Iron Why do I need iron?

Iron
Why do I need iron?
Iron is a mineral that carries oxygen through the body. With low levels of Iron, you can become very
tired, pale-looking and irritable. Certain groups such as young children, pregnant and pre-menopausal
women, some athletes, vegetarians and many older adults are at a higher risk of not getting enough
Iron in their diets.
Food sources of iron
There are two forms of dietary Iron: “heme” and “non-heme”. Heme iron is found in animal foods such
as meat, poultry and fish. Iron found in plant foods, including dried beans, peas, lentils, nuts and
some fruits and vegetables, is non-heme Iron. Non-heme Iron is added to enriched and iron-fortified
foods including grain products like flour, pasta and breakfast cereals. Heme-iron is absorbed better
than non-heme iron. Your body increases the absorption of non-heme iron when eaten with heme
containing foods (meat, poultry and fish) or a source of vitamin C (such as citrus fruits and juices,
cantaloupe, strawberries, broccoli, tomatoes and peppers).
How much iron do I need?
Age in years
Aim for an intake of *
milligrams (mg)/day
8
18
8
27
9
Stay below *mg/day
Men 19 and older
45
Women 19-50
45
Women 51 and older
45
Pregnant women 19 and older
45
Breastfeeding women 19 and
45
older
* This includes sources of Iron from food (heme and non-heme) as well as supplements
Source (Dietitians of Canada, 2011)
Food choices for iron
 Selected food sources of heme iron
Food
Serving size
Iron (mg)
Liver (chicken, turkey, lamb)
75g (2 ½ oz)
6.2-9.7
cooked**
Duck, cooked
75g (2 ½ oz)
2.0-7.4
Beef, various cuts, cooked
75g (2 ½ oz)
1.4-3.3
Turkey, various types, cooked
75g (2 ½ oz)
1.0-2.0
Chicken, various types, cooked 75g (2 ½ oz)
0.4-2.0
Pork, various cuts, cooked
75g (2 ½ oz)
0.6-1.1
Oysters
75g (2 ½ oz)
3.3-9.0
Shrimp
75g (2 ½ oz)
2.3
Sardines, canned
75g (2 ½ oz)
1.7-2.2
Clams, canned
75g (2 ½ oz)
2.1
Tuna, light, canned in water
75g (2 ½ oz)
1.2
**Pregnant women should limit intake of liver to one serving every two weeks Source (Health
Canada, “Canadian Nutrient File”, 2007; as cited in Dietitians of Canada, 2011)
 Selected food sources of non-heme iron
Food
Serving size
Iron (mg)
Cream of wheat, all types,
175ml (3/4 cup)
5.7-5.8
cooked
Cereal, dry, all type
30g (check product label)
4.0
Oatmeal, instant, cooked
175ml (3/4 cup)
5.1-6.3
Spinach, cooked
125ml (1/2 cup)
3.4
Pumpkin or squash seeds
60ml (1/4 cup)
8.6
Tofu
175ml (3/4 cup)
7.3-8.0
Soybeans, mature, cooked
175ml (3/4 cup)
6.5
Lentils
4.9
3.3-9.0
Beans (white, kidney, navy,
175ml (3/4 cup)
2.6-4.9
pinto, black, roman/cranberry),
cooked
Nuts (cashews, almonds,
60ml (1/4 cup)
1.3-2.2
hazelnuts, macadamia,
pistachio, nuts), without shell
Blackstrap molasses
175ml (3/4 cup)
3.6
Source (Health Canada, “Canadian Nutrient File”, 2007; as cited in Dietitians of Canada, 2011)
How will I know that I am deficient in iron?
The best blood test for Iron deficiency screening is “serum ferritin”. Low
serum ferritin results indicate that iron stores are depleted. However, in the
presence of certain conditions iron stores will not be accurately measured.
Serum Ferritin levels of <15 ug/L (<12 in children): Diagnostic of
iron deficiency
Serum Ferritin levels of <15-50 ug/L: Depletion of stored iron, probable iron deficiency
Serum Ferritin levels of <51-100 ug/L: Reduced iron stores, possible iron deficiency
My level was:_______________ug/L
Date:___________________
** Iron deficiency could be due to increased requirements, increased loss, decreased intake, or
decreased absorption.
It is recommended that you take the following:
 Iron tablets (Ferrous Fumarate): 100 mg of elemental iron
 Iron capsules (Ferrous Gluconate): 100 mg recommended, each capsule contains 35 mg of
elemental iron
 Liquid iron supplement: 1 tbsp. (15 ml) a day
 Iron injections: As recommended by a
healthcare provider
Important notes:
 It takes at least 1 month for iron to be restored in the blood and at least 3 months to be
restored in body cells, so the recommendation is to take iron supplements for at least 3
months to see an effect.
 For iron supplementation in the capsule and tablet form, the recommendation is 100-200 mg of
elemental iron a day.
 Iron in the “capsule form” contains pork derived gelatin. If you avoid pork for any reason,
please talk to your pharmacist for the most appropriate form of supplementation for you such
as tablets, liquid iron, or injections.
 The liquid form could be beneficial for those who have difficulty with
swallowing.
 Liquid iron supplements may stain the teeth. It is recommended to
sip through a straw to prevent staining.
What are the common side effects of iron supplements?
 To improve iron absorption from tablet/capsules, it may be suggested to take iron
tablet/capsules on an empty stomach. However, iron supplements in tablet/capsule form may
be hard on your stomach. In this case, you may need to take your iron tablet/capsule with
meals (with foods that don’t interfere with iron absorption).
 To address stomach upset, FeraMax/Proferrin may be recommended.
 Another common side effect of iron supplements is constipation, which can be managed with
lifestyle modifications including increased intake of fluids and fiber. Your doctor may also
recommend a stool softener.
 Iron may turn your stools black. Discoloration of stools is a harmless side effect resulting from
unabsorbed iron.
Do iron supplements have any interactions with
medications?
 Iron supplements may interact with the following medications. If
you are on Sipro, Synthroid, Quinolones, or Bisphosphate,
please talk to your doctor or pharmacist
 If on any medications, it is recommended to take medications 2
hours before taking any iron supplement
Do I need to have blood work done again for Iron?
 Yes, I should have my iron level tested again (a requisition for blood work will be provided)
 No, I do not need to get my iron level tested again
References:
Dietitians of Canada (2011). Increasing your iron intake: Practice-based Evidence in Nutrition [PEN].
Retrieved from:
http://www.pennutrition.com.ezproxy.lib.ryerson.ca/viewhandout.aspx?Portal=UbY=&id=JMfsUQw=&PreviewHandout=bA==Access only by
subscription
Dietitians of Canada (2011). Food sources of iron: Practice-based Evidence in Nutrition [PEN].
Retrieved from: http://www.pennutrition.com.ezproxy.lib.ryerson.ca/viewhandout.aspx?Portal=UbY=&id=JMLnUAQ=&PreviewHandout=bA==.
Access only by subscription
Ontario Association of Medical Laboratories (2012). Guidelines for the Use of Serum Tests for Iron
Deficiency (CLP 002) Retrieved from:
http://www.oaml.com/documents/IronDeficiencyFinalMarch2012.pdf