Iron 101: Sources, Supplements, Anemia and Overload
Iron is like the Goldilocks of minerals: You want the levels in your body to be just right.
Too much can cause damage to your organs, while too little can cause anemia, which is characterized by fatigue and weakness.
Learn how much iron you need to be in the sweet spot — and what to do if you have too much or too little in your body.
What is iron and what role does it play in your body?
“Iron is an essential element for nearly all living organisms. Many parts of your body depend on iron for normal functioning,” says Dr. Virginia Broudy, a hematology-oncology specialist and professor emerita at the University of Washington.
Iron is a mineral that comes in two main forms: heme and non-heme. Heme iron is found in red meat, poultry and seafood and is more easily absorbed. Non-heme iron is found in plants like fortified grains, nuts, legumes, seeds and leafy greens, as well as meat, since animals eat plants that contain non-heme iron.
Once you’ve absorbed iron, its main job is to help with the distribution of oxygen throughout your body.
Iron is an essential part of hemoglobin, the protein in your red blood cells that carries oxygen to your cells, and of myoglobin, a protein that serves as an oxygen reservoir in your muscles. It also is an essential part of many enzymes.
Having healthy amounts of iron in your body aids muscle metabolism, physical growth, neurological development and cellular functioning.
How much iron do you need to be healthy?
The amount of iron you need varies based on age, sex and life circumstance, Broudy notes.
Women who are 19-50 years old, or continuing to menstruate when older than 50, should ingest about 18 mg of iron per day in their diet. This is a slightly higher amount than in other phases of your life because you are losing blood each month when you menstruate.
Women who are over 51 and post-menopausal need less iron, about 8 mg per day. This helps to balance any iron loss from your gastrointestinal tract.
Pregnant women need extra iron, about 27 mg per day during pregnancy, to sustain themselves and their baby. Most pregnant women are able to get this extra boost of iron through prescribed supplemental iron and other vitamins.
“The extra iron is needed to supply the developing fetus with iron, for a mother’s own expanded blood volume during pregnancy and to help replenish the blood loss that occurs with delivery of the baby,” Broudy explains.
What happens if you are iron deficient?
Several factors can cause you to be iron deficient, meaning you don’t have enough iron.
“Iron deficiency often develops gradually. Times of rapid growth during childhood, as well as menstruation or pregnancy, put individuals at increased risk of iron deficiency,” Broudy says.
Other contributing factors can be diets that are low in iron, like vegetarian or vegan diets, and conditions that decrease iron absorption, like having low acid in your stomach, celiac disease or prior gastric surgery.
When you don’t have enough iron, your red blood cells become smaller and contain less hemoglobin. Over time, you can develop iron deficiency anemia.
Symptoms of iron deficiency anemia
Perhaps the most well-known symptoms of iron deficiency anemia are fatigue and weakness, but Broudy notes the symptoms are wide ranging and can vary.
Additional symptoms include pica, a craving for nonfood substances like dirt or clay, restless leg syndrome and a desire to chew large amounts of ice.
There are some tell-tale signs of iron deficiency to look out for. A paler complexion; smooth, red tongue; cracks in the corners of your mouth and spoon-shaped fingernails all indicate that you might not have enough iron in your body, Broudy says.
Treatment for iron deficiency anemia
If you’re worried you might have iron deficiency, it’s important to get checked out by your doctor.
“Development of iron deficiency should prompt an evaluation of the cause, as iron deficiency can be a harbinger of a serious underlying problem such as colon cancer, ulcers or another source of chronic blood loss,” Broudy says.
Your doctor will conduct tests to measure the amount of iron in your blood and determine what is causing the iron deficiency. This way, if the lack of iron is a result of something more serious, you and your doctor are able to address this head on.
The good news is that treatment for most people with iron deficiency is pretty straightforward. Your doctor will prescribe you an iron supplement or multivitamin that contains iron. You can also increase the iron in your diet by eating more meat and eating vitamin C with non-heme iron sources (think leafy greens, dried fruits and nuts), which will help your body absorb the non-heme iron.
What happens if you have too much iron?
While you want to avoid iron deficiency, having too much iron is also dangerous.
Hereditary hemochromatosis is a genetic disease and a common culprit of excess iron in the body. Over time, this can cause iron overload, which is when there is a buildup of iron in your tissues and organs.
“When there is too much iron in the body, the excess iron is deposited in organs such as the liver, heart, pancreas, pituitary gland, skin and small joints in the hand,” Broudy says. “The gradual accumulation of iron over time can damage these organs.”
Broudy notes that regular red blood cell transfusions for situations other than chronic blood loss can also lead to iron overload.
Symptoms of iron overload
Like iron deficiency, two initial symptoms of iron overload are fatigue and weakness. However, over time the more extreme symptoms differ.
“Chronic excess iron can damage your organs and cause cirrhosis of the liver, heart failure, diabetes, hypofunction of the pituitary gland, bronze skin color and arthritis of the small joints in the hands,” Broudy says.
Children, who can be drawn to the bright pills, are most likely to overdose on iron, causing iron poisoning. If you realize your child has overdosed on iron supplements, call your doctor and take your child to the emergency room immediately.
Treatment for iron overload
For those with hereditary hemochromatosis, you can reduce your iron level to the normal range through regular phlebotomies, or withdrawing blood to remove iron from your body.
“A regular phlebotomy program can be used to maintain your iron stores near the normal level, and effectively prevent the consequences of chronic iron overload,” Broudy says.
To prevent iron poisoning, be sure to keep any supplements out of the reach of children.
The bottom line
Iron is an important mineral that helps us grow and function.
We need enough iron so that our bodies can efficiently transport oxygen throughout our body, but not so much that the iron begins to accumulate in our organs.
As you’re trying to strike the right balance, it’s important to speak with your doctor before making decisions about your iron intake or supplements. This way, you know the solution will be safe and effective, whether it’s a simple switch to more iron rich foods or a decision to start a phlebotomy schedule.