I have often heard doctors accused of not making use of nutritionally oriented therapies in their work. Strictly speaking, this is not true. Any doctor who has advised women to take folic acid in pregnancy or suggested calcium supplements has, to some degree, engaged in the practice of nutritional medicine. Another nutrient much favoured by medicos is iron. This mineral plays a vital role in blood-building, and is the number-one treatment for restoring lost energy in those suffering from anaemia. However, recent studies have found that iron's health-enhancing effects may also extend to individuals not afflicted with anaemia. Iron's use by the medical establishment may be well grounded, but there is evidence that doctors might do well to prescribe it with an even freer hand.
Iron's prime role in the body is as an essential ingredient in the manufacture of haemoglobin, the substance responsible for delivering oxygen to cells. Low levels of haemoglobin - the medical term for which is anaemia - starve the tissues of oxygen, and commonly manifest as lethargy. However, studies show that the body can run very low in iron before haemoglobin levels drop significantly. This is important because iron is also integral to processes that generate energy. What this means is that a deficiency in iron can cause fatigue and weariness even when blood tests show no sign of anaemia.
In a recent study in the British Medical Journal, iron therapy was tried in a group of non-anaemic women with unexplained fatigue. They were assessed for overall iron levels using a blood test known as the serum ferritin. Interestingly, half the women were found to have low ferritin levels (less than 20 micrograms per litre of blood). What is more, treatment with iron for just one month increased energy levels significantly better than placebo, even in women with ferritin levels between 20 and 50 (iron levels classed as 'normal').
The results of this and similar studies suggest that the levels of ferritin in women are simply set too low. Interestingly, the accepted levels for ferritin are lower for women than for men. Menstruation may put women at greater risk of low iron levels, but my attitude is that this is not necessarily something we should accept as being their lot. In practice, I have seen plenty of worn-out women with 'normal' blood-test results who feel better when treatment with iron has boosted their ferritin levels into the 80s or 90s.
Checking ferritin levels before dosing up on iron is important - to establish if there is any need for iron, and also because an excess of iron can be hazardous. Those with low ferritin levels may start by increasing their intake of iron-rich foods such as red meat, oysters, fish, dried fruit, and nuts and seeds. Iron supplementation, with an eye kept on ferritin levels, is a sensible option, too. Experience shows that extra iron can be a real boon for those suffering from metal fatigue.
I am self-employed and each year attend a hectic trade show which lasts for a week and involves a lot of stress and very long hours. I end up feeling exhausted and prone to infections. Is there anything I can take beforehand to increase my resistance?
There are a fair few natural agents that can stimulate the immune system or increase the body's resistance to stress. Some, however, do both. One such remedy is Korean ginseng. Studies show that this herb can strengthen the function of the adrenal glands - the organs that sit on top of the kidneys that are key players in our response to stress. It seems to strengthen our resistance to stress and boost all manner of bodily and brain functions including energy, alertness and concentration. In studies, Korean ginseng has also been found to stimulate the function of the immune system, and might therefore help keep infections at bay. I suggest you take Korean ginseng, starting a month before the trade show and finishing a month after. The standard recommended dose of crude Korean ginseng is 1,000-2,000mg a day.
For standardised products (containing 7 to 32 per cent of active substances known as ginsenosides), the recommended dose is 300-400mg per day.
· If you have any issues you would like Dr Briffa to address in his column, please email him on email@example.com. Please note that Dr Briffa cannot enter into any correspondence. You can also visit www.drbriffa.com.