Iron Deficiency: The Most Common Nutritional Deficiency and How to Fix It
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Why Iron Is Essential
Iron is the central atom of hemoglobin — the protein that carries oxygen in red blood cells. It is also in myoglobin (muscle oxygen storage) and dozens of enzymes. Without adequate iron, red blood cells become small and pale (microcytic anemia), unable to carry sufficient oxygen. Result: fatigue, weakness, impaired cognitive function, reduced exercise capacity.
Heme vs Non-Heme Iron
Heme iron (from animal foods): 15–35% absorption rate. Found in red meat, poultry, fish. Not affected by most dietary factors. Non-heme iron (from plant foods): 2–20% absorption. Found in legumes, spinach, fortified cereals, tofu. Absorption is enhanced by vitamin C and inhibited by phytates (whole grains), polyphenols (tea, coffee), calcium.
Signs of Iron Deficiency
Fatigue and weakness (most common). Pale skin, pale inner eyelids. Brittle nails and hair loss. Restless legs syndrome. Pica (craving ice, dirt, starch). Shortness of breath with activity. Cold hands and feet. Decreased concentration and memory. ADHD-like symptoms in children.
Who Is At Risk
Menstruating women (monthly blood loss depletes iron). Pregnant women (3× higher iron requirement in T3). Infants and toddlers (rapid growth). Endurance athletes (foot-strike hemolysis, GI losses). Vegans/vegetarians (only non-heme iron available, lower bioavailability). Regular blood donors. Those with celiac, IBD, or gastric bypass.
Best Food Sources
Clams (85g cooked): 23.8 mg (132% DV). Beef liver (85g cooked): 5.8 mg. Oysters (85g cooked): 7.8 mg. Dark chocolate (28g): 3.4 mg. Tofu (100g): 2.7 mg. Lentils (100g cooked): 3.3 mg. Spinach (100g raw): 2.7 mg. Fortified cereals: varies (up to 18 mg/serving).
Supplementing Iron Correctly
Only supplement with confirmed deficiency (blood test: ferritin, CBC). Ferrous bisglycinate is best tolerated (least GI upset). Ferrous sulfate is most studied — take on an empty stomach for best absorption but with food if stomach upset occurs. Never take calcium or antacids within 2 hours. Take with vitamin C to enhance absorption. Retest ferritin after 3 months.
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