Iron: Overview

One of the most studied nutrients in history, iron deficiency and toxicity are well understood and researched.  Most of the iron in our bodies is complexed with hemoglobin and is essential for oxygen transport in the blood.  Iron deficiency is a major problem in under-developed countries and is the most commonly deficient nutrient in the world.  Fortification of various products is wide-spread in the United States and around the world to combat this deficiency.

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The absorption of iron takes place in the duodenum and upper jejunum (small intestine).  Of total iron intake, only 5-15% is absorbed.  Absorption depends on many factors: the body's requirement (during deficiency state absorption will be better); type of iron (ferric or ferrous form); and concurrent intake of some food items or medication (citrus fruit increase absorption whereas medicines such as antacids can reduce absorption).

Diets based on cereals permit only low levels (2-5%) of absorption, while diets containing low levels of cereals and high levels of meat and fish permit 10-20% absorption.  Oxalates and phytates in the diet, as well as its protein quantity, affect the absorption also.  Presence of vitamin C enhances the iron absorption, which is why consuming citrus fruit along with iron helps.  An excess of calcium or intestinal parasites such as hookworm is believed to reduce absorption of iron.


Tips for Getting and Absorbing Iron:

  • Eat foods that are good sources of iron.  Concentrate on green, leafy vegetables, lean, red meat, beef liver, poultry, fish, wheat germ, oysters, dried fruit, prune juice and iron-fortified cereals.
  • Eat foods high in vitamin C, such as citrus fruits, tomatoes, and strawberries.  Vitamin C helps your body absorb iron from food.
  • If you drink tea, drink it between meals because the tannins in tea inhibit iron absorption.  Alternatively, add milk to the tea – the calcium in milk binds with the tannins.  (Herbal tea does not have tannins.)
  • Take an iron supplement, but check with your doctor first.  Note: Recent research is suggesting that high levels of iron in the blood may increase the risk for heart attacks.
  • Avoid antacids, phosphates (found in soft drinks, beer, ice cream, etc.), and the food additive EDTA.  These block iron absorption.

Various salt forms of iron exist, chelated sources of iron are also excellent sources of this mineral when supplementation is necessary.


Unfortunately, too much iron can lead to oxidative stress (forming excessive free radicals) and adhesion of blood cells.  The iron load on most males in developed countries is sufficient and in many cases in excess.  It is for this reason that many studies do not recommend that men take supplemental iron.  Recent studies have also shown that nearly 90% of women (in the United States) within child-bearing ages are not deficient in iron.  The current US RDA for iron is 18mg.

Iron can help with the following:


Iron Deficiency Anemia

Iron supplementation, with as much as 200mg of elemental iron per day, is the obvious therapy for treating and preventing the recurrence of iron deficiency anemia.  Note, however, that it is dangerous to take iron supplements without first having ferritin levels tested, as taking iron when it is not called for can cause iron overload disorder, potentially a dangerous condition.

Not recommended for

Dental / Oral


Atrophic Gastritis

Ferric iron absorption is decreased in achlorhydria but heme iron absorption is not.


Menorrhagia (Heavy Periods)

The following observations have been made regarding iron:

  • Positive response to iron supplementation alone in 74 of 83 patients (in whom organic pathology had been excluded)
  • A high rate of organic pathology found (fibroids, polyps, adenomyosis, etc.)  in the patients who failed to respond to iron supplementation
  • A decreased response to iron therapy when initial serum iron levels were high
  • A correlation exists between menorrhagia and depleted tissue iron stores (bone marrow) irrespective of serum iron level, thus serum ferritin may be a better test than serum iron
  • A well-controlled study showed improvement in 75% of those on iron supplementation, compared with 32.5% for a placebo group.

'Heme' iron (from meat) is 10 times more absorbable than most other forms of iron.

Pregnancy-Related Issues

Iron is routinely prescribed for pregnant women during the second and third trimesters, when blood volume increases by 50% and the growing baby is also making blood.  Hemoglobin, the blood component that carries oxygen to the cells, is composed in part of iron.  During pregnancy, the baby receives plenty of this critical mineral because the mother's body absorbs iron more efficiently. [Eskeland B, et al. Acta Obstetricia et Gynecologica Scandinavia 1997;76: pp.822-8]

There is some controversy about whether iron supplementation is really needed or effective, except for women such as diabetics or those with anemia, whose iron deficiency is a real threat. [Lao TT, Tami KF. Diabetes Care 1997;20(9): pp.1368-9]  Iron supplementation for anemia often fails because women don't take iron long enough, say researchers at the University of California, Berkeley.  They suggest beginning iron supplementation before conception and continuing until breastfeeding is finished. [Viteri FE. Nutr Rev 1997;55(6): pp.195-9]

The best way to get iron is from natural foods.  Iron supplements may cause nausea and constipation, making the common discomforts of pregnancy worse.  Too much iron is also bad for the circulation.  If a doctor recommends iron supplements, iron chelate is better tolerated by the body and is available from drugstores.  The U.S. RDA is 30mg.



Boils, Abscesses, Carbuncles

Recurrent boils are sometimes associated with low iron levels.


Vitamin B12 Requirement

Extra iron may be needed in severe cases.


Restless Leg Syndrome

RLS has been associated with an iron deficiency as measured by low ferritin levels.  The anemia that results from an iron deficiency may or may not have appeared yet; patients whose serum ferritins were lowest initially improved the most.

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Iron can help prevent the following:


Not recommended for
Parkinson's Disease

Avoiding overexposure to some metals, especially iron, can reduce the risk of developing Parkinson's disease.

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