Are you iron deficient? How to find out your Iron levels

This blog is brought to you by Helen Gibb of Helen Gibb Dietitian Ltd. Helen will be at the show this year. Be sure to visit her at her stall this September!

If you are planning a pregnancy, ask your GP to measure your iron stores as part of your well-being check.  You have an unplanned pregnancy, your  GP or your Lead Maternity Carer (LMC) will test your iron levels at booking and 26 weeks. Ask which test they are doing; iron stores are a more sensitive test of how much iron we have in our bodies than a hemoglobin level (the colored pigment that makes our blood red, which contains iron). There is some disagreement as to what is “acceptable” levels of iron in iron stores measured as ferritin. The normal range for ferritin is 20-200 ng/ml. Some researchers suggest having a ferritin above 40 ng/ml may help women with unexplained tiredness. Research on pregnant women suggests that a level below 13.5 ng/ml puts the baby at risk of iron deficiency. If you are diagnosed as being iron deficient or anemic before or during pregnancy increase your iron intake from food and take a supplement.

How common is iron deficiency?

We know from the 2008/09 New Zealand Adult Nutrition Survey that 7% of women of childbearing age are iron deficient (they have low iron stores). Around one-quarter of women are diagnosed with iron deficiency anemia during their pregnancy. Iron deficiency anemia is where the amount of hemoglobin in the blood is reduced. There is not enough iron in the stores to make enough red blood cells.

Why is iron status important?

Iron is important in pregnancy, as poor iron stores increase the risk of early delivery. Iron is also important for the baby. From week 26, the placenta starts moving iron from the mother’s stores into the baby. This is so s/he will have enough iron until iron-rich weaning foods can be started. Poor iron status in infancy can result in difficulties with learning, memory and regulating emotions.

How much iron and from where?

The recommended intake of iron for pregnant women is 27 mg per day. Achieving this amount from food requires that you think about two things.

1. what foods give you iron and

2. what foods can either enhance or limit the uptake of iron from your foods.

Foods that provide iron

The iron that comes from red meat, chicken, and fish is easily absorbed and utilized by the body. The best sources include:

• beef

• lamb

• chicken

• fish and mussels (must be cooked and served hot and eaten immediately)

• liver (limit to 100 g per week due to high vitamin A levels and ensure it is well cooked, served hot and eaten immediately after cooking).

Good plant-based foods containing iron include:

• wholegrain bread and cereals (especially breakfast cereals with iron added)

• vegetables and legumes (dried beans)

• dried fruit, nuts, and seeds.

Foods that enhance iron absorption

• Vitamin C rich fruits and vegetables

• Protein-rich foods (meat, chicken, fish, eggs)

Foods that inhibit iron absorption

• Tannins (in tea)

• Phytates (found in cereals and legumes)

• Large amounts of calcium-rich food (milk, yogurt, and cheese)

Tips to get the most iron from your food

1. Have an iron-fortified cereal at breakfast time. Add fruit to provide vitamin C.

2. Avoid having tea within 1 hour of any meal – having hot water with lemon juice also gives you some vitamin C.

3. Have wholegrain bread and cereals where possible.

4. If you eat meat try to have a serving of meat, chicken or fish every day. If you can, include 100g liver weekly.

5. If you don’t eat meat aim for 2 servings of legumes such as red kidney beans or chickpeas daily. Canned or pressure-cooked legumes will have more iron available than those which are boiled on the stove top.

6. Don’t drink milk with your meals, this may reduce the amount of iron you absorb.

7. Iron-fortified cereals, nuts, and seeds are snack options to increase your iron intake.

What should I do if I need to take a supplement?

If you need to take an iron supplement, avoid taking within 2 hours of an antacid tablet. Iron can be constipating, so it is important to drink plenty of food and have high fibre cereal. Many women find kiwifruit or kiwifruit blended with prunes a good way to manage constipation. Kiwifruit provides extra Vitamin C to help absorb iron.

Before your next pregnancy

If you had low iron levels in your first pregnancy, plan to increase your levels before you conceive again.