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Iron (Ferrous Sulfate)

If you are a young woman, a dieter, or endurance athlete, you may not be getting enough iron, even if you have a good diet. But they should consult a doctor before taking an iron supplement. The theory that a high iron intake causes heart disease remains unproven. But one million Americans do need to worry about iron overload: they have a hereditary disorder known as hemochromatosis, which causes them to absorb and store too much iron.

Thanks to years of Geritol commercials about “tired blood,” most people know that iron is a nutrient they should pay attention to. And most of us have heard that millions of Americans, especially women of childbearing age, have an iron deficiency and may even be anemic.

However, since 1992, when a widely publicized Finnish study suggested that a high level of iron increases the risk of heart attack, more and more researchers have been warning about the dangers of getting too much iron.

The theory linking high levels of stored iron in the body with coronary artery disease (CAD) was first proposed in 1981. According to it, some factors that affect the risk for a heart attack can be explained by their effect on the body’s iron level. Notably, premenopausal women may be at lower cardiac risk because their menstrual blood loss keeps their iron stores low; thus after menopause, women’s iron stores rise, as does their CAD risk.
The 1992 study found that among men from eastern Finland (where the average ferritin level and death rate from heart attacks are among the highest in the world), those with higher levels of ferritin were twice as likely to have a heart attack as men with lower levels. Since then many studies have looked at the iron question. Most have not found a link between iron levels in the body and CAD.

Iron deficiency is still an issue
All cells in the body contain iron, which plays a vital role in many biochemical reactions. Most iron is incorporat-ed in hemoglobin, which carries oxygen in the blood, and in myoglobin in muscle; it is also stored in the liver, spleen, and bone marrow. Low iron intake over a long period can lead to a depletion of these stores, especially if the body is losing blood, as in menstruation. This depletion reduces production of hemoglobin and red blood cells.

The initial stage of iron deficiency usually has no symp-toms. The second stage occurs when the iron supply in the bone marrow falls short of that needed to produce healthy red blood cells. If the iron balance worsens, full-blown iron-deficiency anemia can gradually develop. Since iron is an essential component of hemoglobin, a shortage of iron can impair the transport of oxygen from the lungs to the body’s cells. It can take months or even years for symptoms of iron defi-ciency—such as weakness, shortness of breath, paleness, poor appetite, and increased susceptibility to infection—to become evident.

What to do
Eat foods that supply your daily requirement of iron (18 milligrams a day for premenopausal women, 8 milligrams for men and older women). There is no benefit in exceeding these levels. Meats, poultry, and fish contain iron in the form which is best absorbed by the body. Iron is also found in nuts, whole grains, beans, and some vegetables, but this is less well absorbed than the iron from meats. Enriched pasta and breads and fortified breakfast cereals are also sources. Cooking acidic foods (such as tomatoes) in iron pots adds iron to them. Consuming foods rich in vitamin C, as well as small amounts of meat, boosts the absorption of iron from plant sources. Vegetarians can get enough iron from their diet if they consume C-rich foods.

Don’t take extra iron just because you are tired and think you may be anemic. Weakness and fatigue can be symptoms of many other conditions.

And by the way: Men, as well as postmenopausal women, do not need iron in their multivitamins, since they need only 8 milligrams of iron a day. The amount in a multi probably won’t hurt them, unless they have hemochromatosis. Still, there’s no reason for them to load up on iron.

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