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Made By Diet\u00ae<\/sup><\/div>\n<\/div>\nIron Deficiency in the Elderly<\/h3>\n
Iron deficiency in the elderly population is a serious issue that can lead to specific health problems, including anemia, weakened immune function, and exacerbation of chronic conditions such as heart failure and chronic obstructive pulmonary disease (COPD). Reduced iron absorption in seniors often occurs due to gastric mucosal atrophy and decreased secretion of hydrochloric acid, which hampers the conversion of non-heme iron into a more absorbable form. Additionally, chronic inflammatory conditions common in older adults can increase hepcidin levels, reducing iron bioavailability by inhibiting its release from macrophages and hepatocytes<\/strong>.<\/p>\n
Iron deficiency in this age group can also contribute to muscle weakness, increased risk of falls, and cognitive decline, significantly impacting the quality of life and independence of seniors. Effective management of iron deficiency in older adults requires a multidisciplinary approach that includes diagnosing the complex causes of deficiency, regular monitoring of blood parameters, and support through a well-tailored diet, as well as supplementation or pharmacological treatment when necessary.<\/p>\n
Identifying the causes of iron deficiency is crucial for implementing effective dietary therapy<\/em> and treatment<\/strong>, helping to prevent serious health consequences.<\/p>\n
7. What Hinders Iron Absorption („Leaches Iron”)?<\/h2>\nAlthough the absorption of iron from animal sources is not significantly affected by other dietary components (see Chapter 2<\/a>), several groups of compounds can hinder the absorption of plant-based (non-heme) iron. These include:<\/p>\n
\n- Phenolic Compounds (Tannins)<\/strong>: Tannins, found mainly in coffee and tea, are phenolic compounds with strong binding properties. They form insoluble complexes with iron, reducing its absorption in the intestines. To minimize their negative impact, it is recommended to consume coffee and tea at least one hour after meals rich in iron<\/strong>.<\/li>\n
- Phytates<\/strong>: Phytic acid and its salts (phytates) are found in whole grain products, nuts, and legumes. Like tannins, phytates form insoluble complexes with iron, limiting its absorption. People on plant-based diets should be particularly cautious. Thermal processing (cooking, baking) can reduce phytate content but may also lead to a loss of vitamin C, which is crucial for iron absorption. Therefore, it is beneficial to pair phytate-rich foods with vitamin C sources<\/strong>.<\/li>\n
- Calcium Salts<\/strong>: Calcium, present in milk, dairy products, and highly mineralized water, can reduce iron absorption since both minerals are absorbed in similar areas and may compete for the same transport mechanisms<\/strong>. It is advisable to avoid combining iron-rich foods with dairy and highly mineralized water during meals.<\/li>\n
- Phosphorus Salts<\/strong>: Phosphorus compounds, such as phosphates, can hinder iron absorption by forming poorly soluble salts, such as iron phosphate, which reduce iron\u2019s bioavailability. Products high in phosphorus, like Coca-Cola, may lower the efficiency of non-heme iron absorption when consumed regularly.<\/li>\n
- Oxalates<\/strong>: Oxalic acid and oxalates found in vegetables like spinach and rhubarb can negatively impact the absorption of plant-based iron by forming insoluble complexes with iron. Oxalic acid binds with iron, creating complexes that are difficult to absorb. To minimize this effect, consume oxalate-rich foods, such as sorrel, spinach, Swiss chard, and rhubarb, in moderate amounts and separate from iron-rich meals.<\/li>\n
- Mineral Antagonism (Zinc, Manganese)<\/strong>: Zinc and manganese can compete with iron for the same transport mechanisms in the intestines, potentially reducing iron absorption. Although all these minerals are essential for health, be mindful of their combination in your diet. If you take supplements, avoid consuming zinc and manganese (e.g., multivitamin supplements) alongside iron-rich foods to prevent limiting iron absorption.<\/strong> For the optimal distribution of these supplements, it\u2019s best to consult with an experienced dietitian or physician.<\/li>\n<\/ol>\n
[\/vc_column_text][vc_single_image media=”2013″ media_lightbox=”yes” media_width_percent=”100″ uncode_shortcode_id=”485344″][vc_column_text uncode_shortcode_id=”116831″]Figure 7. Iron Deficiency and the Vegetarian Diet.<\/strong> For individuals following a plant-based diet, enhancing the bioavailability of non-heme iron, their sole source of this mineral, is crucial. Vitamin C (ascorbic acid), found in citrus fruits and kiwi, significantly improves iron absorption by converting trivalent iron (Fe\u00b3\u207a) into the more absorbable divalent form (Fe\u00b2\u207a).<\/p>\n
8. Iron Absorption Enhancers<\/h2>\nBy composing your meals appropriately, you can significantly enhance iron absorption. It\u2019s important to note that certain food components can increase the absorption of this mineral, which is crucial for maintaining its optimal level in the body. Here\u2019s how to effectively support iron absorption through the right selection of food products.<\/p>\n
Iron and Vitamin C<\/h3>\n
Vitamin C (ascorbic acid) significantly enhances the absorption of non-heme iron. It acts as a reducing agent, converting non-heme iron from the trivalent form (Fe\u00b3\u207a), which is poorly absorbed, to the divalent form (Fe\u00b2\u207a), which is much better absorbed in the small intestine.<\/strong> It is beneficial to combine sources of vitamin C with iron-rich foods, as this can increase iron bioavailability severalfold! [3]<\/p>\n
Which Foods Have the Most Vitamin C?<\/h4>\nThe highest amounts of ascorbic acid can be found in:<\/p>\n
\n- Citrus fruits<\/strong> (lemons, oranges, grapefruits)<\/li>\n
- Kiwi<\/strong><\/li>\n
- Black currants<\/strong><\/li>\n
- Vegetables<\/strong>: red bell pepper, parsley, broccoli, cauliflower, Brussels sprouts<\/li>\n
- Fermented foods<\/strong>: sauerkraut, sourdough bread<\/li>\n<\/ul>\n
Keep in mind that vitamin C is sensitive to high temperatures, so it’s best to consume foods containing it in their raw form (e.g., in salads or slaws) or minimally processed.<\/p>\n
Acidic Environment (Low pH of Stomach Acid)<\/h3>\nAn acidic environment in the stomach promotes better iron absorption. Examples of products that lower pH and can enhance iron absorption include:<\/p>\n
\n- citrus fruits<\/strong> (lemons, oranges, grapefruits),<\/li>\n
- apple cider vinegar<\/strong>, and<\/li>\n
- fermented foods<\/strong> (such as sauerkraut and pickles).<\/li>\n<\/ul>\n
For the same reason, you should avoid consuming alkaline drinks and foods like milk directly before or after iron-rich meals.<\/p>\n
Presence of Amino Acids<\/h3>\n
Amino acids, such as histidine<\/strong> and lysine<\/strong>, found in meat, poultry, fish, and human milk, support iron absorption. Including protein sources in meals enhances the efficiency of iron uptake.<\/p>\n
Presence of Fructose<\/h3>\nFructose, found in fruits, also supports iron absorption. It is beneficial to include fruits rich in fructose, such as apples, pears, melons, and mangoes, in your diet to enhance iron absorption.[\/vc_column_text][vc_single_image media=”2014″ media_lightbox=”yes” media_width_percent=”100″ uncode_shortcode_id=”164402″][vc_column_text uncode_shortcode_id=”679695″]Figure 8. Supplementation, Iron Deficiency, and Health.<\/strong> Numerous studies indicate that improper treatment of iron deficiency in adults, such as overly frequent intake of iron supplements, can actually reduce its absorption from the gastrointestinal tract. This effect is primarily due to increased levels of hepcidin. Therefore, addressing iron deficiency should ideally be preceded by consultation with a dietitian or physician.<\/p>\n
9. Iron Supplementation<\/h2>\nCan Iron Tablets Replace Dietary Iron?<\/h3>\n
Although dietary supplements can effectively address iron deficiency, they should not be used as substitutes for food, and certainly not for preventive purposes<\/strong>. The key principle should be „food first”\u2014prioritize diet. Before opting for supplements, focus on enriching your meals with iron-rich foods (see Chapter 3<\/a>). A well-balanced diet, rich in this mineral, will usually restore adequate iron levels in the body while providing many other valuable nutrients.<\/p>\n
Is Iron Supplementation Worth It?<\/h3>\nIn cases of diagnosed iron deficiency, when a diet rich in this mineral proves insufficient, supplementation may become necessary. Due to the need to determine appropriate iron dosages, the risk of iron overload<\/strong>, and the potential for side effects, iron supplements should be used only after consultation with a dietitian or doctor.<\/strong><\/p>\n
How to Use Iron Supplements?<\/h3>\nNumerous studies indicate that frequent administration of iron supplements can impair its absorption from the gastrointestinal tract. The increase in hepcidin levels stimulated by the first dose inhibits the absorption of subsequent doses by 35\u201345% for at least 24 hours. This adverse effect intensifies with higher doses. [19, 21].
\nGuidelines for Taking Oral Iron Supplements:<\/strong><\/p>\n
\n- Taking on an Empty Stomach<\/strong>: Iron supplements should be taken on an empty stomach or at least two hours after a meal, accompanied only by water or fruit juice (preferably citrus), as most other beverages significantly reduce iron absorption.<\/li>\n
- Avoiding Certain Foods<\/strong>: Avoid consuming foods high in fiber, dairy products, and those containing phytates, phosphates, or calcium around the time of supplementation.<\/li>\n
- Interactions with Medications<\/strong>: Iron supplements should not be taken with certain medications, particularly proton pump inhibitors, antacids, and some antibiotics (fluoroquinolones, tetracyclines), as these significantly decrease iron absorption.<\/li>\n
- Competition with Other Minerals<\/strong>: Avoid taking supplements containing zinc and manganese simultaneously with iron, as they compete for the same absorption sites.<\/li>\n
- Morning or Evening Supplementation<\/strong>: Iron is best taken when hepcidin levels are lowest, such as in the evening. Due to high hepcidin levels during physical activity, it is advisable to schedule iron supplementation away from workout times.<\/li>\n<\/ol>\n
Forms of Iron in Supplements<\/h3>\nAccording to European Union regulations [27], 17 iron compounds can be used in dietary supplements. Below are some of the most popular:<\/strong><\/p>\n
Inorganic Iron (Ferrous, Fe\u00b2\u207a):<\/strong><\/p>\n
\n- Ferrous Sulfate (FeSO\u2084): <\/strong>The most commonly used iron salt in supplements, considered the standard. It is well absorbed but may cause side effects like stomach pain or constipation.<\/li>\n
- Ferrous Gluconate (C\u2081\u2082H\u2082\u2082FeO\u2081\u2084): <\/strong>An alternative form with similar bioavailability, potentially causing fewer side effects.<\/li>\n
- Ferrous Fumarate (C\u2082H\u2082(COO)\u2082Fe): <\/strong>Similar properties as the above.<\/li>\n<\/ul>\n
Inorganic Iron (Ferric, Fe\u00b3\u207a):<\/strong><\/p>\n
\n- Ferric Pyrophosphate (Fe\u2084O\u2082\u2081P\u2086): <\/strong>Available as sucrosomal iron<\/strong>, where ferric pyrophosphate molecules are protected by a double phospholipid membrane patented as Sucrosome\u00ae. This form is designed for better bioavailability and excellent tolerance [22].<\/li>\n<\/ul>\n
Organic Iron (Ferrous, Fe\u00b2\u207a):<\/strong><\/p>\n
\n- Ferrous Bisglycinate (C\u2084H\u2081\u2080FeN\u2082O\u2084): <\/strong>A chelate of iron with glycine, classified as organic iron, where the central iron atom (Fe\u00b2\u207a) is bound to ligands, forming a stable complex<\/strong>. It is more easily absorbed than inorganic iron salts and is well tolerated.<\/li>\n<\/ul>\n
Elemental Iron:<\/strong><\/p>\n
\n- Elemental Iron: <\/strong>Iron in its free state <\/strong>that ionizes in the gastrointestinal tract. It has high bioavailability and causes fewer side effects compared to soluble iron salts.<\/li>\n<\/ul>\n
Iron supplements are often combined with vitamin C and folic acid. There are also sustained-release (SR) formulations of iron, which can be suitable for individuals who do not tolerate immediate-release oral preparations. Additionally, products containing heme iron, such as powdered hemoglobin, are available on the market.<\/strong><\/p>\n
In cases of overdose, iron can have toxic effects on the body, which is why the maximum amount of iron allowed in the recommended daily dose<\/strong> of dietary supplements in Poland is set at:<\/p>\n
\n- 20 mg<\/strong> in supplements intended for the general population<\/li>\n
- 30 mg <\/strong>in supplements labeled as dedicated for pregnant women<\/strong> [28]<\/li>\n<\/ul>\n
Side Effects<\/strong><\/h3>\nThe most common side effects associated with oral iron supplementation affect the gastrointestinal tract and include nausea, abdominal pain, constipation, and diarrhea. Dark stool coloration due to the presence of unabsorbed iron is a natural occurrence and is not harmful to health.<\/p>\n
10. Symptoms of Iron Excess: Hemochromatosis<\/h2>\n
Excess iron, although much rarer than deficiency, poses a serious health risk. High levels of iron in the body can lead to significant health problems, which are equally, if not more, concerning than the consequences of iron deficiency. Hemochromatosis, a condition characterized by chronic iron accumulation, is one of the most severe diseases caused by iron overload.<\/p>\n
What Are the Risks of Excess Iron in the Diet?<\/h3>\n
Excess iron in the body is toxic. This condition catalyzes the formation of free radicals, which damage cell membrane lipids and organelles, leading to cell death. High levels of iron enhance collagen synthesis, which can lead to organ fibrosis. In extreme cases, iron deposits accumulate in the liver, pancreas, heart, and gonads, potentially causing permanent damage to these organs. Symptoms of iron overload include abdominal pain, weakness, fatigue, heart rhythm disturbances, darkening of the skin, and joint pain. Prolonged excess iron can lead to cirrhosis of the liver, diabetes, heart failure, and increase the risk of cancers, particularly liver cancer.<\/p>\n
Those at risk of iron overload include individuals engaging in prolonged, uncontrolled supplementation, often motivated by the belief in the ergogenic effects of iron, such as athletes involved in endurance sports like cycling or running.<\/strong> High ferritin levels, indicative of iron overload, are frequently observed in this group. Additionally, individuals with genetic predispositions to hemochromatosis, inheriting mutations in the HFE genes (e.g., C282Y, H63D), are particularly vulnerable to iron excess and should regularly monitor their iron levels.<\/p>\n
11. Summary<\/h2>\nIron plays many crucial roles in the body, from oxygen transport and supporting energy metabolism to influencing gene transcription and strengthening the immune system. Therefore, regular blood tests, at least once a year, are essential to detect any potential deficiencies in time. A lack of iron can lead to serious health issues that are better prevented than treated. A balanced diet rich in natural sources of this mineral can help maintain optimal levels.<\/p>\n
To address iron deficiency, it is advisable to start by increasing the intake of iron-rich foods, both heme (animal-based) and non-heme (plant-based). In many cases, this approach is sufficient to restore balance in the body without the need for supplements.<\/p>\n
Excess iron can be far more dangerous than its deficiency, which is why the decision to supplement should be carefully considered and preceded by a consultation with a dietitian or doctor.<\/p>\n
At Made By Diet\u00ae<\/sup>, we have extensive experience working with individuals struggling with iron metabolism issues. If you need support in creating a diet that provides the right amount of iron or are dealing with anemia or low iron absorption, we are here to help. Together, we will find the best solution for you!<\/p>\n
Book a consultation<\/a><\/p>\n
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- Kunahowicz H., Nadolna I., Iwanow A., Przygoda B., Warto\u015b\u0107 od\u017cywcza wybranych produkt\u00f3w spo\u017cywczych i typowych potraw <\/strong> , wydawnictwo lekarskie PZWL, Warszawa 2012 https:\/\/pzwl.pl\/Wartosc-odzywcza-wybranych-produktow-spozywczych-i-typowych-potraw,78924806,p.html<\/a><\/li>\n
- Rozporz\u0105dzenie Komisji nr\u00a0432\/2012 z\u00a0dnia 16\u00a0maja 2012\u00a0r. ustanawiaj\u0105ce wykaz dopuszczonych o\u015bwiadcze\u0144 zdrowotnych dotycz\u0105cych \u017cywno\u015bci, innych ni\u017c o\u015bwiadczenia odnosz\u0105ce si\u0119 do zmniejszenia ryzyka choroby oraz rozwoju i\u00a0zdrowia dzieci Tekst maj\u0105cy znaczenie dla EOG<\/li>\n
- Przewodnik do rozporz\u0105dzenia (WE) nr 1169\/2011 w sprawie przekazywania konsumentom informacji na temat \u017cywno\u015bci, ma na celu pom\u00f3c wszystkim podmiotom \u0142a\u0144cucha \u017cywieniowego a w szczeg\u00f3lno\u015bci w\u0142a\u015bciwym organom krajowym w lepszym zrozumieniu i prawid\u0142owym stosowaniu rozporz\u0105dzenia. Niniejszy dokument nie posiada oficjalnego statusu prawnego i w razie sporu ostateczn\u0105 interpretacj\u0119 prawa dokonuj\u0105 S\u0105dy Administracyjne.<\/li>\n
- Niedob\u00f3r \u017celaza w krajach rozwijaj\u0105cych si\u0119<\/strong>, Medycyna Praktyczna, 2004 (dost\u0119p 11 sierpnia 2024 r.)<\/li>\n
- Carpenter, C. E., & Mahoney, A. W. (1992). Contributions of heme and nonheme iron to human nutrition.\u00a0<\/strong>Critical Reviews in Food Science and Nutrition<\/em>,\u00a031<\/em>(4), 333\u2013367. https:\/\/doi.org\/10.1080\/10408399209527576<\/a><\/li>\n
- Andrews SC, Treffry A, Harrison PM. Siderosomal ferritin. The missing link between ferritin and haemosiderin? <\/strong> Biochem J. 1987 Jul 15;245(2):439-46. doi: 10.1042\/bj2450439. PMID: 3663170; PMCID: PMC1148141. https:\/\/pubmed.ncbi.nlm.nih.gov\/3663170\/<\/a><\/li>\n<\/ol>\n
[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n<\/section>","protected":false},"excerpt":{"rendered":"
Iron – although present in your body in an amount of only about 4 grams – plays a crucial role, participating in over 180 biochemical reactions! As an integral component of hemoglobin, it is essential for transporting oxygen from the lungs to every cell in the body (except for red blood cells themselves, which rely on anaerobic metabolism).<\/p>\n","protected":false},"author":4,"featured_media":2006,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[19],"tags":[],"class_list":["post-2004","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog"],"yoast_head":"\n
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[\/vc_column_text][vc_single_image media=”2013″ media_lightbox=”yes” media_width_percent=”100″ uncode_shortcode_id=”485344″][vc_column_text uncode_shortcode_id=”116831″]Figure 7. Iron Deficiency and the Vegetarian Diet.<\/strong> For individuals following a plant-based diet, enhancing the bioavailability of non-heme iron, their sole source of this mineral, is crucial. Vitamin C (ascorbic acid), found in citrus fruits and kiwi, significantly improves iron absorption by converting trivalent iron (Fe\u00b3\u207a) into the more absorbable divalent form (Fe\u00b2\u207a).<\/p>\n
8. Iron Absorption Enhancers<\/h2>\nBy composing your meals appropriately, you can significantly enhance iron absorption. It\u2019s important to note that certain food components can increase the absorption of this mineral, which is crucial for maintaining its optimal level in the body. Here\u2019s how to effectively support iron absorption through the right selection of food products.<\/p>\n
Iron and Vitamin C<\/h3>\n
Vitamin C (ascorbic acid) significantly enhances the absorption of non-heme iron. It acts as a reducing agent, converting non-heme iron from the trivalent form (Fe\u00b3\u207a), which is poorly absorbed, to the divalent form (Fe\u00b2\u207a), which is much better absorbed in the small intestine.<\/strong> It is beneficial to combine sources of vitamin C with iron-rich foods, as this can increase iron bioavailability severalfold! [3]<\/p>\n
Which Foods Have the Most Vitamin C?<\/h4>\nThe highest amounts of ascorbic acid can be found in:<\/p>\n
\n- Citrus fruits<\/strong> (lemons, oranges, grapefruits)<\/li>\n
- Kiwi<\/strong><\/li>\n
- Black currants<\/strong><\/li>\n
- Vegetables<\/strong>: red bell pepper, parsley, broccoli, cauliflower, Brussels sprouts<\/li>\n
- Fermented foods<\/strong>: sauerkraut, sourdough bread<\/li>\n<\/ul>\n
Keep in mind that vitamin C is sensitive to high temperatures, so it’s best to consume foods containing it in their raw form (e.g., in salads or slaws) or minimally processed.<\/p>\n
Acidic Environment (Low pH of Stomach Acid)<\/h3>\nAn acidic environment in the stomach promotes better iron absorption. Examples of products that lower pH and can enhance iron absorption include:<\/p>\n
\n- citrus fruits<\/strong> (lemons, oranges, grapefruits),<\/li>\n
- apple cider vinegar<\/strong>, and<\/li>\n
- fermented foods<\/strong> (such as sauerkraut and pickles).<\/li>\n<\/ul>\n
For the same reason, you should avoid consuming alkaline drinks and foods like milk directly before or after iron-rich meals.<\/p>\n
Presence of Amino Acids<\/h3>\n
Amino acids, such as histidine<\/strong> and lysine<\/strong>, found in meat, poultry, fish, and human milk, support iron absorption. Including protein sources in meals enhances the efficiency of iron uptake.<\/p>\n
Presence of Fructose<\/h3>\nFructose, found in fruits, also supports iron absorption. It is beneficial to include fruits rich in fructose, such as apples, pears, melons, and mangoes, in your diet to enhance iron absorption.[\/vc_column_text][vc_single_image media=”2014″ media_lightbox=”yes” media_width_percent=”100″ uncode_shortcode_id=”164402″][vc_column_text uncode_shortcode_id=”679695″]Figure 8. Supplementation, Iron Deficiency, and Health.<\/strong> Numerous studies indicate that improper treatment of iron deficiency in adults, such as overly frequent intake of iron supplements, can actually reduce its absorption from the gastrointestinal tract. This effect is primarily due to increased levels of hepcidin. Therefore, addressing iron deficiency should ideally be preceded by consultation with a dietitian or physician.<\/p>\n
9. Iron Supplementation<\/h2>\nCan Iron Tablets Replace Dietary Iron?<\/h3>\n
Although dietary supplements can effectively address iron deficiency, they should not be used as substitutes for food, and certainly not for preventive purposes<\/strong>. The key principle should be „food first”\u2014prioritize diet. Before opting for supplements, focus on enriching your meals with iron-rich foods (see Chapter 3<\/a>). A well-balanced diet, rich in this mineral, will usually restore adequate iron levels in the body while providing many other valuable nutrients.<\/p>\n
Is Iron Supplementation Worth It?<\/h3>\nIn cases of diagnosed iron deficiency, when a diet rich in this mineral proves insufficient, supplementation may become necessary. Due to the need to determine appropriate iron dosages, the risk of iron overload<\/strong>, and the potential for side effects, iron supplements should be used only after consultation with a dietitian or doctor.<\/strong><\/p>\n
How to Use Iron Supplements?<\/h3>\nNumerous studies indicate that frequent administration of iron supplements can impair its absorption from the gastrointestinal tract. The increase in hepcidin levels stimulated by the first dose inhibits the absorption of subsequent doses by 35\u201345% for at least 24 hours. This adverse effect intensifies with higher doses. [19, 21].
\nGuidelines for Taking Oral Iron Supplements:<\/strong><\/p>\n
\n- Taking on an Empty Stomach<\/strong>: Iron supplements should be taken on an empty stomach or at least two hours after a meal, accompanied only by water or fruit juice (preferably citrus), as most other beverages significantly reduce iron absorption.<\/li>\n
- Avoiding Certain Foods<\/strong>: Avoid consuming foods high in fiber, dairy products, and those containing phytates, phosphates, or calcium around the time of supplementation.<\/li>\n
- Interactions with Medications<\/strong>: Iron supplements should not be taken with certain medications, particularly proton pump inhibitors, antacids, and some antibiotics (fluoroquinolones, tetracyclines), as these significantly decrease iron absorption.<\/li>\n
- Competition with Other Minerals<\/strong>: Avoid taking supplements containing zinc and manganese simultaneously with iron, as they compete for the same absorption sites.<\/li>\n
- Morning or Evening Supplementation<\/strong>: Iron is best taken when hepcidin levels are lowest, such as in the evening. Due to high hepcidin levels during physical activity, it is advisable to schedule iron supplementation away from workout times.<\/li>\n<\/ol>\n
Forms of Iron in Supplements<\/h3>\nAccording to European Union regulations [27], 17 iron compounds can be used in dietary supplements. Below are some of the most popular:<\/strong><\/p>\n
Inorganic Iron (Ferrous, Fe\u00b2\u207a):<\/strong><\/p>\n
\n- Ferrous Sulfate (FeSO\u2084): <\/strong>The most commonly used iron salt in supplements, considered the standard. It is well absorbed but may cause side effects like stomach pain or constipation.<\/li>\n
- Ferrous Gluconate (C\u2081\u2082H\u2082\u2082FeO\u2081\u2084): <\/strong>An alternative form with similar bioavailability, potentially causing fewer side effects.<\/li>\n
- Ferrous Fumarate (C\u2082H\u2082(COO)\u2082Fe): <\/strong>Similar properties as the above.<\/li>\n<\/ul>\n
Inorganic Iron (Ferric, Fe\u00b3\u207a):<\/strong><\/p>\n
\n- Ferric Pyrophosphate (Fe\u2084O\u2082\u2081P\u2086): <\/strong>Available as sucrosomal iron<\/strong>, where ferric pyrophosphate molecules are protected by a double phospholipid membrane patented as Sucrosome\u00ae. This form is designed for better bioavailability and excellent tolerance [22].<\/li>\n<\/ul>\n
Organic Iron (Ferrous, Fe\u00b2\u207a):<\/strong><\/p>\n
\n- Ferrous Bisglycinate (C\u2084H\u2081\u2080FeN\u2082O\u2084): <\/strong>A chelate of iron with glycine, classified as organic iron, where the central iron atom (Fe\u00b2\u207a) is bound to ligands, forming a stable complex<\/strong>. It is more easily absorbed than inorganic iron salts and is well tolerated.<\/li>\n<\/ul>\n
Elemental Iron:<\/strong><\/p>\n
\n- Elemental Iron: <\/strong>Iron in its free state <\/strong>that ionizes in the gastrointestinal tract. It has high bioavailability and causes fewer side effects compared to soluble iron salts.<\/li>\n<\/ul>\n
Iron supplements are often combined with vitamin C and folic acid. There are also sustained-release (SR) formulations of iron, which can be suitable for individuals who do not tolerate immediate-release oral preparations. Additionally, products containing heme iron, such as powdered hemoglobin, are available on the market.<\/strong><\/p>\n
In cases of overdose, iron can have toxic effects on the body, which is why the maximum amount of iron allowed in the recommended daily dose<\/strong> of dietary supplements in Poland is set at:<\/p>\n
\n- 20 mg<\/strong> in supplements intended for the general population<\/li>\n
- 30 mg <\/strong>in supplements labeled as dedicated for pregnant women<\/strong> [28]<\/li>\n<\/ul>\n
Side Effects<\/strong><\/h3>\nThe most common side effects associated with oral iron supplementation affect the gastrointestinal tract and include nausea, abdominal pain, constipation, and diarrhea. Dark stool coloration due to the presence of unabsorbed iron is a natural occurrence and is not harmful to health.<\/p>\n
10. Symptoms of Iron Excess: Hemochromatosis<\/h2>\n
Excess iron, although much rarer than deficiency, poses a serious health risk. High levels of iron in the body can lead to significant health problems, which are equally, if not more, concerning than the consequences of iron deficiency. Hemochromatosis, a condition characterized by chronic iron accumulation, is one of the most severe diseases caused by iron overload.<\/p>\n
The highest amounts of ascorbic acid can be found in:<\/p>\n
- \n
- Citrus fruits<\/strong> (lemons, oranges, grapefruits)<\/li>\n
- Kiwi<\/strong><\/li>\n
- Black currants<\/strong><\/li>\n
- Vegetables<\/strong>: red bell pepper, parsley, broccoli, cauliflower, Brussels sprouts<\/li>\n
- Fermented foods<\/strong>: sauerkraut, sourdough bread<\/li>\n<\/ul>\n
Keep in mind that vitamin C is sensitive to high temperatures, so it’s best to consume foods containing it in their raw form (e.g., in salads or slaws) or minimally processed.<\/p>\n
Acidic Environment (Low pH of Stomach Acid)<\/h3>\n
An acidic environment in the stomach promotes better iron absorption. Examples of products that lower pH and can enhance iron absorption include:<\/p>\n
- \n
- citrus fruits<\/strong> (lemons, oranges, grapefruits),<\/li>\n
- apple cider vinegar<\/strong>, and<\/li>\n
- fermented foods<\/strong> (such as sauerkraut and pickles).<\/li>\n<\/ul>\n
For the same reason, you should avoid consuming alkaline drinks and foods like milk directly before or after iron-rich meals.<\/p>\n
Presence of Amino Acids<\/h3>\n
Amino acids, such as histidine<\/strong> and lysine<\/strong>, found in meat, poultry, fish, and human milk, support iron absorption. Including protein sources in meals enhances the efficiency of iron uptake.<\/p>\n
Presence of Fructose<\/h3>\n
Fructose, found in fruits, also supports iron absorption. It is beneficial to include fruits rich in fructose, such as apples, pears, melons, and mangoes, in your diet to enhance iron absorption.[\/vc_column_text][vc_single_image media=”2014″ media_lightbox=”yes” media_width_percent=”100″ uncode_shortcode_id=”164402″][vc_column_text uncode_shortcode_id=”679695″]Figure 8. Supplementation, Iron Deficiency, and Health.<\/strong> Numerous studies indicate that improper treatment of iron deficiency in adults, such as overly frequent intake of iron supplements, can actually reduce its absorption from the gastrointestinal tract. This effect is primarily due to increased levels of hepcidin. Therefore, addressing iron deficiency should ideally be preceded by consultation with a dietitian or physician.<\/p>\n
9. Iron Supplementation<\/h2>\n
Can Iron Tablets Replace Dietary Iron?<\/h3>\n
Although dietary supplements can effectively address iron deficiency, they should not be used as substitutes for food, and certainly not for preventive purposes<\/strong>. The key principle should be „food first”\u2014prioritize diet. Before opting for supplements, focus on enriching your meals with iron-rich foods (see Chapter 3<\/a>). A well-balanced diet, rich in this mineral, will usually restore adequate iron levels in the body while providing many other valuable nutrients.<\/p>\n
Is Iron Supplementation Worth It?<\/h3>\n
In cases of diagnosed iron deficiency, when a diet rich in this mineral proves insufficient, supplementation may become necessary. Due to the need to determine appropriate iron dosages, the risk of iron overload<\/strong>, and the potential for side effects, iron supplements should be used only after consultation with a dietitian or doctor.<\/strong><\/p>\n
How to Use Iron Supplements?<\/h3>\n
Numerous studies indicate that frequent administration of iron supplements can impair its absorption from the gastrointestinal tract. The increase in hepcidin levels stimulated by the first dose inhibits the absorption of subsequent doses by 35\u201345% for at least 24 hours. This adverse effect intensifies with higher doses. [19, 21].
\nGuidelines for Taking Oral Iron Supplements:<\/strong><\/p>\n- \n
- Taking on an Empty Stomach<\/strong>: Iron supplements should be taken on an empty stomach or at least two hours after a meal, accompanied only by water or fruit juice (preferably citrus), as most other beverages significantly reduce iron absorption.<\/li>\n
- Avoiding Certain Foods<\/strong>: Avoid consuming foods high in fiber, dairy products, and those containing phytates, phosphates, or calcium around the time of supplementation.<\/li>\n
- Interactions with Medications<\/strong>: Iron supplements should not be taken with certain medications, particularly proton pump inhibitors, antacids, and some antibiotics (fluoroquinolones, tetracyclines), as these significantly decrease iron absorption.<\/li>\n
- Competition with Other Minerals<\/strong>: Avoid taking supplements containing zinc and manganese simultaneously with iron, as they compete for the same absorption sites.<\/li>\n
- Morning or Evening Supplementation<\/strong>: Iron is best taken when hepcidin levels are lowest, such as in the evening. Due to high hepcidin levels during physical activity, it is advisable to schedule iron supplementation away from workout times.<\/li>\n<\/ol>\n
Forms of Iron in Supplements<\/h3>\n
According to European Union regulations [27], 17 iron compounds can be used in dietary supplements. Below are some of the most popular:<\/strong><\/p>\n
Inorganic Iron (Ferrous, Fe\u00b2\u207a):<\/strong><\/p>\n
- \n
- Ferrous Sulfate (FeSO\u2084): <\/strong>The most commonly used iron salt in supplements, considered the standard. It is well absorbed but may cause side effects like stomach pain or constipation.<\/li>\n
- Ferrous Gluconate (C\u2081\u2082H\u2082\u2082FeO\u2081\u2084): <\/strong>An alternative form with similar bioavailability, potentially causing fewer side effects.<\/li>\n
- Ferrous Fumarate (C\u2082H\u2082(COO)\u2082Fe): <\/strong>Similar properties as the above.<\/li>\n<\/ul>\n
Inorganic Iron (Ferric, Fe\u00b3\u207a):<\/strong><\/p>\n
- \n
- Ferric Pyrophosphate (Fe\u2084O\u2082\u2081P\u2086): <\/strong>Available as sucrosomal iron<\/strong>, where ferric pyrophosphate molecules are protected by a double phospholipid membrane patented as Sucrosome\u00ae. This form is designed for better bioavailability and excellent tolerance [22].<\/li>\n<\/ul>\n
Organic Iron (Ferrous, Fe\u00b2\u207a):<\/strong><\/p>\n
- \n
- Ferrous Bisglycinate (C\u2084H\u2081\u2080FeN\u2082O\u2084): <\/strong>A chelate of iron with glycine, classified as organic iron, where the central iron atom (Fe\u00b2\u207a) is bound to ligands, forming a stable complex<\/strong>. It is more easily absorbed than inorganic iron salts and is well tolerated.<\/li>\n<\/ul>\n
Elemental Iron:<\/strong><\/p>\n
- \n
- Elemental Iron: <\/strong>Iron in its free state <\/strong>that ionizes in the gastrointestinal tract. It has high bioavailability and causes fewer side effects compared to soluble iron salts.<\/li>\n<\/ul>\n
Iron supplements are often combined with vitamin C and folic acid. There are also sustained-release (SR) formulations of iron, which can be suitable for individuals who do not tolerate immediate-release oral preparations. Additionally, products containing heme iron, such as powdered hemoglobin, are available on the market.<\/strong><\/p>\n
In cases of overdose, iron can have toxic effects on the body, which is why the maximum amount of iron allowed in the recommended daily dose<\/strong> of dietary supplements in Poland is set at:<\/p>\n
- \n
- 20 mg<\/strong> in supplements intended for the general population<\/li>\n
- 30 mg <\/strong>in supplements labeled as dedicated for pregnant women<\/strong> [28]<\/li>\n<\/ul>\n
Side Effects<\/strong><\/h3>\n
The most common side effects associated with oral iron supplementation affect the gastrointestinal tract and include nausea, abdominal pain, constipation, and diarrhea. Dark stool coloration due to the presence of unabsorbed iron is a natural occurrence and is not harmful to health.<\/p>\n
10. Symptoms of Iron Excess: Hemochromatosis<\/h2>\n
Excess iron, although much rarer than deficiency, poses a serious health risk. High levels of iron in the body can lead to significant health problems, which are equally, if not more, concerning than the consequences of iron deficiency. Hemochromatosis, a condition characterized by chronic iron accumulation, is one of the most severe diseases caused by iron overload.<\/p>\n
- Elemental Iron: <\/strong>Iron in its free state <\/strong>that ionizes in the gastrointestinal tract. It has high bioavailability and causes fewer side effects compared to soluble iron salts.<\/li>\n<\/ul>\n
- Ferrous Bisglycinate (C\u2084H\u2081\u2080FeN\u2082O\u2084): <\/strong>A chelate of iron with glycine, classified as organic iron, where the central iron atom (Fe\u00b2\u207a) is bound to ligands, forming a stable complex<\/strong>. It is more easily absorbed than inorganic iron salts and is well tolerated.<\/li>\n<\/ul>\n
- Ferric Pyrophosphate (Fe\u2084O\u2082\u2081P\u2086): <\/strong>Available as sucrosomal iron<\/strong>, where ferric pyrophosphate molecules are protected by a double phospholipid membrane patented as Sucrosome\u00ae. This form is designed for better bioavailability and excellent tolerance [22].<\/li>\n<\/ul>\n
What Are the Risks of Excess Iron in the Diet?<\/h3>\n
Excess iron in the body is toxic. This condition catalyzes the formation of free radicals, which damage cell membrane lipids and organelles, leading to cell death. High levels of iron enhance collagen synthesis, which can lead to organ fibrosis. In extreme cases, iron deposits accumulate in the liver, pancreas, heart, and gonads, potentially causing permanent damage to these organs. Symptoms of iron overload include abdominal pain, weakness, fatigue, heart rhythm disturbances, darkening of the skin, and joint pain. Prolonged excess iron can lead to cirrhosis of the liver, diabetes, heart failure, and increase the risk of cancers, particularly liver cancer.<\/p>\n
Those at risk of iron overload include individuals engaging in prolonged, uncontrolled supplementation, often motivated by the belief in the ergogenic effects of iron, such as athletes involved in endurance sports like cycling or running.<\/strong> High ferritin levels, indicative of iron overload, are frequently observed in this group. Additionally, individuals with genetic predispositions to hemochromatosis, inheriting mutations in the HFE genes (e.g., C282Y, H63D), are particularly vulnerable to iron excess and should regularly monitor their iron levels.<\/p>\n
11. Summary<\/h2>\nIron plays many crucial roles in the body, from oxygen transport and supporting energy metabolism to influencing gene transcription and strengthening the immune system. Therefore, regular blood tests, at least once a year, are essential to detect any potential deficiencies in time. A lack of iron can lead to serious health issues that are better prevented than treated. A balanced diet rich in natural sources of this mineral can help maintain optimal levels.<\/p>\n
To address iron deficiency, it is advisable to start by increasing the intake of iron-rich foods, both heme (animal-based) and non-heme (plant-based). In many cases, this approach is sufficient to restore balance in the body without the need for supplements.<\/p>\n
Excess iron can be far more dangerous than its deficiency, which is why the decision to supplement should be carefully considered and preceded by a consultation with a dietitian or doctor.<\/p>\n
At Made By Diet\u00ae<\/sup>, we have extensive experience working with individuals struggling with iron metabolism issues. If you need support in creating a diet that provides the right amount of iron or are dealing with anemia or low iron absorption, we are here to help. Together, we will find the best solution for you!<\/p>\n
Book a consultation<\/a><\/p>\n
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- Przewodnik do rozporz\u0105dzenia (WE) nr 1169\/2011 w sprawie przekazywania konsumentom informacji na temat \u017cywno\u015bci, ma na celu pom\u00f3c wszystkim podmiotom \u0142a\u0144cucha \u017cywieniowego a w szczeg\u00f3lno\u015bci w\u0142a\u015bciwym organom krajowym w lepszym zrozumieniu i prawid\u0142owym stosowaniu rozporz\u0105dzenia. Niniejszy dokument nie posiada oficjalnego statusu prawnego i w razie sporu ostateczn\u0105 interpretacj\u0119 prawa dokonuj\u0105 S\u0105dy Administracyjne.<\/li>\n
- Niedob\u00f3r \u017celaza w krajach rozwijaj\u0105cych si\u0119<\/strong>, Medycyna Praktyczna, 2004 (dost\u0119p 11 sierpnia 2024 r.)<\/li>\n
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[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n<\/section>","protected":false},"excerpt":{"rendered":"
Iron – although present in your body in an amount of only about 4 grams – plays a crucial role, participating in over 180 biochemical reactions! As an integral component of hemoglobin, it is essential for transporting oxygen from the lungs to every cell in the body (except for red blood cells themselves, which rely on anaerobic metabolism).<\/p>\n","protected":false},"author":4,"featured_media":2006,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[19],"tags":[],"class_list":["post-2004","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog"],"yoast_head":"\n
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- Andrews SC, Treffry A, Harrison PM. Siderosomal ferritin. The missing link between ferritin and haemosiderin? <\/strong> Biochem J. 1987 Jul 15;245(2):439-46. doi: 10.1042\/bj2450439. PMID: 3663170; PMCID: PMC1148141. https:\/\/pubmed.ncbi.nlm.nih.gov\/3663170\/<\/a><\/li>\n<\/ol>\n
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Iron – although present in your body in an amount of only about 4 grams – plays a crucial role, participating in over 180 biochemical reactions! As an integral component of hemoglobin, it is essential for transporting oxygen from the lungs to every cell in the body (except for red blood cells themselves, which rely on anaerobic metabolism).<\/p>\n","protected":false},"author":4,"featured_media":2006,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[19],"tags":[],"class_list":["post-2004","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog"],"yoast_head":"\n
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