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How long to correct iron deficiency?

Mike writes:

Dear Georgie, I got an email from my doc this morning, after having my bloodwork done recently, and it went has follows:

“I would recommend 325mg twice a day of ferrous sulfate taken in conjunction with 500mg of chewable vitamin C to help absorption. 325mg of ferrous sulfate equates to roughly 67mg of elemental iron. I would do the 2 times/day dosing over the next 4 weeks and then switch to daily.  Your ferritin was 24 ng/mL and we usually recommend supplementing to  get it a least above 35 if not higher.”

I’m surprised, because I eat my fair share of red meat, a ton of spinach and broccoli (which I hear has a good dose of iron) and I eat beans on a weekly basis.  What’s your opinion on what causes iron deficiency and how long will it take to correct? (He said I probably work out too much). Thanks!

Ferritin is a protein that can be used as a reliable indicator of your body’s iron stores. A level of 24 is on the low side. Having inadequate iron stores can lead to fatigue and limited oxygen transport. I agree 100% with your MDs suggestion, including the pairing of vitamin C with the supplemental iron, since it helps absorption. He is also wise to recommend split dosing, which also helps ensure better absorption of the iron.  

As for the cause, running a lot has been known to contribute to anemia: you literally break blood cells while pounding the pavement. Sweat also contributes to iron losses. One study reports that male athletes lose 1.75 mg of iron a day (between urine, feces and sweat), compared to 1 mg for non-athletes. That’s 75% more, a significant margin!

Medications or physiological factors may also decrease iron absorption, even if you are eating iron-rich foods regularly. Do you have any stomach issues, or take medications related to GERD/ulcers? These medications may reduce the amount of iron you absorb from foods you eat. It’s unlikely, but anemia can also be caused by a GI bleed somewhere inside, which leads to hidden blood losses. Your risk of GI bleeding is increased if you take NSAIDS (over the counter pain medications) regularly.

Don’t worry, I’m sure it will right itself with some supplementation. As for how long it takes, everyone is a little different. Some people need weeks to improve their iron status, some need months. Certainly it won’t be overnight, but within 6-8 weeks you should see some improvement. Full repletion may take up to 4 months. I would suggest obtaining a follow up bloodwork after several months on iron therapy, because it can become toxic if continued for too long, especially in males. You don’t want to take it for longer than needed.

Be prepared for the iron supplement to constipate you though. It’s common. (If it does happen, it will stop once you stop the iron therapy) Keep up the fiber and stay hydrated to prevent this.

One last note, consumption of iron-containing supplements is one of the leading causes of accidental poisoning in children, so be careful and store them out of any children’s reach.


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  • admin December 21, 2010, 6:53 pm

    Pat! Good to see you ’round these parts! Miss you man!

  • Pat D December 21, 2010, 5:49 pm

    A great way to increase iron content in foods is simply to use a cast iron skillet. Vegetarian or not. Just cook food in the iron skillet and voila! Iron content of the food increases.