Do you suffer from low iron?

 Did you know that anaemia is the most common nutritional deficiency around the world
particularly with menstruating females?
So what are the reasons for low iron and how we can help to improve iron levels within the body? 
Let's first look at why iron is important for our health and wellbeing.

Iron plays a crucial role in women's health due to its involvement in various bodily functions.
Iron is an essential component of haemoglobin, the protein in red blood cells that carries
oxygen from the lungs to the body's tissues. Adequate iron levels are necessary to maintain healthy haemoglobin levels
Women of childbearing age often require more iron due to menstrual blood loss. On
average, women lose about 30-40 millilitres of blood per menstrual cycle, which contains
iron. Replenishing iron stores is important to compensate for this loss and prevent iron
deficiency.
Iron needs actually increase during pregnancy to support the growth and development of the foetus, as well as to accommodate the expansion of the maternal blood volume. Iron deficiency during pregnancy can lead to maternal and foetal complications, including
anaemia, preterm birth, low birth weight, and developmental issues.

Iron is involved in the production of adenosine triphosphate (ATP), the main molecule
responsible for storing and releasing energy within cells. Sufficient iron levels are necessary to maintain optimal energy metabolism and to prevent fatigue and weakness.
Iron is essential for a properly functioning immune system. It helps support immune cell
function and the production of antibodies, which play a vital role in defending the body
against infections and diseases.

Adequate iron levels are important for optimal cognitive function, memory, and
concentration. Iron deficiency has been associated with impaired cognitive performance,
especially in children and women.

Did you know that Iron and the thyroid are interconnected in several ways.
Iron is necessary for the synthesis of thyroid hormones, specifically thyroxine (T4) and
triiodothyronine (T3). These hormones regulate the body's metabolism, growth,
development, and energy production. Iron deficiency can impair the production and release of thyroid hormones, leading to hypothyroidism. Its also necessary for the proper transport and utilisation of thyroid hormones in the body. Iron is required for the production of proteins that bind to thyroid hormones and carry them to target tissues. Inadequate iron levels can affect the availability and effectiveness of thyroid hormones in various tissues.

Iron is also involved in the activity of an enzyme called thyroid peroxidase (TPO), which is
crucial for the production of thyroid hormones. TPO helps convert iodide to iodine, which is necessary for the synthesis of T3 and T4. Iron deficiency can affect TPO function, impairing the production of thyroid hormones.
Iron deficiency has also been associated with an increased risk of autoimmune thyroid
diseases, such as Hashimoto's thyroiditis and Graves' disease. Autoimmune thyroid diseases occur when the immune system mistakenly attacks the thyroid gland. As Iron plays a role in regulating immune function, its deficiency may contribute to the development or progression of these conditions.

There are many factors that can affect the absorption of iron and the gut plays a big role. The absorption of iron primarily occurs in the small intestine, specifically the duodenum and proximal jejunum, but we need adequate stomach acid for the absorption of certain forms of dietary iron, known as non-heme iron. Stomach acid helps convert non-heme iron into a more absorbable form. Individuals with low stomach acid production, such as those with certain digestive disorders or those taking acid-suppressing medications, may have reduced iron absorption.
Iron absorption involves the action of specific transporters in the small intestine. These
transporters help move iron from the gut lumen into the bloodstream. Disruptions in the
expression or function of these transporters can affect iron absorption. Gut health conditions that lead to intestinal inflammation or damage, such as celiac disease or inflammatory bowel disease, may impair iron absorption.

The gut microbiota, the community of bacteria residing in the intestines, can influence iron absorption. Some gut bacteria produce substances that can chelate or bind to iron, making it less available for absorption. On the other hand, certain bacteria can enhance iron absorption by producing compounds that increase iron solubility or reduce gut inflammation.
Imbalances in the gut microbiota, such as dysbiosis, can impact iron absorption.
Certain gut conditions, such as celiac disease, Crohn's disease, and ulcerative colitis, can
cause malabsorption of nutrients, including iron. Inflammation, damage to the intestinal
lining, or surgical removal of parts of the intestine can all affect iron absorption. These
conditions may require specific management strategies, including iron supplementation, to address iron deficiency.
Another condition we see commonly in clinical practice is SIBO (small intestine bacterial overgrowth) and this can also lead to deficiency in iron and B12. This is something we test for regularly and symptoms can include bloating, gas, pain, nausea, diarrhoea and or constipation. 

So what else can affect iron levels within the body?

Certain compounds found in plants, such as phytates (in whole grains, legumes, and some
vegetables) and oxalates (in spinach, rhubarb, and beet greens), can bind to iron and inhibit its absorption. However, cooking or processing these foods can help reduce their impact on iron absorption.
Tannins are naturally occurring compounds found in tea, coffee, and some fruits, such as
grapes and pomegranates. They can interfere with iron absorption when consumed
alongside iron-rich foods or iron supplements.

Tea consumption can indeed impact iron absorption in the body. Tea contains compounds
called tannins, which are known to inhibit iron absorption. Tannins bind to iron, forming
complexes that are less easily absorbed by the body.
Both black and green teas contain tannins, but black tea tends to have higher levels. Herbal teas, such as chamomile or peppermint, usually have lower tannin content and may have a milder effect on iron absorption.
While the effect of tea on iron absorption can vary depending on various factors, studies
have shown that consuming tea with meals can reduce iron absorption by around 50-90%. We always recommend drinking tea beverages between meals rather than with meals which can help minimise their effect on iron levels. Additionally, adding vitamin C-rich foods (such as citrus fruits, strawberries, broccoli or bell peppers) to your meals can enhance iron absorption, as vitamin C helps to counteract the inhibitory effects of tannins.

Calcium has been shown to inhibit the absorption of both heme and non-heme iron.
Consuming calcium-rich foods or taking calcium supplements at the same time as iron-rich foods may reduce iron absorption. Similarly, high consumption of dairy products has been associated with lower iron absorption. It's best to separate calcium-rich foods or supplements from iron sources by a few hours.
There are certain medications, such as antacids, proton pump inhibitors (PPIs), and some antibiotics, which can interfere with iron absorption. Additionally, some dietary supplements, like calcium or zinc supplements, may also affect iron absorption. If you're taking any medications or supplements, it's always a good idea to consult with a healthcare professional for personalised advice and guidance. Nutritional Therapists are trained to assess these interactions and make adjustments as appropriate. 
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Remember, while these factors can affect iron absorption, a well-balanced diet that includes a variety of iron-rich foods, along with vitamin C-rich foods, can enhance iron absorption.
If you have been struggling with low iron and not sure what to do, please get in touch as we can help look at underlying issues, interactions that could be impacting on your health and help give you the tools you need to address any nutritional deficiencies and improve your health and wellbeing.
It's amazing how many people struggle on with round after round of iron tablets over the years without ever finding out the root cause of their chronic deficiency. It's always better to find out the why which for some people may be as a result of multiple causes. 
As a clinic we offer a range of functional testing to find out more and get to root cause, including stool testing, SIBO testing, comprehensive hormone screens, full thyroid function including antibodies and more. 

To book a discovery call to discuss your case and find out more about how we can help you click the link here