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Iron - knowing what deficiency can look like

The most abundant element, by mass, on earth.

IRON - What you need to know

Iron is an important nutrient we need throughout our lives but especially during pregnancy. It has many jobs to do like transporting oxygen throughout our bodies, including our brains, it plays a role in development, normal cell functioning, metabolism, healthy connective tissue and the normal production of hormones. There are two forms of iron - heme and non-heme iron. Heme iron is more bioavailable, meaning we more easily assimilate it’s nutrients, than non-heme iron. Both forms are found in meats and fish and non-heme iron is found in certain vegetables and fruits.

Symptoms of iron deficiency include


  • Fatigue

  • Poor memory and concentration

  • Palpitations

  • SOB on exertion or noticable reduce stamina during your workouts

  • Susceptibility to colds and infections

  • Difficulty controlling body temperature

  • Constipation

  • Restless leg syndrome (I believe this is often why we see this in pregnancy)

  • Pica (the desire to eat non-food products such as ice and dirt)

As you can see, a lot of these symptoms can also look like an under functioning thyroid, so testing is very important to determine the cause!

Who is at risk?

An analysis of data collected between 1999 - 2006 (NHANES), found that 18% of pregnant women had iron deficiency. The breakdown of this per trimester was 6.9% in first, 14.3% in second, and 29.7% in third. Keep in mind, iron carries oxygen across the blood brain barrier, so low iron can lead to lower IQ and impaired cognitive function in babies/children.

  • Pregnant women

  • Women with a heavy menses, uterine fibroids

  • Teens with heavy periods

  • Cancer (especially colon)

  • History of GI disorders including IBS, Crohn’s and ulcerative colitis.

  • Chronic inflammation, infections

  • People with chronic heart failure

  • Frequent blood donor

  • Vegan/vegetarian

  • PPI drugs (Prilosec/Nexium) due to their interference with stomach acid which is necessary for iron absorption.


Testing for iron depletion:

Conventional thought to test for iron deficiency is to check hemoglobin and hematocrit. The problem here is that these two tests are not sensitive or specific enough so by the time something shows up, we may be experiencing some pretty significant issues. Remember, we want to thrive throughout our lives and our pregnancies and we want our children to thrive, so catching something early to prevent it from getting more serious is important. What I would suggest is, if you fall under a higher risk category and/or are experiencing some of the above symptoms; ask your doctor for a full iron panel that includes the following:

  • HGB - hemoglobin (12.5 - 15)

  • HCT - hematocrit

  • Ferritin (50 - 80)

  • TIBC

  • %Saturation

  • MCV (80-100)

This extended testing can help identify early or mild iron deficiency and depletion of iron storage.


Food sources

The richest sources of heme iron, which is more bioavailable than non-heme iron, are found in lean meats and fish. Eating these foods with an acid source, like vitamin c containing foods is needed for proper assimilation.



  • Lean meats and poultry

  • Fish

  • Eggs

  • Dark leafy green, spinach

  • Nuts

  • Lentils

  • Dried apricots and raisins

  • White and kidney beans

  • Peas

Foods that contain phytates which are present in grains and beans (beans are an iron source and full of nutrients so diversify your iron containing foods), polyphenol containing foods such as chocolate and coffee, and oxalic acid containing foods can inhibit the absorption of iron. Something to consider if you can’t seem to get your numbers up.

Supplementing and considerations

If iron deficiency or anemia has been a life long issue, even possibly your mother also had anemia, consider using digestive enzymes with HCL to increase your body’s ability for absorption. Good stomach acid is needed to break down minerals properly. Zinc can also be added to aid in iron absorption. Most prenatals contain 100% of your daily value (18mg) but quality of prenatal, ability to absorb, dietary restrictions, and other factors can mean you need more. Plus daily values are based on levels to keep us alive, not levels in which we thrive, so please consider this too. Take into account how you are feeling and trust your intuition. Floradix Iron Plus Herbs is my #1 go to when recommending a supplement. It is a liquid, food derived supplement that includes vitamin c (important for proper absorption) and is non-constipating. If you are taking a thyroid supplement, you MUST separate your iron supplement by 4 hours to avoid interference. And while it is not common, you can overload your system with iron. Symptoms of iron overload include nausea, vomiting, constipation, and fainting. The upper limit of elemental iron supplementation per day is 45mg, do not exceed this unless there is a medical reason and you are being monitored by your doctor.

I hope you found this helpful and as always, let me know if you have any questions or concerns. Next up, MAGNESIUM!! So stay tuned to stay healthy! Love and blessings, Emily



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