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Iron is an essential mineral that keeps our blood healthy. When someone doesn’t get enough iron, they can develop a condition called iron-deficiency anaemia. It is the most common nutritional deficiency around the world, leading to severe tiredness and feelings of faintness. 

Iron-deficiency anaemia can happen to anyone, but groups such as children, pregnant women, and those on kidney dialysis are at the highest risk. Iron plays a vital role in haemoglobin, a type of protein in our red blood cells that carries oxygen from our lungs to other parts of the body. Without sufficient iron, our bodies can’t produce enough red blood cells to transport oxygen, which can cause us to feel very tired. Iron also helps myoglobin, a protein that carries and stores oxygen in our muscles. This mineral is crucial for helping children grow and develop, as well as for the normal functioning of various cells and hormones in the body. 

Food provides iron in two types: heme and non-heme. Heme iron is found in meat, poultry, and seafood, while non-heme iron comes from plant-based foods like whole grains, nuts, seeds, legumes, and leafy greens. Non-heme iron is also present in animals since they eat plant foods containing it, and some foods are fortified with iron. The body stores iron in a form called ferritin, and it is delivered to various parts of the body by a protein called transferrin. If a doctor thinks someone may be anaemic, they might check these iron levels in the blood. 

Recommended Daily Amounts

The Recommended Daily Allowance (RDA) for iron varies with age and gender. For adults aged 19-50, the RDA is 8 mg for men and 18 mg for women. Pregnant women need more—about 27 mg—to support increased blood circulation for the growing baby. Breastfeeding women need about 9 mg. For adolescents aged 14-18, boys need 11 mg and girls 15 mg, with pregnant teens needing 27 mg. After age 51, women’s RDA for iron drops to 8 mg, as periods usually stop after menopause. The Tolerable Upper Intake Level (UL), which is the maximum amount unlikely to cause harm, is 45 mg for anyone 14 years old and above. For younger children, the UL is 40 mg. 

Food Sources

Heme iron is found abundantly in meats, poultry, and seafood. Non-heme iron can be found in fortified grains, nuts, seeds, legumes, and vegetables. In the US, many breads, cereals, and baby formulas are fortified with iron. Heme iron is absorbed better by the body compared to non-heme iron. Eating vitamin C-rich foods together with non-heme iron can help improve its absorption, while things like bran fibre, large amounts of calcium, and some plant substances can reduce it. 

Good Sources of Heme Iron

- Oysters, clams, and mussels 

- Beef or chicken liver 

- Organ meats 

- Canned sardines 

- Beef 

- Poultry 

- Canned light tuna 

Good Sources of Non-Heme Iron

- Fortified breakfast cereals 

- Beans 

- Dark chocolate (at least 45%) 

- Lentils 

- Spinach 

- Potatoes with skin 

- Nuts and seeds 

- Enriched rice or bread 

What About Iron Supplements?

Iron supplements are available for those who need extra iron, and some cereals and multivitamins are also fortified with iron. High-strength iron supplements for those with iron-deficiency anaemia can have 65 mg or more. However, many people experience side effects from high doses, such as constipation and nausea. There are different types of iron supplements, like ferrous sulphate or ferrous gluconate. Labels can be confusing due to two numbers shown—one larger and one smaller. The larger number refers to the total compound, while the smaller one shows the actual amount of iron, known as elemental iron, which is what the body can use. Always ask your doctor to clarify how much elemental iron you need. 

Signs of Iron Deficiency

Iron deficiency often occurs in children, menstruating or pregnant women, and those with a low-iron diet. It typically develops in stages, starting with lower iron stores and leading to a drop in red blood cells. Eventually, someone may develop iron-deficiency anaemia (IDA), which can be diagnosed through blood tests. 

Common Signs of IDA Include:

- Fatigue and weakness 

- Light-headedness 

- Confusion or trouble concentrating 

- Cold sensitivity 

- Shortness of breath 

- A rapid heartbeat

 - Pale skin 

- Hair loss and brittle nails 

- Cravings for non-food items (known as pica) 

To treat IDA, oral iron supplements providing up to 150-200 mg of elemental iron daily may be used. Monitoring should occur regularly, with lower dosages or discontinuation if iron levels return to normal, as high doses can lead to other digestive problems. 

Groups More Likely to Have IDA:

- Pregnant Women: They need more iron due to increased blood supply for the growing baby. 

- Menstruating Women: Heavy periods can lead to IDA. 

- Children: Growing kids have higher iron needs. 

- Elderly:  Older adults might not eat enough iron-rich foods, increasing their risk. 

- Vegetarians: Without heme iron from meat, if not careful, they can miss out on enough iron. 

- Endurance Athletes: Running can cause slight internal bleeding, putting athletes at risk. 

- People on Dialysis: Kidney failure affects iron levels because the kidneys don’t make enough red blood cell-producing hormones. 

Toxicity

Iron toxicity is rare, as the body usually controls iron absorption. High doses can cause issues, particularly from unnecessary supplements or certain genetic conditions. Signs of excessive iron include constipation, upset stomach, and abdominal pain. Some people have a condition called hemochromatosis, where iron builds up in the body, potentially leading to serious health issues like liver disease if untreated. 

Source: https://nutritionsource.hsph.harvard.edu/iron/