Iron is an essential mineral. It is part of our blood cells and found in every cell of the human body. Blood cells contain hemoglobin while muscles have myoglobin; both carry oxygen to all tissues of the body.
According to the USDA recommendations, men and women differ in their iron needs (8 mg for men versus 18 mg for women), while pregnant women need almost double (30 mg). Supplementation is a must during pregnancy as iron rich foods are not sufficient to cover the increased demand.
Iron deficiency anemia occurs when hemoglobin count is low and red blood cells lack sufficient oxygen due to low iron in the body. Iron supplements may be prescribed by your physician if blood tests show decreased iron absorption, low consumption or increased physiologic need. It is important to rule out other types of anemia, such as folic acid anemia or B12 anemia, before consuming iron supplements. When low in iron, you may experience fatigue, loss of energy, shortness of breath, headaches, difficulty concentrating, as well as unusually rapid heartbeat.
Those commonly at risk for low iron include menstruating women with heavy periods, pregnant and postpartum women (extra iron is needed for the growing fetus), 6-9 month old infants transitioning to solid foods (which must be high in iron, such as iron-rich cereals as iron stores last about six months), toddlers who develop milk anemia (milk is low in iron--toddlers may drink too much milk and not consume other solid foods), vegans or strict vegetarians, long-distance runners, those that donate blood often or those with absorption problems in the GI tract.
What to Look for
Depending on your particular needs, products vary widely by dose, by type of iron, and by form (chewable tablet, time-release tablet, liquid) and some contain additional ingredients. Physicians may prescribe a multivitamin containing iron together with other vitamins and minerals or just an iron supplement. These are best absorbed on an empty stomach or at least 2 hours after a meal.
In March 1999, the Dietary Supplement Health Education Act (DSHEA) established new label standards to ensure that consumers receive adequate information regarding supplements. While not required by DSHEA, it is preferable to purchase a supplement with an expiration date and lot or batch number.
Federal law requires manufacturers to ensure their products are safe and follow the Good Manufacturing Practices (GMP). Some companies apply strict regulations while others follow the US Pharmacopeia (USP) standard used to manufacture pharmaceutical drugs. Depending on the program, special "approval seals" may be allowed on the labels of supplements.
Combine iron supplements with foods high in iron, including animal protein-rich foods: oysters, liver, red meat (especially beef), poultry, dark red meat, tuna, salmon, lamb, pork and shellfish. Plant sources, such as iron-fortified cereals, dried beans, whole grains and dark leafy greens are not well absorbed, unless combined with vitamin C rich foods, which increase iron absorption.
Common Pitfalls
Interactions with other drugs (antibiotics, antacids), high fiber foods or foods rich in calcium are common; this can lead to decreased iron absorption. If you are taking calcium supplements or other phosphate binders, be sure to space the iron at least 1 hour apart because they will bind to iron and prevent absorption.
Be cautious of supplements that contain more than the 100% dosage for your age (unless prescribed by your physician) to avoid iron toxicity. The same applies to children; keep iron supplements and other multivitamins out of children's reach to avoid accidental poisoning in toddlers. Symptoms of iron overload can include fatigue, vomiting, diarrhea, headache, irritability and joint problems.
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