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Supplements may be needed for adequate iron intake

Dear Mayo Clinic: I’m a 43-year-old woman recently diagnosed with iron deficiency. Tests show my ferritin is very low, but my hemoglobin is in the normal range. My doctor recommends daily iron supplements. Are there dietary changes I can make instead?

A: In some cases, increasing the amount of iron-rich foods in your diet may be enough to increase your body’s iron. But sometimes getting enough iron through dietary sources alone can be difficult, and a supplement is necessary to ensure you get the iron you need. Iron is a mineral that helps your bone marrow produce hemoglobin, the substance within a red blood cell that carries oxygen to your body’s tissues. Your body can store a certain amount of extra iron in ferritin, a blood cell protein. When you don’t get enough iron in your diet to make hemoglobin, your body starts using the iron stored in ferritin. For women, ferritin levels are considered normal between 11 and 307 nanograms per milliliter. When your ferritin is low and your iron stores are in danger of becoming depleted, that condition is known as iron deficiency. If your body uses up all the iron stored in ferritin, then it can’t make hemoglobin, and your hemoglobin level starts decreasing, too. Low hemoglobin is a condition called anemia. Several factors can lead to iron deficiency, including not having enough iron in your diet. The Institute of Medicine recommends women ages 19 through 50 get at least 18 milligrams of iron per day. If low iron intake is your concern, then eating more iron-rich foods may be enough to raise your iron to adequate levels. Red meat, pork and poultry are good choices because your body absorbs more iron from meat than it does from other foods. If you don’t eat meat, try other iron-rich foods such as beans, dark green leafy vegetables, eggs and iron-fortified breads, pastas and cereals. When absorption or blood loss is the issue, then treatment beyond diet changes is usually necessary.

Dr. Richa Sood works in the Women’s Health Clinic at the Mayo Clinic in Rochester, Minn.