Supplements

Iron

Iron is an essential mineral required for life, necessary for the production of hemoglobin (red blood corpuscles), myoglobin (red pigment in muscles), and certain enzymes. These enzymes are involved in cellular respiration, detoxification, and protection against free radical damage.

Iron can be found in two forms in the body: heme and nonheme. Heme iron is part of the hemoglobin and myoglobin molecules. Hemoglobin is the oxygen-carrying pigment of erythrocytes. Myoglobin transports and stores oxygen within muscle and releases it to meet increased metabolic demands during muscle contraction. Iron in meat, fish, and poultry is found in a chemical structure known as heme. Heme iron is absorbed very efficiently by your body. Iron in plants such as lentils and beans is arranged in a different chemical structure called nonheme iron. Nonheme iron is not as well absorbed as heme iron. Flours, cereals, and grain products that are enriched or fortified with iron are good dietary sources of nonheme iron.

Iron is the mineral found in the largest amounts in the blood. It is essential for many enzymes, including catalase, and is important for growth. Iron is also required for a healthy immune system and for energy production.

Anemia may be the best known danger of iron deficiency. Children, women in their menstruating years and older people face the greatest likelihood of an iron deficiency.

A woman's persistent inability to lose weight, a consequence of low thyroid output, can signal iron deficiency. In one study, women who took iron supplements responded with an increase in thyroid function.

When a group of teenage girls took supplements to correct slight, nonanemic deficiencies, they increased their ability to learn, as demonstrated by their better scores on memory and learning test.

High amounts of iron have been found in the brains of people afflicted with Parkinson's disease, and it could disrupt the central nervous system enough to aggravate, if not cause, mental disorders.

Excess iron is implicated in other diseases, too. It could accumulate to a toxic extent in our organs and tissues, including the joints, the liver, the gonads, and the heart. It could feed the growth of harmful bacteria and malignant tumor cells, as well as stimulate additional cancer-promoting free radical activity.

Jukka Salonen, M.D., a Finish heart researcher, established that LDL cholesterol becomes an artery-blocking danger only when it oxidizes and that men with high concentration of iron (or copper) in their bodies are at a particularly grave risk.

Swedish research confirms that iron-fortified flour can more than triple the incidence of primary liver cancer and multiply by more than ten times the incidence of hemochromatosis, in which the intestines absorb more iron than the body needs.

Copper, cobalt, manganese, and vitamin C are necessary to assimilate iron. Iron is necessary for proper metabolization of B vitamins.

At least two of the following tests should be performed to diagnose iron deficiency (the most common cause of anemia) or overload.

• Plasma ferritin-measures iron stores
• Transferrin saturation-measures iron supplies to the tissues
• Erythrocyte protoporphyrin-measures the ratio of zinc protoporphyrin to heme. (Zinc is incorporated into protoporphyrin when iron stores are too low.)
• Hemoglobin or hematocrit measurement-8 to 11 g/dL of hemoglobin is considered anemic

Deficiency: Anemia, brittle hair, difficulty swallowing, digestive disturbances, dizziness, fatigue, fragile bones, hair loss, inflammation of the tissues of the mouth, nails that are spoon-shaped or that have ridges running lengthwise, nervousness, obesity, pallor, and slowed mental reactions.

Depleting Agents: phosphoproteins in eggs and phytates in unleavened whole wheat reduce iron availability to the body.

Sources: Iron occurs in foodstuffs as heme and nonheme iron. Heme iron, contained in food products from animals, is in the form of hemoglobin or myoglobin. Nonheme iron is iron salts and is contained in plant and dairy products. Nonheme iron makes up the majority of dietary iron, but heme iron is better absorbed.

Iron is found in eggs, fish, liver, meat, poultry, green leafy vegetables, whole grains, and enriched breads and cereals. Other food sources include almonds, avocados, beets, blackstrap molasses, brewer's yeast, dates, dulse, kelp, kidney and lima beans, lentils, millet, peaches, pears, dried prunes, pumpkins, raisins, rice and wheat bran, sesame seeds, soybeans, and watercress.

Herb Sources: Alfalfa, burdock root, catnip, cayenne, chamomile, chickweed, chicory, dandelion, dong quai, eyebright, fennel seed, fenugreek, horsetail, kelp, lemongrass, licorice, milk thistle seed, mullein, nettle, oat straw, paprika, parsley, peppermint, plantain, raspberry leaf, rose hips, sarsaparilla, shepherd's purse, uva ursi, and yellow dock.

Precautions: Phyllis A. Balch CNC, author of Prescription for Nutritional Healing, states that unless you are diagnosed as anemic, you should not take iron supplements. Multi-vitamin and mineral supplements without iron are preferred. When taking iron supplements, be sure not to take them with Vitamin E.

Iron supplements should be kept in childproof bottles and out of the reach of children. Children between the ages of 12 and 24 months are at the highest risk of iron poisoning due to accidental ingestion.

Parenteral iron therapy should be used only when there are specific indications because of the chance of rare anaphylactic reactions, which can be fatal.

Dosage Ranges and Duration of Administration: Recommended dietary allowances of iron are as follows:

• Neonates to 6 months: 6 mg
• Infants 6 months to 1 year: 10 mg
• Children 1 to 10 year: 10 mg
• Men 11 to 18 year: 12 mg
• Men 19+ years: 10 mg
• Women 11 to 50 years: 15 mg
• Women 51+ years: 10 mg
• Pregnant women: 30 mg
• Lactating women: 15 mg

INTERACTIONS

Angiotensin-Converting Enzyme (ACE) Indhibitors
Iron diminishes absorption of ACE inhibitors. In a double-blind, place-controlled, cross-over study, seven healthy adult volunteers took captopril (25 mg) concomitantly with either ferrous sulphate (300 mg) or placebo. Coadministration of iron salts with captopril resulted in a 37% decrease in area under the curve plasma levels for unconjugated captopril. This decrease may be due to an interaction in the gastrointestinal tract when these substances are ingested together.

Carbidopa; Levodopa
Iron salts may reduce the bioavailability of carbidopa and levodopa. However, the clinical relevance of this potential interaction is not known.

Cimetidine
Iron absorption is dependent upon gastric pH; therefore, medications that affect gastric pH may interfere with absorption of iron. Iron can bind cimetidine in the gastrointestinal tract and reduce the absorption of this drug. The bioavailability of the bound iron may also be decreased. Iron supplements should not be taken with cimetidine; doses of either substance should be staggered by 2 hours before or after administration of the other.

Cholestyramine Resin; Colestipol
In vitro investigations have demonstrated that cholestyramine and colestipol both bind iron citrate. The amount of iron citrate bound by colestipol ranged from 95 to 98%. Cholestyramine bound 24 to 97% of the iron citrate in a pH-dependent manner.

Levothyroxine
Iron may decrease the effectiveness of levothyroxine. A case report describes a patient who became hypothyroid when ferrous sulfate was added to the medication regimen; increasing the dose of levothyroxine countered these effects. However, when the ferrous sulfate was discontinued, the patient became hyperthyroid at the higher levothyroxine dose. Thyroid function should be monitored in patients taking iron salts and levothyroxine concomitantly.

Oral Contraceptives
Oral contraceptives have been shown to increase the levels of iron in women.

Quinolone Antibiotics
Quinolone antibiotics form chelates with metal cations, such as aluminum, magnesium, calcium, iron, zinc, copper, and manganese, which significantly reduces the absorption of these medications. In a clinical trial with 12 healthy volunteers, ferrous sulfate (325 mg po tid) produced a 65% reduction in the absorption of orally administered ciprofloxacin. This reduction in bioavailability has also been observed when iron salts were coadministered with levofloxacin, norfloxacin, and ofloxacin. Dietary supplements and antacids containing aluminum and magnesium should be taken two to four hours before or after administration of these antibiotics.

Tetracycline Derivatives
Tetracyclines form chelates with divalent and trivalent cations, including iron, aluminum, magnesium, and calcium. These chelates are poorly soluble and can significantly reduce the absorption and efficacy of tetracyclines. Iron salts should be taken at least 3 hours before or 2 hours after tetracyclines.