How do you know if you have iron deficiency or anemia? We asked an expert about the symptoms to watch for— plus the foods that are high in iron
Do you ever feel tired, even after a good night's sleep? Or find yourself feeling exhausted after activities you're used to doing? If so, you may be missing a vital mineral in your system: iron. Iron deficiency is common among Canadians, and it's a nutrient deficiency can fly under the radar for an extended period of time. According to the Canadian Digestive Health Foundation, there are many instances where Canadians 'don't recognize the subtle signs of a deficiency until their symptoms have advanced.'
Megan Helei Hou, a Canadian clinical dietitian with Aurum Medicine and Wellness Clinic, spoke to Yahoo Canada about what Canadians can do to take care of their iron and their over all health.
This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Contact a qualified medical professional before engaging in any physical activity, or making any changes to your diet, medication or lifestyle.
What is iron deficiency?
Iron deficiency is 'a health condition characterized by low iron stores' with approximately 10.5 per cent of the Canadian population living with the condition at any point in their lives.
'We have iron in our blood; and at the same time it [iron] is stored in our body,' said Hou. 'Our body tries to use its storage first, but if there is no more storage to use then it [iron] will be reflected into our blood cells."
According to HealthLink BC, iron deficiency is commonly diagnosed through a complete blood count (CBC), a blood test that can be ordered by a healthcare provider or general practitioner.
What are symptoms of iron deficiency? How is it caused?
Hou stated that those who live with 'excessive blood loss' are more likely to develop iron deficiency. People with gastrointestinal (GI) bleeding and menstrual bleeding are more susceptible to iron deficiency given the volume of blood that can be lost. Those who have 'low iron absorption' can develop iron deficiency.
'People who have celiac [disease] absorb low amounts of iron, and those people tend to absorb iron less effectively," Hou said.
In addition, there are two types of iron, heme and nonheme iron that our bodies are able to absorb, coming from different food sources. With low amounts of either iron, it is possible to develop iron deficiency.
'Heme iron can be found in our blood and comes from animal sources, and nonheme iron means that sources are not from blood, like plant sources,' said Hou.
As a result, the most common symptoms of iron deficiency have a high possibility to interrupt one's daily life.
'You start to feel dizziness, your heart rate starts to beat faster, you are more tired than usual,' Hou said.
Other symptoms of iron deficiency can include:
Headaches
Hair loss
Impaired immune function
Irritability
Depression
Cold intolerance
Restless leg syndrome
Nail changes (thin, concave nails)
What is the difference between iron depletion, deficiency and anemia?
People with low iron can develop different conditions, like iron deficiency, iron depletion and anemia.
'Iron depletion means that the storage in our body has run out, and you don't necessarily feel a lot of the symptoms,' said Hou. 'With iron deficiency, you start to feel the common symptoms. With anemia, there is a lower amount of hypochromic in your body and the red blood cells change."
Our bodies need iron to produce hemoglobin, a protein in red blood cells. Red blood cells help carry oxygen to the rest of our body. According to the American Red Cross, approximately 70 per cent of our body's iron is found in hemoglobin.
If iron deficiency isn't treated properly, it can impact our production of hemoglobin. This would be a sign that a person's iron stores are so low they are now considered anemic.
What are the symptoms of anemia?
People with anemia may experience symptoms like:
Extreme fatigue
Weakness
Pale skin
Dizziness and/or lightheadedness
Craving for ice, dirt
Poor appetite
Brittle nails
Who is at risk for iron deficiency?
Women are more likely to develop iron deficiency due to the amount of blood that can be lost during a menstrual cycle, along with women who aer pregnant and breastfeeding.
Hou also noted athletes, particularly female athletes, can be high-risk for iron deficiency.
'Athletes in general have higher iron requirements. You lose iron through your sweat, so during exercise you lose iron through that,' she said. 'Teenagers already have higher iron requirements because they are growing, iron is something that is being used when making bodily tissues, so that is already high. Younger female athletes probably first started their menstruation and therefore experience blood loss.'
Hou also pointed out that vegetarians and vegans are a 'high risk population' to iron deficiency because they mostly consume foods nonheme iron, which is less "efficiently' stored in our bodies.
Foods high in iron
Heme sources of iron, which are found in animal-based foods, include:
Red meat (beef, lamb, pork)
Poultry
Liver/kidney meats
Seafood
Shellfish
Non-heme sources of iron for people who want to eat less meat:
Nuts
Legumes
Leafy greens
Tofu
Beans/soybeans
Seeds
How can iron deficiency be managed?
According to Hou, one of the best ways to alleviate the symptoms of iron deficiency is to undergo a diet change that involves higher intake of iron. It it can take up to six months to feel a difference, so boosting one's iron levels is not just a one-and-done task.
'It's not like you eat a high-iron meal and tomorrow it will all go back to normal, it takes time,' she said.
Having your iron levels assessed by a medical professional is key. Your healthcare provider may suggest supplements or further treatment based on the results.
Understanding iron supplements
There are several different kinds of iron supplements that vary in the amount of elemental iron they provide by weight.
Ferrous sulfate: 20 per cent elemental iron
Ferrous gluconate: 12 per cent elemental iron
Ferric citrate: Approximately 21 per cent elemental iron
Ferrous fumarate: 33% elemental iron
Ferric sulfate: Approximately 27% elemental iron
Although the elemental iron levels may vary by product, it should be readily available on the product's label.
Depending on your doctor's recommended dosage, it can take anywhere from one to four weeks to feel better.
How to properly take iron supplements
It's important to take your iron supplements as prescribed by your healthcare provider. There are some common mistakes that people make which could be impacting the effectiveness of your supplements. Iron supplements should be taken on an empty stomach approximately one to two hours before meals.
Similarly, you should avoid drinking milk or caffeine (coffee, tea or cola) for approximately two hours after taking your supplements, since they can impact how your body absorbs iron. Taking your supplements with foods high in vitamin C can help your body absorb iron.
Always ask your doctor how iron supplements can interfere with other medications you're taking. For example, iron supplements can prevent the body from absorbing certain medications that treat high blood pressure and osteoporosis. You may need to adjust how and when you're taking your medications.
Iron supplement side effects
Iron supplements can potentially cause side effects like:
Stomachaches (your healthcare provider may recommend taking supplements with food )
Nausea
Diarrhea
Darkened stool
Heartburn
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