lot but nothing was ever wrong. My skin gets really dry really easily and that's really unpleasant. My hands also get horrifically cold, so much so that shaking hands with people can be profoundly awkward and I get comments. My hair used to get really bad split ends, but that's at least somewhat better since I started using special shampoo.
Well, you have a bunch of signs of iron deficiency, so do make that appointment. Tomorrow. Or today if you are reading this on Monday.
I could not believe how much proper treatment relieved my suffering, and I hope the same for you.1 -
kshama2001 wrote: »PrismaticPhoenix wrote: »Thanks everyone for the suggestions! I'll give some more information for those who wanted it:
I've always struggled with anemia, even when I wasn't doing anything specific with meat in my diet (I was first diagnosed with anemia as a teen and I eating meat heavily then). My doctors' suggestions have always simply been to stick me on a supplement. Right now I'm on a multivitamin and a specific iron supplement, both of which I don't intend to stop taking without consulting my doctor and keeping an eye on what is going on with my iron. I do have extremely heavy periods, so it's possible that my issue isn't a matter of diet, or isn't wholly a matter of diet. The last time I was checked for anemia, it was under control, although I haven't been checked terribly recently.
I don't intend to stop eating meat, at least at this time. However, I do want to cut back and eat more fruits and vegetables instead, partially because I'm not getting enough fruits and vegetables in my diet (particularly vegetables) in addition to other issues.
I went to see either a dietitian or a nutritionist (it was someone at a hospital who I was referred to by my doctor, I wasn't aware there was a difference) twice and it wasn't very helpful.
Next time you get checked, try to schedule it for right after your period - if you get checked right before this might reflect a count better than most of the month. And do get checked at least once per year.
Are you having symptoms of iron deficiency? My two most noticeable ones are crippling fatigue and a crazy amount of hair loss.
Now that my anemia has been under control for some time, I have a lot less split ends in my hair than I used to.
https://www.healthline.com/nutrition/iron-deficiency-signs-symptoms
Intuitively, this seems ... wrong. I wasn't able to find any research studies that went directly to the point I think you're trying to make (that women lose iron in their menstrual flow, so iron in women's blood is higher before menstruation -- if that's not your point, please correct me). But the menstrual lining that a woman builds up during the month isn't part of her circulating blood, so that iron has already been lost from her circulating blood by the time in her cycle just before her period. I would think iron in the circulating blood would be highest at the end of one's period, because the body has had a break of several days to a week from diverting iron from its other systems to the uterine lining.
I could be wrong -- for example, there could be hormonal effects on iron that I'm not taking into account.1 -
lynn_glenmont wrote: »kshama2001 wrote: »PrismaticPhoenix wrote: »Thanks everyone for the suggestions! I'll give some more information for those who wanted it:
I've always struggled with anemia, even when I wasn't doing anything specific with meat in my diet (I was first diagnosed with anemia as a teen and I eating meat heavily then). My doctors' suggestions have always simply been to stick me on a supplement. Right now I'm on a multivitamin and a specific iron supplement, both of which I don't intend to stop taking without consulting my doctor and keeping an eye on what is going on with my iron. I do have extremely heavy periods, so it's possible that my issue isn't a matter of diet, or isn't wholly a matter of diet. The last time I was checked for anemia, it was under control, although I haven't been checked terribly recently.
I don't intend to stop eating meat, at least at this time. However, I do want to cut back and eat more fruits and vegetables instead, partially because I'm not getting enough fruits and vegetables in my diet (particularly vegetables) in addition to other issues.
I went to see either a dietitian or a nutritionist (it was someone at a hospital who I was referred to by my doctor, I wasn't aware there was a difference) twice and it wasn't very helpful.
Next time you get checked, try to schedule it for right after your period - if you get checked right before this might reflect a count better than most of the month. And do get checked at least once per year.
Are you having symptoms of iron deficiency? My two most noticeable ones are crippling fatigue and a crazy amount of hair loss.
Now that my anemia has been under control for some time, I have a lot less split ends in my hair than I used to.
https://www.healthline.com/nutrition/iron-deficiency-signs-symptoms
Intuitively, this seems ... wrong. I wasn't able to find any research studies that went directly to the point I think you're trying to make (that women lose iron in their menstrual flow, so iron in women's blood is higher before menstruation -- if that's not your point, please correct me). But the menstrual lining that a woman builds up during the month isn't part of her circulating blood, so that iron has already been lost from her circulating blood by the time in her cycle just before her period. I would think iron in the circulating blood would be highest at the end of one's period, because the body has had a break of several days to a week from diverting iron from its other systems to the uterine lining.
I could be wrong -- for example, there could be hormonal effects on iron that I'm not taking into account.
I can only address this as an N=1 but many, many years ago my doctor had me test my iron every week (he loaned me a testing machine like they use at blood donation centers) and I did it for 10 weeks. My highest reading was 2 weeks after my period started, about the time of ovulation. My lowest reading was a few days before my period started, about the time of PMS. One week after my period started I was still on my low end but it improved quite a bit in the next week and stayed good for one more week before dropping.0 -
lynn_glenmont wrote: »kshama2001 wrote: »PrismaticPhoenix wrote: »Thanks everyone for the suggestions! I'll give some more information for those who wanted it:
I've always struggled with anemia, even when I wasn't doing anything specific with meat in my diet (I was first diagnosed with anemia as a teen and I eating meat heavily then). My doctors' suggestions have always simply been to stick me on a supplement. Right now I'm on a multivitamin and a specific iron supplement, both of which I don't intend to stop taking without consulting my doctor and keeping an eye on what is going on with my iron. I do have extremely heavy periods, so it's possible that my issue isn't a matter of diet, or isn't wholly a matter of diet. The last time I was checked for anemia, it was under control, although I haven't been checked terribly recently.
I don't intend to stop eating meat, at least at this time. However, I do want to cut back and eat more fruits and vegetables instead, partially because I'm not getting enough fruits and vegetables in my diet (particularly vegetables) in addition to other issues.
I went to see either a dietitian or a nutritionist (it was someone at a hospital who I was referred to by my doctor, I wasn't aware there was a difference) twice and it wasn't very helpful.
Next time you get checked, try to schedule it for right after your period - if you get checked right before this might reflect a count better than most of the month. And do get checked at least once per year.
Are you having symptoms of iron deficiency? My two most noticeable ones are crippling fatigue and a crazy amount of hair loss.
Now that my anemia has been under control for some time, I have a lot less split ends in my hair than I used to.
https://www.healthline.com/nutrition/iron-deficiency-signs-symptoms
Intuitively, this seems ... wrong. I wasn't able to find any research studies that went directly to the point I think you're trying to make (that women lose iron in their menstrual flow, so iron in women's blood is higher before menstruation -- if that's not your point, please correct me). But the menstrual lining that a woman builds up during the month isn't part of her circulating blood, so that iron has already been lost from her circulating blood by the time in her cycle just before her period. I would think iron in the circulating blood would be highest at the end of one's period, because the body has had a break of several days to a week from diverting iron from its other systems to the uterine lining.
I could be wrong -- for example, there could be hormonal effects on iron that I'm not taking into account.I can only address this as an N=1 but many, many years ago my doctor had me test my iron every week (he loaned me a testing machine like they use at blood donation centers) and I did it for 10 weeks. My highest reading was 2 weeks after my period started, about the time of ovulation. My lowest reading was a few days before my period started, about the time of PMS. One week after my period started I was still on my low end but it improved quite a bit in the next week and stayed good for one more week before dropping.
I was guessing based on it taking up to 10 days to feeling back to normal
I lose @ 15x a normal amount of blood so normal level fluctuations may not apply to very heavy bleeders like me.0 -
kshama2001 wrote: »
Well, apparently 80 ml loss of blood is normal: https://community.myfitnesspal.com/en/discussion/comment/44365249/#Comment_44365249
When I was fighting with the VA to get them to prescribe tranexamic acid it was important for me to be able to quantity my "heavy bleeding". I have a 30 ml capacity menstrual cup and if I empty it 40 times that's 1200 ml, so 15 x the normal amount of 80 ml
When I learned that 80mL was "normal" I was SHOCKED! That's maybe a couple of hours on my heavier days. When I told the doctor that I go through a cup, plus a pad, plus clothes (sigh) in under an hour sometimes, he was more than happy to give me a presciption.
The tranexamic acid tablets for heavy bleeding have made a huge difference to me. My iron levels are now normal (no supplements), and I have so much more energy in general, plus I can leave the house on those heavy days without an arsenal of supplies and spare clothing!
I wish I had spoken to my doctor about it years ago - but it was just my "normal".0
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