How is iron deficiency treated?
Iron deficiency is usually treated either by increasing the amount of iron in your diet or by taking a medicine with iron in it.
Which foods contain iron?
Haem iron is the form of iron most easily absorbed by the body and is found in meat and fish. Meat also improves the absorption of non-haem iron, which is found in vegetables. A well-balanced diet that contains some meat or fish should contain adequate iron for a healthy person - supplements should not be necessary.
If you do not eat meat or fish, it is even more important to ensure that you include some or all of the following food groups in your diet:
- Pulses: chickpeas, lentils, kidney beans, and soy beans, including tofu.
- Dark green leafy vegetables: cabbage, broccoli and kale. (Beware spinach and chard though, as they contain oxalic acid which is thought to interfere with iron absorption.)
- Cereals, such as breakfast cereals (may also have added iron).
- Grains: brown rice and wholemeal pasta.
- Dried fruit: especially apricots, raisins, dates and prunes.
- Nuts: cashews and almonds.
The following table shows some examples of the iron content of foods. It has been taken from the 'Iron Fact Sheet' produced by the United States National Institutes of Health, Office of Dietary Supplements:
|Food||Mg per serving||% daily value (DV)*|
|Breakfast cereal, fortified with 100% of the DV for iron, 1 serving||18||100|
|Oysters cooked with moist heat, 3 oz/85 g||8||44|
|White beans, canned, 1 cup/250 ml||8||44|
|Dark chocolate, 45-69% cocoa solids 3 oz/85 g||7||39|
|Beef liver, pan-fried, 3 oz/85 g||5||28|
|Lentils, boiled and drained, ½ cup/125 ml||3||17|
|Tofu, firm, ½ cup/125 ml||3||17|
|Kidney beans, canned, ½ cup/125 ml||2||11|
|Sardines. canned in oil, drained solids with bone, 3 oz/85 g||2||11|
|Chickpeas, boiled and drained, ½ cup/125 ml||2||11|
|Tomatoes, tinned, stewed, ½ cup/125 ml||2||11|
|Beef, braised, trimmed of fat, 3 oz/85 g||2||11|
|Potato, baked, flesh and skin, 1 medium potato||2||11|
|Cashew nuts, oil-roasted, 18 nuts (1 oz/28 g)||2||11|
|Green peas, boiled, ½ cup/125 ml||1||6|
|Chicken, roasted, meat and skin, 3 oz/85 g||1||6|
|Enriched white long-grain rice, boiled ½ cup/125 ml||1||6|
|Bread, wholewheat, 1 slice||1||6|
|Bread, white, 1 slice||1||6|
|Raisins, ¼ cup/60 ml||1||6|
|Spaghetti, wholewheat, cooked, 1 cup/250 ml||1||6|
|Tuna light, canned in water, 3 oz/75 g||1||6|
|Turkey roasted, breast meat and skin, 3 oz/75 g||1||6|
|Pistachio nuts, dry-roasted, 1 oz/28 g (about 50 nuts)||1||6|
|Broccoli, boiled, ½ cup/125 ml||1||6|
|Egg, hard boiled, 1 large||1||6|
|Brown rice, cooked, 1 cup/250 ml||1||6|
|Cheddar cheese, 1½ oz/45 g||0||0|
|Cantaloupe melon, diced, ½ cup/125 ml||0||0|
|Mushrooms, white, sliced and stir-fried, ½ cup/125 ml||0||0|
|Cottage cheese 2% fat, 1 cup/250 ml||0||0|
|Milk, 1 cup/250 ml||0||0|
|*Daily value is the amount recommended for daily consumption by the US Food and Drug Administration|
What about iron supplements?
If possible, a dietary deficiency should be treated by improving your diet. However, if your iron deficiency is due to some other cause then you may need to take iron supplements. There are several different forms of iron supplements that are available to treat iron deficiency:
- Ferrous sulfate
- Ferrous fumarate
- Ferrous gluconate
These all have the potential to cause side-effects and are dangerous in overdose, so should always be kept out of the reach of children.
Are there side-effects to treatment?
Side-effects of iron supplements are common: nausea, tummy pain, diarrhoea and constipation. Side-effects may be reduced if lower doses are taken or if the medicine is taken with meals. There are also concerns that excess iron in the gut, over and above what the body needs, may be harmful in the long term, although this is not certain.
There are things you can do to help your body to absorb iron, which may reduce the side-effects of iron tablets, but also help you to absorb as much of the iron in your diet as possible. You can read more about this in the following section on prevention.
New forms of iron supplements have been created as nanoparticles. It is hoped that, in future, nanoparticle iron will be better absorbed and have fewer side-effects than currently available forms.
Further reading and references
Scientific Advisory Committee on Nutrition Iron and Health Report; Public Health England, February 2011
Micronutrient Deficiencies, Iron Deficiency Anaemia; World Health Organization
Iron Dietary Supplement Fact Sheet; Office of Dietary Supplements, National Institutes of Health
Wheal MS, DeCourcy-Ireland E, Bogard JR, et al; Measurement of haem and total iron in fish, shrimp and prawn using ICP-MS: Implications for dietary iron intake calculations. Food Chem. 2016 Jun 15201:222-9. doi: 10.1016/j.foodchem.2016.01.080. Epub 2016 Jan 21.
Jackson J, Williams R, McEvoy M, et al; Is Higher Consumption of Animal Flesh Foods Associated with Better Iron Status among Adults in Developed Countries? A Systematic Review. Nutrients. 2016 Feb 168(2):89. doi: 10.3390/nu8020089.
Pereira DI, Bruggraber SF, Faria N, et al; Nanoparticulate iron(III) oxo-hydroxide delivers safe iron that is well absorbed and utilised in humans. Nanomedicine. 2014 Nov10(8):1877-86. doi: 10.1016/j.nano.2014.06.012. Epub 2014 Jun 28.
Hoppe M, Onning G, Berggren A, et al; Probiotic strain Lactobacillus plantarum 299v increases iron absorption from an iron-supplemented fruit drink: a double-isotope cross-over single-blind study in women of reproductive age. Br J Nutr. 2015 Oct 28114(8):1195-202. doi: 10.1017/S000711451500241X.
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