Who Should Take Iron Supplements?

We get a lot of questions at Vitamin & Me, and we love it! It’s important to understand that every person is different, but being aware of general guidelines can be really helpful. So, now, we’ve decided to share some of our most common Q&A with you. Today, we’re focusing on the question: “Who should take iron?”

Q: At 58, with heart disease in my family, I have taken a multivitamin and mineral supplement with iron for many years. A friend recently told me that men shouldn’t take supplemental iron. Is that true?

—Brian M., Santa Barbara, Calif.

A : Iron (the scientific abbreviation is Fe) is an essential nutrient. It’s needed to make hemoglobin, the oxygen-carrying red pigment of blood. It also plays important roles in energy production and in supporting the health of the immune, reproductive, and central nervous systems.

As important as this mineral is, however, getting too much of it in supplement form can be dangerous. The reason for this is simple: the body is efficient at storing Fe, but it doesn’t do a good job of eliminating stored Fe except through bleeding. That’s why men and postmenopausal women are generally advised not to take an iron supplement except under a doctor’s orders.

Did You Know?

Dried apricots are a rich food source of Fe, with 3.5 mg per cup.

Understanding Iron Levels

Most people know that too little Fe can lead to iron-deficiency anemia, which is most likely to develop in menstruating and pregnant women, vegans, people who take medications that cause internal bleeding, or people who have digestive disorders that interfere with Fe absorption. But the opposite problem—iron overload, usually due to too much supplementation—is drawing more attention these days.

Research suggests that building up large stores in the body over the years can increase the production of free radicals, damage internal organs, and may increase the risk of diabetes, heart attack, and cancer, particularly in older people. In examining more than 1,000 white Americans ages 67–96 who participated in the Framingham Heart Study, researchers found that only about 3 percent had an Fe deficiency, but 13 percent had Fe levels considered too high. The authors of the study concluded that the likely liability in elderly white Americans eating a Western diet is iron overload, not deficiency.

Overload can be inherited—as in hemochromatosis, the genetic iron overload disorder—or it can be acquired by receiving numerous blood transfusions, getting Fe injections, or consuming high levels of supplemental iron. According to the nonprofit Iron Disorders Institute, too much iron can lead to chronic fatigue, joint pain, abdominal pain, liver disease, diabetes, and heart attack.

Data from the large Framingham study suggests that the low risk of heart disease among premenopausal woman may be partially attributable to menstruation and the monthly loss of Fe that goes with it. After menopause, when menstruation stops, women begin to catch up to men in heart disease risk, suggesting that higher Fe stores may be a factor.

Some studies also link high Fe levels with diabetes. For example, among 32,000 women followed for 10 years in the Nurses’ Health Study, those with the highest levels of stored iron were nearly three times as likely to have diabetes as those with the lowest levels. Other studies have shown that when people with high levels of stored Fe donate blood regularly, their insulin sensitivity and risk of diabetes decrease.

Intake Recommendations

So, what should you do to get just the right amount of this important mineral? The best idea is to play it safe. Try these tips:

• Focus on whole-food sources of Fe, including beef, turkey, liver, dried fruit, broccoli, peas, and sunflower seeds.
• Watch your intake of fortified foods. Some fortified breakfast cereals contain 100 percent of the Daily Value for Fe.
• Avoid cooking in cast-iron skillets because iron filings can get into food.
• Unless they’ve been diagnosed with a deficiency, most men and postmenopausal women should take an iron-free multi (see below).
• If you’re a postmenopausal woman or a man concerned about the possibility of overload, many doctors advise donating blood.

To determine your status, ask your doctor for a complete panel of tests, including CBC, serum iron, serum ferritin, iron serum transferrin saturation, total iron-binding capacity (TIBC), and percentage of saturation. Find out more about these tests at IronDisorders.org.

Written by Melissa Diane Smith for Better Nutrition and legally licensed through the Matcha publisher network. Please direct all licensing questions to legal@getmatcha.com.