Iron Deficiency Symptoms, Food Source, Health Benefit

Iron Deficiency Symptoms is a mineral that is naturally present in many foods, added to some food products, and available as a dietary supplement. Iron is an essential component of hemoglobin, an erythrocyte protein that transfers oxygen from the lungs to the tissues. As a component of myoglobin, a protein that provides oxygen to muscles, iron supports metabolism. Iron is also necessary for growth, development, normal cellular functioning, and synthesis of some hormones and connective tissue.

Types of Iron 

Ferrous Iron

There are two types of iron that are prescribed: ferric and ferrous iron. Ferrous iron is better absorbed by the body than ferric iron. For this reason, most iron supplements contain ferrous iron. Three types of ferrous iron are typically prescribed: ferrous sulfate, ferrous fumarate, and ferrous gluconate. These supplements are available in many forms, including tablets, capsules, liquids, drops, and extended-release.

Ferric Iron

Because ferric iron is not absorbed as well as ferrous iron, it is not prescribed as often. In addition, studies have shown that ferrous iron is tolerated better by patients than ferric iron. Because the gastrointestinal tract has less ability to reduce ferric iron to its ferrous form, there is a reduced chance of iron poisoning with iron citrate, which is the most commonly used form of ferric iron.

Deficiency Symptoms of Iron

Symptoms of iron deficiency are not unique to iron deficiency (i.e. not pathognomonic). Iron is needed for many enzymes to function normally, so a wide range of symptoms may eventually emerge, either as the secondary result of the anemia or as other primary results of iron deficiency. Symptoms of iron deficiency include:

    • Fatigue
    • Dizziness/lightheadedness
    • Feeling tired and weak
    • Decreased work and school performance
    • Slow cognitive and social development during childhood
    • Difficulty in maintaining body temperature
    • Decreased immune function, which increases susceptibility to infection
    • Glossitis (an inflamed tongue)
    • Tiredness.
    • Struggling to concentrate at work or college.
    • Memory problems.
    • Reduced ability to exercise.
    • Hair losing its condition, and possibly hair loss.
    • Nails becoming brittle and breaking or splitting easily. They may even change shape, becoming concave or spoon-shaped, or may develop ridges.
    • Cuts and grazes taking a long time to heal.
    • A sore tongue.
    • Sores at the corners of your mouth.
    • Restless legs syndrome.
    • Infants with iron deficiency may not develop as quickly as normal.
    • Pica syndrome: the craving or eating of substances not normally eaten, such as clay, chalk or coal.
    • pallor
    • Twitches
    • Irritability
    • Weakness
    • Brittle or grooved nails
    • Hair thinning
    • Plummer–Vinson syndrome: painful atrophy of the mucous membrane covering the tongue, the pharynx, and the esophagus
    • Impaired immune function
    • Pagophagia

Continued iron deficiency may progress to anemia and worsening fatigue. Thrombocytosis, or an elevated platelet count, can also result. A lack of sufficient iron levels in the blood is a reason that some people cannot donate blood.

Recommended Intakes of Iron

Intake recommendations for iron and other nutrients are provided in the Dietary Reference Intakes (DRIs) developed by the Food and Nutrition Board (FNB) at the Institute of Medicine (IOM) of the National Academies (formerly National Academy of Sciences) . DRI is the general term for a set of reference values used for planning and assessing nutrient intakes of healthy people. These values, which vary by age and gender, include:

  • Recommended Dietary Allowance (RDA) – Average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%–98%) healthy individuals; often used to plan nutritionally adequate diets for individuals.
  • Adequate Intake (AI) – Intake at this level is assumed to ensure nutritional adequacy; established when evidence is insufficient to develop an RDA.
  • Estimated Average Requirement (EAR) – Average daily level of intake estimated to meet the requirements of 50% of healthy individuals; usually used to assess the nutrient intakes of groups of people and to plan nutritionally adequate diets for them; can also be used to assess the nutrient intakes of individuals.
  • Tolerable Upper Intake Level (UL) – Maximum daily intake unlikely to cause adverse health effects.

Lists the current iron RDAs for nonvegetarians. The RDAs for vegetarians are 1.8 times higher than for people who eat meat. This is because heme iron from meat is more bioavailable than nonheme iron from plant-based foods, and meat, poultry, and seafood increase the absorption of nonheme iron.

For infants from birth to 6 months, the FNB established an AI for iron that is equivalent to the mean intake of iron in healthy, breastfed infants.

Recommended Dietary Allowances (RDAs) for Iron 
AgeMaleFemalePregnancyLactation
Birth to 6 months0.27 mg*0.27 mg*
7–12 months11 mg11 mg
1–3 years7 mg7 mg
4–8 years10 mg10 mg
9–13 years8 mg8 mg
14–18 years11 mg15 mg27 mg10 mg
19–50 years8 mg18 mg27 mg9 mg
51+ years8 mg8 mg

* Adequate Intake (AI)

Food Sources and Iron Deficiency Symptoms

Several food sources of iron are listed in Table 2. Some plant-based foods that are good sources of iron, such as spinach, have low iron bioavailability because they contain iron-absorption inhibitors, such as polyphenols.

 Selected Food Sources of Iron 
FoodMilligrams
per serving
Percent DV*
Breakfast cereals, fortified with 100% of the DV for iron, 1 serving18100
Oysters, eastern, cooked with moist heat, 3 ounces844
White beans, canned, 1 cup844
Chocolate, dark, 45%–69% cacao solids, 3 ounces739
Beef liver, pan fried, 3 ounces528
Lentils, boiled and drained, ½ cup317
Spinach, boiled and drained, ½ cup317
Tofu, firm, ½ cup317
Kidney beans, canned, ½ cup211
Sardines, Atlantic, canned in oil, drained solids with bone, 3 ounces211
Chickpeas, boiled and drained, ½ cup211
Tomatoes, canned, stewed, ½ cup211
Beef braised bottom round, trimmed to 1/8” fat, 3 ounces211
Potato, baked, flesh and skin, 1 medium potato211
Cashew nuts, oil roasted, 1 ounce (18 nuts)211
Green peas, boiled, ½ cup16
Chicken, roasted, meat and skin, 3 ounces16
Rice, white, long grain, enriched, parboiled, drained, ½ cup16
Bread, whole wheat, 1 slice16
Bread, white, 1 slice16
Raisins, seedless, ¼ cup16
Spaghetti, whole wheat, cooked, 1 cup16
Tuna, light, canned in water, 3 ounces16
Turkey, roasted, breast meat and skin, 3 ounces16
Nuts, pistachio, dry roasted, 1 ounce (49 nuts)16
Broccoli, boiled and drained, ½ cup16
Egg, hard boiled, 1 large16
Rice, brown, long or medium grain, cooked, 1 cup16
Cheese, cheddar, 1.5 ounces00
Cantaloupe, diced, ½ cup00
Mushrooms, white, sliced and stir-fried, ½ cup00
Cheese, cottage, 2% milk fat, ½ cup00
Milk, 1 cup00

* DV = Daily Value. DVs were developed by the U.S. Food and Drug Administration (FDA) to help consumers compare the nutrient contents of products within the context of a total diet. The DV for iron is 18 mg for adults and children age 4 and older. Foods providing 20% or more of the DV are considered to be high sources of a nutrient.

The U.S. Department of Agriculture’s (USDA’s) Nutrient Database Web site lists the nutrient content of many foods and provides a comprehensive list of foods containing iron arranged by nutrient content and by food name.

World’s Healthiest Foods ranked as quality sources of
iron
FoodServing
Size
CalsAmount
(mg)
DRI/DV
(%)
Nutrient
Density
World’s
Healthiest
Foods Rating
Spinach1 cup41.46.433615.5excellent
Swiss Chard1 cup35.03.962211.3excellent
Cumin2 tsp15.82.791617.7excellent
Parsley0.50 cup10.91.881017.2excellent
Turmeric2 tsp15.61.821011.7excellent
Beet Greens1 cup38.92.74157.0very good
Collard Greens1 cup62.72.15123.4very good
Bok Choy1 cup20.41.77108.7very good
Asparagus1 cup39.61.6494.1very good
Mustard Greens1 cup36.41.2273.4very good
Turnip Greens1 cup28.81.1564.0very good
Leeks1 cup32.21.1463.5very good
Chili Peppers2 tsp15.20.9356.1very good
Romaine Lettuce2 cups16.00.9155.7very good
Soybeans1 cup297.68.84493.0good
Lentils1 cup229.76.59372.9good
Sesame Seeds0.25 cup206.35.24292.5good
Garbanzo Beans1 cup269.04.74261.8good
Lima Beans1 cup216.24.49252.1good
Olives1 cup154.64.44252.9good
Navy Beans1 cup254.84.30241.7good
Kidney Beans1 cup224.83.93221.7good
Black Beans1 cup227.03.61201.6good
Pinto Beans1 cup244.53.57201.5good
Tofu4 oz164.43.02171.8good
Pumpkin Seeds0.25 cup180.32.84161.6good
Green Peas1 cup115.72.12121.8good
Brussels Sprouts1 cup56.21.87103.3good
Beets1 cup74.81.3471.8good
Kale1 cup36.41.1773.2good
Broccoli1 cup54.61.0561.9good
Cabbage1 cup43.50.9962.3good
Thyme2 TBS4.80.84517.3good
Green Beans1 cup43.80.8151.9good
Oregano2 tsp5.30.74414.0good
Basil0.50 cup4.90.67413.7good
Summer Squash1 cup36.00.6541.8good
Fennel1 cup27.00.6442.4good
Black Pepper2 tsp14.60.5633.8good
Sea Vegetables1 TBS10.80.5635.2good
Cloves2 tsp11.50.5034.3good
Tomatoes1 cup32.40.4931.5good
World’s Healthiest
Foods Rating
Rule
excellentDRI/DV>=75% OR
Density>=7.6 AND DRI/DV>=10%
very goodDRI/DV>=50% OR
Density>=3.4 AND DRI/DV>=5%
goodDRI/DV>=25% OR
Density>=1.5 AND DRI/DV>=2.5%

Health Benefit or Iron Deficiency Symptoms

Effective for

  • Anemia caused by chronic conditions – Many diseases such as cancer, kidney problems, or heart problems can cause anemia. Taking iron along with other medications such as epoetin alfa can help build red blood cells and prevent or treat anemia in people with kidney problems or being treated for cancer with chemotherapy. Receiving iron by injection is more effective than taking iron by mouth.
  • Anemia caused by low iron levels – Taking iron by mouth or by injection is effective for treating and preventing anemia caused by too little iron in the body.
  • Low iron levels during pregnancy – Taking iron by mouth might reduce the risk of anemia caused by too little iron in the body when taken by women who are pregnant.

Possibly Effective for

  • Coughs caused by ACE inhibitors – Medications used for high blood pressure called ACE inhibitors can sometimes cause coughing as a side effect. Some research shows that taking iron by mouth might reduce or prevent this side effect. The ACE inhibitor medications include captopril (Capoten), enalapril (Vasotec), lisinopril (Prinivil, Zestril), and many others.
  • Improving thinking – Taking iron by mouth might help improve thinking, learning, and memory in children ages 6-18 years with low levels of iron. An early study suggests that taking iron might improve attention in girls ages 13-18 with unknown iron status.
  • Heart failure – Up to 20% of people who have heart failure also have low levels of iron. Some research shows that giving iron by injection can improve symptoms of heart failure such as the ability to exercise and other symptoms.
  • Restless legs syndrome (RLS) Research shows that taking iron by mouth decreases symptoms of RLS such as leg discomfort and sleep problems. In fact, taking the iron to improve symptoms is recommended for people with RLS and low iron levels. Some people with RLS also have improved symptoms after having iron injected into the vein (by IV). But it’s too soon to know if all forms of ironwork when given by IV.
  • Preterm labor – Taking iron during pregnancy starting in the second trimester doesn’t seem to increase the duration of pregnancy or increase the weight of the infant at birth.
  • ADHD – Developing research shows that taking iron by mouth for 1-3 months improves some symptoms of attention problems in children with a condition called attention deficit-hyperactivity disorder (ADHD) and low iron levels.
  • Breath-holding attacks – Early research suggests that taking iron by mouth or through a shot reduces the number of breath-holding attacks in children.
  • Child development – Early research shows that iron does not improve thinking or learning in infants and children who do not have anemia. However, there might be an improvement in movement skills. Other early evidence shows that taking iron does not increase growth in children.
  • Cancer of the tube that connects the throat and stomach (esophageal cancer) – Early research found that people who take iron supplements are 32% less likely to develop one type of esophageal cancer.
  • Fatigue – There is some early evidence that taking iron as ferrous sulfate might improve unexplained fatigue in women.
  • Stomach cancer – Early research found that people who take iron supplements are about 1.6 times more likely to develop one type of stomach cancer.
  • Anemia in people with HIV – Early research shows that children with HIV and anemia who take iron along with a multivitamin for 3 months have a lower chance of still having anemia 3 months later compared to children who take only a multivitamin.
  • Physical performance – Early research shows that taking iron by mouth can improve the ability to exercise in younger women and children.
  • Canker sores.
  • A digestive tract disease called Crohn’s disease.
  • Depression.
  • Female infertility.
  • Heavy menstrual bleeding.

References

  1. https://ods.od.nih.gov/factsheets/Iron-HealthProfessional/
  2. https://en.wikipedia.org/wiki/Iron_deficiency
  3. https://www.livestrong.com/article/70183-types-iron-supplements/
  4. http://www.whfoods.com/genpage.php?tname=nutrient&dbid=70
  5. https://www.webmd.com/vitamins/ai/ingredientmono-912/iron
  6. https://www.ncbi.nlm.nih.gov/books/NBK285556/

Iron Deficiency Symptoms, Food Source, Health Benefit

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