Iron – it’s not: “are you getting enough?”, it’s: “are you getting too much?”

Iron is one of the most important nutrients in the diet, mostly all health experts agree. But experts disagree widely on the amount of iron a person is supposed to ingest to maintain health. For example, according to the WHO and the Linus Pauling Institute at Oregon State University, iron deficiency is endemic even in developed countries, with an estimated half the population of the world deficient in iron (20% of maternal deaths worldwide are attributable directly or indirectly by anaemia, states the WHO). According to THIS article in the New York Times: “Today iron deficiency is more likely in infants who are exclusively breast-fed, young children who consume too much milk, menstruating and pregnant women, vegans and strict vegetarians…“ ) and, tipping the see-saw on the anaemic vegetarian debate in the other direction, are the Vegetarian Resource Group, who state that: “Vegetarians do not have a higher incidence of iron deficiency than do meat eaters.“ and the World’s Healthiest Foods website HERE, which states that vegetarians are less likely to be anaemic.

Basically, what we all want to know is whether supplementation is necessary – no, says the NHS online: “You should be able to get all the iron you need from your daily diet.”

Looking at the nuts and bolts of this topic, what are iron’s functions?

l   Critical for blood formation, especially red blood generation in the bones

l   Helps to deliver oxygen to body tissues

l   Supports energy production

l   Production of immune cells, and the ability of the immune cells to kill viruses, bacteria & fungi

l   Cell division is possible because iron is present

l   Iron is a coenzyme (enzyme helper)

What are the symptoms of iron deficiency?

Lack of iron brings on anemia, even slightly low levels brings on weakness, listlessness, fatigue. People are pale, tired and incapable of doing normal work. Very low levels lead to heat failure, poor immunity & increased cancer risks. Pregnant women with low iron levels are at risk from pregnancy complications and poor pregnancy outcomes. Other at risk groups are people who do a lot of exercise and people long-term gastro-intestinal problems, where iron is not properly absorbed in digestion.

What shocked me when I was researching this topic is Dr. Russell Blaylock’s provocative podcast (Iron – the double-edged sword), where he explains that high levels of iron can be even more harmful than depressed levels, especially in neurodegenerative diseases, heart disease and heart failure, joint pain, liver failure and rapid ageing, diabetes (especially type 1).

Dr. Blaylock explains that, because iron is so toxic at high levels, the body has to store the iron in “secret places” so as to remove it from tissues where it would cause oxidative damage, and the body needs special proteins to escort the iron to the sites where it is needed.

The absorption of iron is tightly controlled. We only absorb 2 ml out of the 20 ml that is ingested typically every day. To prevent too much iron from escaping into the blood system once it enters the blood stream, it is bound to transferrin, which carries it to the cells. Normally 20 – 30% of transferrin is saturated, so that more iron can be absorbed, if need be; for example if oxygen levels are low we can absorb more iron. Once this bound iron gets to the liver, it is transferred to another hormone called ferritin, so that iron is not able to damage tissues. Once it becomes free from those proteins (known as “unbound” iron), it becomes an intense generator of oxidation from free radicals. Proteins regulate the shifting of iron – pepsidin controls the regulation of iron, and puts it inside cells. It hides iron from other microorganisms, like cancer, fungi, viruses and bacteria, which need iron to reproduce. It creates a functionial iron deficiency. Ferroportin does the opposite, regulates the removal of iron from the cell, so that the blood and bone marrow can use it. The two act as iron escorts.

Iron plays a major part in brain diseases; iron levels are very high in neurodegenerative diseases such as Alzheimer’s, MS and Parkinson’s. One of the early symptoms of Parkinsons’ is a high level of iron in the brain. As it gets worse, more iron is accumulated, and symptoms get worse. Excitotoxins increase iron accumulation and in turn iron increases exitotoxicity. Removing iron from the brain can reduce the excitotoxicity.

The Linus Pauling Institute adds: Iron has been implicated in the pathogenesis of type 2 diabetes mellitus. Some epidemiological studies have associated high serum or plasma levels of ferritin with an increased risk of type 2 diabetes (53-58)as well as metabolic syndrome (59, 60).”

Further, if you have exposure to environmental pollution you can have a much higher level of oxidation. This is also true of the aluminium in vaccines.

In a meta study in the US, women with transferrin saturation over 50% had a greater mortality rate, linked to high red meat consumption. This is because the iron from red meat is easily absorbable. A study shows that drinking alcohol releases iron from transferrin and raises free iron levels in the body to over 50% (normal levels being between 20% and 30%). Study subjects were at higher risk of heart attacks. Reducing iron levels by binding it to chelators reduces atherosclerosis and heart disease.

Women at menstruating age have a much lower risk of neurodegenerative disease and heart attacks because they lose so much blood – and therefore iron – in menstruation, not because of the hormone levels, as was previously thought.

There is a high correlation between cancer and high iron levels. Higher than normal levels of iron lead to a worse prognosis in subjects with leukemia. High iron levels damage the p53 suicide cells, so that the cell cannot commit suicide when there is a risk of it becoming cancerous. Women with breast cancer have been shown to have lower than normal levels of ferroportin – which means there is relatively much more unbound iron in their system.

So if iron deficiency is endemic (even in the affluent, over-fed West, where we have all the opportunity to absorb all the iron we need,) why does the body only absorb 10% of the iron it ingests? Also, why is it that phytates and polyphenols, substances that are found in otherwise “healthy” foods, that people have been eating for millennia, actually inhibit the absorption of iron? In a normal body, 70% of transferrin is cruising around the blood, actively looking for extra unbound iron to pick up, because it’s so highly toxic. According to all evidence, it seems as though too much iron is definitely not a good thing, and nature finds ways to make sure the balance is kept.

Personally speaking, I am a pre-menopausal, vegan woman, and I also have Crohn’s disease, a digestive disorder which prevents me from absorbing the same quantity of nutrients as most people. Statistically, therefore, I should be at risk from iron deficiency. However, my last blood test a year ago showed that I am not anaemic. Since becoming vegan, I have much better moods, much clearer and able to focus, I am more energetic, I have better skin, hair and nails. There are as many people who say that a strictly vegetarian or even vegan diet is every bit as healthy as an omnivorous one. My feeling is that there is no one-size-fits-all guideline for the amount of iron people need. For example, the Dalai Lama tried to become vegetarian for ethical purposes but he became ill, as he is constitutionally not able to sustain a non-haem diet, whereas other people feel much more vital and energetic without animal products. And that is pretty much where all comparisons between myself and the Dalai Lama end.

Obviously, a regular iron test would be advisable for everyone, as every body is different, and we experience the need for different levels of iron as our lifestyles change. In some medical situations, for example in anaemia or iron storage disease, such as hemochromatosis, the above considerations (too much or too little iron) do not apply.

 What are the best sources of iron in food?

 Meat sources:

Offal from various land animals, especially liver, kidneys and heart, the highest being chicken, next beef. Also the meat from the animals, eg: steak and breasts. Fish also have high quantities of haem iron, especially tuna, salmon and shrimp.

Vegetable sources:

Beans and peas especially soy beans and soy flour, dark green leafy vegetables especially parsely, swiss chard and watercresss (avoid spinach as it contains oxalic acid which prevents the absorption of iron), prune juice, whole grains, sesame seeds, nuts and dried fruit. Also molasses, oatmeal, olives, cumin, turmeric, chili peppers. A lot of non-haem iron is lost in cooking vegetables, by contrast with cooking meat, where the iron is a lot more stable. Therefore, cook for less time in less water, or eat raw, to get a greater amount of iron.

What prevents us from absorbing iron?

l   Foods high in polyphenols, such as grapes, wine and chocolate

l   High calcium intake.

Note: it used to be thought that fibre from whole grains and pulses inhibited the absorption of iron as they contain phytates. This is true, as raw / uncooked and whole grains and pulses do contain very high levels of phytates. However, the experiments on the grains and phytates were carried out with these in their raw state. Once grains and pulses are soaked as usual, the water drained and refreshed, then cooked as they usually are, they do not contain phytates in quantities large enough to impact on the absorption of iron. One wonders about scientists in labs doing experiments on rock-hard peas and beans. Maybe none of them had ever eaten a lentil and didn’t know what it was or how it was eaten?

What enhances iron absorption in the diet?

Vitamin C when taken with iron helps the body to absorb iron. Heme and non-heme iron, when eaten together, enhance the absorption of iron.

How do we get rid of too much iron in the diet?

Natural iron chelators : sylamarin from milk thistle and baicalin from skullcap. Green tea and black tea chelate iron. Quercatin (a group of flavonoids), and curcumin (from turmeric) binds on iron in the cell and exports it from the body, as does phytic acid (oatmeal and beans) . Lactoferrin binds on iron. Use all of them in combination, from supplements.

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