Get the iron your body needs at every stage of life
CAROL SEAVEY Live Well editor | Posted: Saturday, June 27, 2009 12:00 am
A dull headache hummed in Jenny's head
as she tried to stir the energy to get up and get ready for work.
She started a new diet last week. This one, unlike the last, was
guaranteed to help her lose those last five pounds by her 30th
birthday. But instead of feeling refreshed, she feels weak and
exhausted.
"I shouldn't have started a diet the
same week as my period," she thought, vowing to plan better next
time.
Finally, she drags herself from bed
and puts on a pot of coffee. A little kick start should do the
trick, she hopes.
Although Jenny is imaginary, she is
not unlike many women. She suffers from anemia caused by iron
deficiency.
Iron, which is found in red blood
cells, is used to transport oxygen throughout the body. Anemia is
when there aren't enough healthy, red blood cells to do the
job.
"Women are constantly losing blood
during menstrual cycles, and they are certainly at risk [for
anemia] if they are not replacing the iron they are losing," said
Dr. Arnold Friedman, chairman of the department of obstetrics and
gynecology at Beth Israel Medical Center in New York City and board
member of the National Anemia Action
Council.
In
fact, three-fourths of women ages 12 to 49 do not get the
recommended dietary allowance for iron through their diets,
according to a 1996 survey by the U.S. Department of
Agriculture.
"A lot of women in their childbearing
years are dieting and they may not be getting enough red meat, and
we all don't get enough green vegetables," said Dr. Cora F.
Salvino, an obstetrician and gynecologist at Women's Primary Health
in
Casper.
Since women use more blood at certain stages of their lives, their
iron needs change, too.
Childbearing Years
(about ages 12 to
49)
Women ages 9 - 13: 8 mg a
day
Women ages 14 - 18: 15 mg a
day
Women ages 19 - 50: 18 mg a
day
Twelve percent of women ages 12 to 49
in the
U.S. have
iron-deficiency - enough iron to function, but none in storage -
and women who lose an excessive amount blood during menstruation
have a greater risk for developing
it.
Heavy menstrual blood loss affects 10
percent of women in this group. To help identify heavy menstrual
blood loss, The National Anemia Action Council lists the following
symptoms:
• Soaking through a tampon and/or pad
every hour or less for several hours in a
row
• Needing to use double protection
during your period
• Having to change your pad or tampon
during the night
• Passing large blood clots in your
menstrual flow
• Periods lasting longer than seven
days
• Severe
cramping
Women who experience heavy menstrual
blood loss should contact their doctors. They may be able to
pinpoint a cause, such as uterine fibroids. Fibroids, muscular
tumors on the wall of the uterus, cause heavy bleeding and are
common in women over age 30.
The Paragard IUD Contraceptive can
also increase blood loss.
In some cases, switching or starting a
prescription for oral contraception may
help.
"One of the side-effects is a shorter,
lighter period, so we prescribe it to get that side affect,"
Salvino said.
Pregnant women: 27 mg a
day
As women's bodies grow during
pregnancy, their red blood cell mass increases 20 to 30 percent,
increasing their need for iron. Iron goes directly to the growing
fetus, and whatever is left goes to the
mother.
Iron supplements are included in all
prenatal vitamin regimens because most women cannot get enough iron
through diet alone.
"Even if a woman thinks she is getting
everything she needs, it's a nice safety net to protect both the
mother and baby," said Chris Douglas, a registered dietician and
state supervisor and nutrition coordinator for
Wyoming's
Women, Infants and Children
program.
If a woman is iron deficient at the
start of pregnancy, it can be difficult to catch
up.
"Even if her blood count is normal in
the beginning of the pregnancy, if her iron stores are low, the
baby is going to take it and she becomes anemic as a result,"
Friedman said.
Anemia during pregnancy increases the
risk for preterm delivery, delivering a child having fetal growth
retardation and low birth weight. Mothers who are severely anemic
can have difficulty bonding with their child after birth and have a
higher risk of needing a blood transfusion, Friedman
said.
Anemia can be difficult to spot during
pregnancy. One symptom that stands out is unusual cravings, and not
just for pickles and ice cream. Craving ice cubes, paint fragments
or even dirt, a condition called Pica, could be a sign of anemia,
Friedman said.
To increase iron levels, doctors may
prescribe additional iron
supplements.
Be cautious after the birth, too. If a woman's iron stores are low
from the pregnancy, birth and the return of periods, she may be
more likely to become or stay
anemic.
Women ages 51 and over: 8 mg a
day
Iron-deficiency anemia is very
uncommon after menopause because women in this group aren't
constantly losing blood, as they once
did.
"Post menopausal women need to be
careful about getting too much iron," Salvino said. "Once you stop
menstruating you need to stop taking excessive amounts of iron
because you could overload."
Iron overload is when unused iron
collects in vital organs, causing them to function poorly or not at
all.
According to the The Iron Disorders
Institute, symptoms of iron overload
include:
• chronic
fatigue
• joint
pain
• abdominal
pain
• irregular heart
rhythm
• loss of
period
• loss of interest in
sex
• hair loss
• changes in skin
color
People who experience these symptoms
should contact their doctor.
One cause of iron overload is
hemochromatosis, a genetic condition in which too much iron is
absorbed. While hemochromatosis is more common in older men, it can
also affect post-menopausal women.
Sources:
U.S. Department of Health and Human Services Centers
for Disease Control's 1998 report titled, "Recommendations to
Prevent and Control Iron Deficiency in the United States." The National Institute of Health's Office of
Dietary Supplements. The National Anemia Action Council.
U.S. Department of Health and Human Services Centers
for Disease Control. The Iron Disorders
Institute.
Where to get iron
Iron comes in two forms: heme and non-heme. Heme iron is found in meat, poultry and fish, while non-heme iron is found in plant-based foods and iron-fortitfied foods.
Heme iron is two to three times
more absorbable than non-heme iron. When eaten with other foods,
heme iron increases absorption from the other sources, as
well.
Because non-heme iron is more
difficult to absorb, vegetarians must plan diligently to get enough
iron in their diets.
One way to increase the amount
of iron one absorbs is to take Vitamin C with meals. It enhances
iron absorption.
For more information about
iron disorders,
see:
On the Web
Healthy people can get iron from a variety of food sources.
After menopause
During pregnancy