Vitamins and mineralsIron and anemia — is a supplement always a good idea?
Sources: 12 · Article: 12 186 characters
Jerzy Jaśkowski stresses that iron deficiencies should be corrected once confirmed by a test.
- Taking iron supplements can be difficult because the products may be poorly absorbed and may cause gastrointestinal problems.
- Hubert Czerniak notes that low iron can lower hemoglobin levels and lead to anemia, which can cause symptoms such as fatigue and weakness.
- Symptoms of iron deficiency can resemble those of an underactive thyroid, so they should not immediately be attributed to the thyroid.
What the authors write
Henryk Różański
Iron ascorbate is easily absorbed, while iron oxide and iron carbonate may be poorly absorbed.
„Iron ascorbate is an easily absorbed form of iron. Vitamin C helps iron pass from the intestines into the blood. Iron is essential for delivering oxygen to cells. It enables cellular respiration, or the oxidation of energy-providing substances, to release the energy needed for vital processes.”Askorbinian żelaza jest łatwo przyswajalną formą żelaza. Witamina C ułatwia wchłanianie żelaza z jelit do krwi. Żelazo warunkuje dostawę tlenu do komórek. Umożliwia oddychanie wewnątrzkomórkowe, czyli utlenianie składników energetycznych, w celu wyzwolenia energii niezbędnej do przeprowadzenia procesów życiowych.
Jerzy Jaśkowski
Taking iron supplements can be difficult because available products are poorly absorbed and may cause gastrointestinal problems.
„In Poland, raising iron levels can be difficult because available products are poorly absorbed and may cause gastrointestinal problems. There is a lack of medical publications that establish how well the compounds available in pharmacies are absorbed.”Uzupełnianie poziomu żelaza jest w Polsce trudne, ponieważ dostępne preparaty słabo się wchłaniają, mogąc powodować dolegliwości ze strony przewodu pokarmowego. Brakuje publikacji medycznych określających wchłanialność związków dostępnych w aptekach.
Henryk Różański
Iron oxide is sometimes described as a poor-quality source of iron in supplements.
„Dietary supplements have an advantage over medicines in that they are not routinely checked by GIS and GIF for their chemical composition. Supplements may always contain ingredients of questionable quality and usefulness, such as magnesium oxide as a source of magnesium (it is known not to provide Mg), or calcium oxide or iron oxide instead of a good, absorbable calcium or iron compound.”Suplementy diety mają taką przewagę nad lekami, że nie są kontrolowane w praktyce przez GIS i GIF (pod względem chemicznym) i suplementy zawsze mogą zawierać składniki wątpliwej jakości i przydatności, np. tlenek magnezu jako źródło magnezu (wiadomo, że nie dostarczy Mg), albo tlenek wapnia lub tlenek żelaza zamiast porządnego przyswajalnego związku wapnia i żelaza.
Jerzy Jaśkowski
First, deficiencies confirmed by testing should be corrected.
„First, once the test results are available, any deficiencies found should be corrected.
Vitamin D3 should be taken together with vitamin K2. Taking vitamin D3 alone has negative effects on a child’s health.”W pierwszej kolejności po otrzymaniu wyników wykonanego badania należy doprowadzić do wyrównania stwierdzanych niedoborów.
Podawanie witaminy D3 należy łączyć z podaniem witaminy K2. Samo podawanie witaminy D3 powoduje skutki negatywne dla zdrowia dziecka.
Jerzy Jaśkowski
Symptoms of iron deficiency can resemble those of an underactive thyroid, so they should not immediately be attributed to the thyroid.
„The topic of an underactive thyroid mainly concerns women. This diagnosis is being made more and more often, and more quickly. Whether this is justified is questionable, because the same symptoms that occur with an underactive thyroid can also be caused by deficiencies of iron, selenium, vitamin D, and iodine.”Temat niedoczynności tarczycy dotyczy głównie kobiet. Jest to coraz częściej i szybciej stawiana diagnoza, czy słusznie – kwestia wątpliwa, ponieważ te same objawy, jakie są przy niedoczynności tarczycy, występują też przy niedoborze żelaza, selenu, witaminy D i jodu.
Hubert Czerniak
Low iron can lower hemoglobin levels and lead to microcytic anemia, whose symptoms may include fatigue, weakness, pale skin, and shallow breathing.
„A drop in iron causes a drop in hemoglobin, which in turn causes red blood cells to become smaller and leads to microcytic anemia. This is the body’s defense against oxygen deprivation. A smaller red blood cell has a larger surface area relative to its mass, so it releases oxygen more quickly to the peripheral tissues.”Spadek żelaza powoduje spadek ilości hemoglobiny, a to powoduje spadek wielkości erytrocytów i anemię mikrocytarną. Jest to obrona organizmu przed niedotlenieniem. Mniejsza krwinka czerwona ma większy stosunek powierzchni do masy, dzięki czemu szybciej oddaje tlen, niesiony przez nią do tkanek obwodowych.
Henryk Różański
Iron is needed to make hemoglobin, and ceruloplasmin helps with this process.
„Ceruloplasmin is needed to oxidize iron ions from Fe II to Fe III and to incorporate iron into hemoglobin. It enables iron to be released from storage tissues, such as the liver, and incorporated into transferrin, which transports iron in the blood plasma.
The human body contains about 110–150 mg of copper.”Ceruloplazmina jest potrzebna do utleniania jonów żelaza Fe II do Fe III i wbudowywania żelaza w hemoglobinę. Zapewnia uwalnianie żelaza z tkanek magazynujących (np. wątroby) i wbudowywanie go do transferyny (transportujące żelazo w osoczu).
W organizmie człowieka jest około 110-150 mg miedzi.
Henryk Różański
Iron deficiency can cause weakness, reduced muscle strength, poorer intellectual performance, and increased susceptibility to infections.
„Symptoms of iron deficiency include weakness, a marked reduction in the strength of striated muscles, impaired intellectual performance, and an increased tendency to contract infectious diseases.
Unfortunately, iron ascorbate is now only occasionally used in medicines and supplements because of its high cost.”Objawem niedoboru żelaza jest osłabienie z wyraźnym zmniejszeniem siły mięśni prążkowanych, upośledzeniem sprawności intelektualnej i zwiększoną skłonnością do zapadania na choroby zakaźne.
Niestety askorbinian żelaza jest obecnie sporadycznie używany w lekach i suplementach z powodu wysokiej ceny.
Research from PubMed · Europe PMC
We selected 3 studies with the best, positive results. This is a selection, not a full review of all research.
Total number of studies on this topic in PubMed: 5 766.
A review found that iron supplementation in infants increased hemoglobin levels and reduced the risk of anemia and iron deficiency anemia.
Aim of the study: Anemia is a prevalent health problem worldwide. Some types are preventable or controllable with iron supplementation (pills or drops), fortification (sprinkles or powders containing iron added to food) or improvements to dietary diversity and quality (e.g. education or counselling).
Results: We included 75 systematic reviews, 33 of which provided GRADE assessments; these varied between high and very low. Infants (6 to 23 months; 13 reviews) Iron supplementation increased Hb levels and reduced the risk of anaemia and IDA in two reviews. Iron fortification of milk or cereals, multiple-micronutrient powder (MMNP), home fortification of complementary foods, and supplementary feeding increased Hb levels and reduced the risk of anaemia in six reviews. In one review, lipid-based nutrient supplementation (LNS) reduced the risk of anaemia. In another, caterpillar cereal increased Hb levels and IDA prevalence. Food-based strategies (red meat and fortified cow's milk, beef) showed no evidence of a difference (1 review). Preschool and school-aged children (2 to 10 years; 8 reviews) Daily or intermittent iron supplementation increased Hb levels and reduced the risk of anaemia and ID in two reviews.
Money for the studygovernment, public institutions · World Health Organization
Do the authors have ties to companies?not stated
Did a manufacturer help with the study?unknown
Type of studyreview of many studies
“Not stated” does not mean nobody paid — the database does not always record it.
Iron supplementation improved endurance performance in female athletes with iron deficiency.
Aim of the study: Iron facilitates key biological functions underpinning sports performance, and up to 60% of female athletes experience iron deficiency. However, the effects of iron deficiency on sports performance in female athletes is unclear, as are the degree of benefits of iron supplementation (FeSup). This study characterizes the effects of iron deficiency and FeSup on sports performance in high-level female athletes.
Results: A total of 23 studies comprising 669 athletes (age range: 13-47 years) across 16 sports were included in the review. Iron deficiency negatively affects endurance performance by 3%-4%. However, endurance performance improved by 2%-20% when ID athletes were treated with 100 mg/day of elemental iron for up to 56 days via oral supplementation, or bi-daily via parenteral administration over 8-10 days. ID non-anemic athletes with low sFer stores may be predisposed to reduced maximal aerobic capacity. However, maximal aerobic capacity improved by 6%-15% following 16 mg/day-100 mg/day of elemental iron for 36-126 days. Isokinetic strength and anaerobic power performance may be impeded (-23% to +4%) among ID athletes, but the effect of FeSup on anaerobic power varied markedly (-5% to +9%) following 100 mg/day of elemental iron over 42-56 days, or 100 mg of elemental iron bi-daily over 8-10 days. The quality of studies was moderate (77%), ranging from low (57%) to high (100%).
Money for the studynot stated
Do the authors have ties to companies?no — the authors say so
Did a manufacturer help with the study?NO
Type of studyreview of many studies
Participants669
“Not stated” does not mean nobody paid — the database does not always record it.
In people with heart failure and iron deficiency, intravenous iron improved physical capacity and quality of life.
Aim of the study: Iron deficiency is a major heart failure co-morbidity present in about 50% of patients with stable heart failure irrespective of the left ventricular function. Along with compromise of daily activities, it also increases patient morbidity and mortality, which is independent of anaemia.
Results: Intravenous iron preparations, in the first-line ferric carboxymaltose, demonstrated in previous clinical trials superior clinical effect in comparison with oral iron preparations, improving New York Heart Association functional class, 6 min walk test distance, peak oxygen consumption, and quality of life in patients with chronic heart failure. Beneficial effect of iron deficiency treatment on morbidity and mortality of heart failure patients is waiting for conformation in ongoing trials. Although the current guidelines for treatment of chronic and acute heart failure acknowledge importance of iron deficiency correction and recommend intravenous iron supplementation for its treatment, iron deficiency remains frequently undertreated and insufficiently diagnosed in setting of the chronic heart failure.
Money for the studygovernment, public institutions · Slovenian Research Agency, Serbian Ministry of Science
Do the authors have ties to companies?no — the authors say so
Did a manufacturer help with the study?NO
Type of studydiscussion of other studies
“Not stated” does not mean nobody paid — the database does not always record it.
Perspectives and opinion materials
The content below presents the authors’ opinions, interpretations and hypotheses. It is not treated as equal to scientific studies and systematic reviews.
Orthomolecular Medicine News Service Opinion material
„A copper deficiency anemia is quite rare, but the iron deficiency anemia is much more common. [12,13] However, the iron deficiency anemia rarely ever occurs without a significant loss of blood, as can be seen with heavy menses or a bleeding gastrointestinal tumor. The bottom line for patient management, however, is that when there is a normal hemoglobin and a normal hematocrit, NO iron or copper should ever be supplemented. The ferritin level can never be considered too low and a reason for iron supplementation if the hemoglobin level is normal.”A copper deficiency anemia is quite rare, but the iron deficiency anemia is much more common. [12,13] However, the iron deficiency anemia rarely ever occurs without a significant loss of blood, as can be seen with heavy menses or a bleeding gastrointestinal tumor. The bottom line for patient management, however, is that when there is a normal hemoglobin and a normal hematocrit, NO iron or copper should ever be supplemented. The ferritin level can never be considered too low and a reason for iron supplementation if the hemoglobin level is normal.
Orthomolecular Medicine News Service Opinion material
„Iron deficiency anemia is common in young women and among senior citizens. By the time microcytic anemia occurs, the brain and heart have already been compromised. The chelated iron formula, iron bisglycinate, is better absorbed and minimizes side effects common with inorganic iron salts such as ferrous sulfate and ferrous fumarate. Meat. fish, dark chicken and turkey, and eggs are good sources of iron, as are a wide variety of vegetables including greens, broccoli, peas, and beans. Folic acid, vitamin B12, and vitamin C are helpful partners of iron absorption and building red blood cell mass.”Iron deficiency anemia is common in young women and among senior citizens. By the time microcytic anemia occurs, the brain and heart have already been compromised. The chelated iron formula, iron bisglycinate, is better absorbed and minimizes side effects common with inorganic iron salts such as ferrous sulfate and ferrous fumarate. Meat. fish, dark chicken and turkey, and eggs are good sources of iron, as are a wide variety of vegetables including greens, broccoli, peas, and beans. Folic acid, vitamin B12, and vitamin C are helpful partners of iron absorption and building red blood cell mass.
Orthomolecular Medicine News Service Opinion material
„Anemia would increase significantly if crops lose even a small amount of iron. The highest risk regions - South and Southeast Asia, Africa, and the Middle East - are especially vulnerable, since they do not have the means and access to compensate using nutritional supplements. 5. The RDA for essential nutrients is too low The recommended nutrient reference intake (NRI) has been defined by UK authorities and the EU Food Safety Agency as the dose that is adequate for 95 percent of the population.”Anemia would increase significantly if crops lose even a small amount of iron. The highest risk regions - South and Southeast Asia, Africa, and the Middle East - are especially vulnerable, since they do not have the means and access to compensate using nutritional supplements. 5. The RDA for essential nutrients is too low The recommended nutrient reference intake (NRI) has been defined by UK authorities and the EU Food Safety Agency as the dose that is adequate for 95 percent of the population.
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