Iron Deficiency and High Cholesterol: Is There a Connection?

If blood tests show you're iron deficient and you have high cholesterol, you may wonder whether there's a connection between the two. But, focus first on the good news — that both of these health concerns can be managed — and learn the steps you need to take.

There's some evidence that in certain populations there may be a connection between low iron and low cholesterol, which may be related to nutrition. But as for a connection between low iron and high cholesterol, "the connection is very poor," says Nancy Berliner, MD, hematologist and professor at Harvard Medical School in Boston. "I wouldn't spend a lot of time thinking about it," she says.

The bottom line: Tackle each test result separately. There are different approaches for addressing iron deficiency and high cholesterol. Work with your doctor to determine what's best for you.

Iron is a mineral that's part of hemoglobin, the substance that helps your red blood cells carry vital oxygen throughout your body, according to the American Society of Hematology (ASH). When your iron level is low (like an iron level 5 g/dL), you could develop anemia, which is a shortage of red blood cells or red blood cells that don't work properly.

This iron-deficiency anemia can cause symptoms, according to the ASH, such as:

• Paleness or yellow skin
• Fatigue
• Shortness of breath or chest pain, particularly when you're active
• Fast heartbeat
• Pounding in your ears
• Brittle nails
• Hair loss

Common causes of iron deficiency include:

• ‌Blood loss‌, often from menstrual periods but also because of surgery, trauma or gastrointestinal (GI) bleeding.
• ‌Pregnancy‌, when the fetus takes iron from the parent.
• ‌Vegan or vegetarian diets‌, which don't include animal sources of iron (plant-based foods also contain iron, but it's harder for your body to absorb).
• ‌GI diseases or surgeries‌, particularly conditions like celiac disease or prior GI procedures such as weight-loss surgery, as these reduce your body's ability to absorb iron from food.

To treat iron deficiency, Dr. Berliner says she usually prescribes oral iron as the first step. As for eating specific foods for iron-deficiency anemia, she says that "it's extremely difficult to replete the iron just through diet."

People often have difficulty taking iron supplements because they can cause GI upset, including constipation. If that happens to you, the formulation you take may make a difference. "Iron gluconate is a little better tolerated than iron sulfate," she says, adding that for severe iron deficiency, doctors can give intravenous iron.

Cholesterol is another material essential to your body. It's a waxy substance used to build cells, according to the American Heart Association (AHA). Your liver makes all the cholesterol you need, but you also get some from the foods you eat.

There are two main kinds of cholesterol. LDL, known as the "bad" cholesterol, contributes to thick deposits inside your arteries that limit the flow of blood and can lead to a heart attack or stroke. HDL is considered the "good" cholesterol because it helps carry bad cholesterol away from your arteries, according to the AHA.

A good way to remember the difference is by the first letter in each: In general, you want your LDL to be low and your HDL to be high.

To improve your cholesterol levels, the AHA recommends:

• ‌Eating a heart-healthy diet.‌ Limit foods that are high in saturated fats. These are typically animal-based foods such as red meat, eggs and whole-milk dairy products. Eating foods that are high in fiber — including fruits, vegetables and whole grains — can also help reduce your LDL cholesterol levels.

• ‌Losing excess weight.‌ Having overweight or obesity can raise your LDL and lower your HDL.

• ‌Getting active.‌ Physical activity can help increase your HDL.

• ‌Quitting smoking.‌ In addition to increasing your risk for heart disease on its own, smoking also lowers good cholesterol.

If these approaches don't improve your cholesterol levels enough, your doctor may prescribe medication that can help.