Don't discount the power of iron for maintaining health

Expert Michael Murray, ND, discusses the most common nutrient deficiency in the U.S. and the benefits of maintaining healthy iron levels

Many retailers, as well as physicians, overlook the most common nutrient deficiency in the United States: iron. A lack of this simple, essential mineral can lead to symptoms of attention deficit disorder and attention deficit hyperactivity disorder in children, and cause low energy levels and poor immune function in people of all ages.

The groups at greatest risk of deficiency are children, who often don't get enough dietary iron for their growing bodies; the elderly, due to a hindered ability to absorb the nutrient; teenage girls, who lose iron through menstruation; and pregnant women, who share their nutrient stores with the fetus. Studies have found evidence of iron deficiency in 30 percent to 50 percent of people in each of these groups.

While it's widely known that iron deficiency is the most common cause of anemia, many people don't realize that anemia is the last stage of iron deficiency. Even a slight deficiency can cause fatigue and impair brain function, since the iron-dependent enzymes involved in energy production and metabolism are affected long before anemia occurs. Iron deficiency has also been linked to narrower attention spans and decreased attentiveness and mental effort.

Of course, a lack of virtually any nutrient can impair brain function, especially in children. But because iron is the most commonly deficient nutrient among American kids, it's also the leading nutrition-related cause of learning disabilities, such as pervasive developmental delay and ADD/ADHD. One small study published in the Archives of Pediatrics & Adolescent Medicine in 2004 found that 84 percent of kids with ADHD were iron deficient. Think of all the prescriptions for drugs like Ritalin, Concerta and Adderall being dispensed to kids who simply may need better nutrition. Supplementing with 60 to 80 mg of iron per day brings significant improvement in all symptoms of ADD/ADHD in children.

Iron and pregnancy

While iron supplementation throughout childhood is very important, perhaps the most crucial time is during pregnancy, when women's iron needs increase dramatically—from 30 to 60 mg a day to a minimum of 60 mg a day. Rarely do you find this amount in prenatal multiple vitamins. This need doesn't stop once the baby is born, either. During delivery, women lose  150 to 300 mg of iron from blood loss. Lactation drains iron stores even further, so women should continue supplementing while nursing.

Lastly, iron is important for everyone's immune function. Even slightly low levels can significantly reduce the body's ability to fight off infection, resulting in chronic illnesses and frequent colds.

Customers will ask you what is the best form of supplemental iron. Although ferrous sulfate is the most popular form, it often causes constipation or other gastrointestinal disturbances. It's best absorbed when taken on an empty stomach, but doing so often brings on nausea or gastrointestinal upset, which prompts people to take it with food, greatly reducing absorption.

The best form across the board may be micronized ferrous pyrophosphate. It's extremely stable, has no taste or flavor, causes no gastrointestinal side effects and provides a sustained-release form of iron (up to 12 hours) with a high relative bioavailability, especially if taken on an empty stomach.

But take note: Iron supplementation above the recommended dietary intake (which varies by age and sex) is really only indicated for people at risk for or who already have iron deficiency. Although proper iron supplementation should be safe, excess iron is linked to increased risk of atherosclerosis, cancer and certain types of infection. People with iron-overload disorders like hemochromatosis, hemosiderosis and thalassemia shouldn’t take iron supplements unless a physician advises.

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