Do I need an Iron Supplment?

Do I need an iron supplement? Having been a health-conscious individual for my whole life, I have asked myself this question many times. Now, as a Functional Medicine Practitioner, I talk to my patients about nutrient deficiencies all the time and when to supplement with an iron supplement. So – Do I need an iron supplement? – the answer is, not necessarily. It is possible for us to get enough iron from our diet but whether we actually are depends on many factors.

Why do we need iron?

Iron is the backbone of haemoglobin, the protein that carries oxygen around your body.

Iron:

• Promotes the production of healthy red blood cells (which carry oxygen throughout the body)
• Supports a healthy pregnancy, plus foetal growth and development
• Facilitates normal immune system function
• Supports cognitive functions and also sleep
• Is important for overall well-being

Iron deficiency

Iron plays a crucial role in nearly every aspect of our wellbeing and yet, many of us are deficient in this mineral. Back in 2020, the UK National Diet and Nutrition Survey found that 49% of girls aged 11-18 and 25% of women aged 19-64 in the UK have low iron intake.¹ How many times a day have you uttered the words, “I’m tired”?

Our bodies don’t make iron so we have to get it through the foods we eat.

Iron deficiency can occur from:

• A diet low in essential nutrients
• Blood loss (from an injury or menstruation)
• An inability to absorb iron from the food we eat (due to chronic disease)

Symptoms of Iron Deficiency

When our iron is low, everything feels harder. It can affect our mood, patience and ability to show up for those we love.

• Extreme fatigue
• Weakness
• Pale skin
• Chest pain, fast heartbeat or shortness of breath during normal activities
• Headache, dizziness or light-headedness
• Cold hands and feet
• Inflammation or soreness of the tongue
• Brittle nails
• Hair loss
• Pica – Unusual cravings for non-nutritive substances (ice, dirt or starch)
• Poor appetite (especially in infants and children)

These symptoms are often missed because they are vague and can be attributed to other deficiencies or health issues. If you or someone you love may have a few of these, it may be worth exploring with a healthcare professional.

Types of Iron

• Haem iron – from animal foods, easier to absorb
• Non-haem iron – from plants, a little trickier for the body

It’s not just about how much iron you eat…it’s about how well your body can absorb it.

Iron-rich foods

Here are some foods that are rich in iron that I recommend to my patients as a first-line approach:

• Organic, grass-fed liver*, beef
• Organic spirulina
• Seaweed
• Wild sardines
• Wild oysters
• Organic, free-range chicken
• Organic, free-range turkey
• Organic beans and lentils
• Organic, non-GMO tofu
• Organic baked potatoes
• Organic cashews, pistachios
• Organic dark, green, leafy vegetables such as spinach, kale
• Organic fortified foods
• Organic whole-grain and enriched breads
• Organic dark chocolate
• Free-range eggs
• Organic dried fruit like raisins, apricots

* Pregnant women should not eat liver because of its high vitamin A content and risk to the development of their baby.

How much iron do we need?

The NHS recommends the following amounts of iron²:

• 7 mg/day for men aged 19 and over
• 8 mg/day for women aged 19-49
• 7 mg/day for women aged 50 and over

How do I know if I am iron-deficient?

Here are some tests that your doctor may perform if they suspect you have low iron.

• CBC/FBC – A complete blood count / full blood count – shows your haemoglobin level, the number of red blood cells and other important markers
• Iron Panel – shows your iron level, transferrin saturation, total iron-binding capacity and unsaturated iron-binding capacity. This can provide a more complete picture.
• Ferritin – Serum ferritin is an iron-storage protein and can show how much back-up iron stores there are.

Who may need to take iron supplements?

Research suggests that 3% of men and 8% of women in the UK have iron deficiency anaemia.³ Iron deficiency anaemia occurs when the body lacks sufficient iron to make haemoglobin. Some special groups of people are more prone to having low iron:

• Women with heavy periods
• Perimenopausal or menopausal women
• Pregnant or postpartum women
• Growing children and teenagers
• Athletes
• People who donate blood frequently
• Vegetarians and vegans
• People with gut issues (IBS, IBD, low stomach acid)
• Those under chronic stress
• Anyone recovering from illness
• Someone who suffered an injury with blood loss
• Older adults with poor appetites
• People with alcoholism

Who should NOT take iron supplements?

Everyone’s body is unique.

• People with haemochromatosis (iron overload which is a genetic condition where the body stores too much iron)
• People suffering from constipation

Iron Supplementation

If you are struggling to get enough iron from food alone, you might consider an Iron Supplement. I get it. There are a lot of iron supplements out there and it can be confusing where to start. Generally, iron in solid form tends to be best for boosting your iron levels, while liquid iron is better for maintenance and gentler on the stomach.

How to increase iron absorption

 Here are the things I teach my patients – and use myself:

• Take iron on an empty stomach if you can
• Pair it with vitamin C (a squeeze of lemon with non-haem iron)
• Drink plenty of water
• Eat fibre from whole foods
• Move your body gently – even a walk helps
• Have tea or coffee between meals not with them
• Support your gut with a probiotic
• Be patient – iron stores take time to rebuild

What happens if we take too much iron?

Therapeutic iron replacement prescribed by your doctor can contain high doses of elemental iron. Side effects that can start with doses (over 20 mg/day) of iron include:

• Constipation
• Feeling sick (nausea)
• Being sick (vomiting)
• Stomach pain
• Dehydration

Taking iron supplements can cause a change in the colour of our bowel movements from normal to green or black. Very high doses of iron can be fatal, particularly if taken by children, so please always keep iron supplements out of the reach of children.

The bottom line

Iron is essential for our health and we need to make sure we are eating iron-rich foods and adjusting this based on our individual needs. If you think you are deficient or are symptomatic, consult a healthcare professional for further investigation.

Taking a multivitamin with iron or an iron supplement can be helpful but it is not just about the dose. It’s about absorption, tolerance and choosing a form your body actually likes.

References

1. NDNS: Results from years 9 to 11 (combined) – statistical summary, 11 Nov 2024
2. NHS: Vitamins and Minerals: Iron, 03 August 2020
3. National Institute for Health and Care Excellence: Anaemia – iron deficiency: how common is it? 22 May 2024

Dr Tamara Whiston.
Functional Medicine Practitioner
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