Improving Iron Absorption

Low iron is one of the most common patient complaints I see in the clinic. This is in both  men and women but especially young women. Low iron will present as low ferritin on blood work and symptoms may include fatigue, light-headedness and dizziness, brittle hair and nails, pale complexion and even a craving for ice. Unfortunately, iron supplements are not well tolerated by many patients. And if they are tolerated well, it takes a long time to see significant improvement.

The body absorbs heme and non-heme iron differently. Heme iron comes from hemoglobin and myoglobin found in animal products and is easily absorbed by the body. Non-heme iron is the majority of our diet based iron and the form of most supplements. Non-heme iron absorption is easily influenced by our diet choices. Whether you are taking an iron pill or focusing on iron rich foods, there are 3 things you can do to improve iron absorption!

1.      Add Vitamin C

Vitamin C has been shown to increase the absorption of iron, specifically non-heme iron. Adding vitamin C rich foods, such as citrus fruits, peppers and broccoli, to your meal or taking a vitamin C pill can help your body absorb more of the available iron.

2.      Avoid calcium

Iron and calcium compete with each other for absorption. If they are both present in a meal, the absorption of both is affected. So this means, calcium rich foods should not be eaten with iron rich foods if the goal is to improve iron levels. Common calcium rich foods include dairy, leafy greens and salmon. Calcium supplementation should also be spaced away from meals. It is recommended to take iron and calcium about 2 hours apart to allow for maximum absorption.

3.      Avoid oxalates

Oxalates and tannins will inhibit iron absorption, especially plant-based non-heme iron. Some common foods that are high in oxalates include coffee and tea, leafy greens, soy and almonds. Spinach is often recommended as an iron rich food, but it is also high in oxalic acid. This means that most of the iron found in spinach will not be absorbed by the body.

It can be overwhelming trying to create a meal with vitamin c and without calcium and oxalates. The goal is not perfection! I want you to be mindful of your food pairings. Following the 3 recommendations is significantly easier when you are taking an iron pill compared to creating a proper iron rich meal.

If ferritin levels still won’t elevate, iron IV infusions are an option for most patients as well. Discuss IV iron with your naturopathic doctor to determine if you are a candidate!