Virtual Clinic for Women's Hormonal Health & Digestion in Ontario

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How to absolutely maximize iron absorption

Sometimes a patient’s iron level is low and we need to hurry to get it up. This can be after an acute blood loss (an injury, surgery or flooding period), or it can within a biological phase (like pregnancy). Either way, in order to get iron levels up as quickly as possible we need to utilize multiple routes of absorption to raise ferritin.

I always believe that the diet is the safest and most effective means of nutrient intake. Partially because it’s the most sustainable intervention, but also because our digestive tract has checks and balances to make sure we’re absorbing more of a nutrient when we need it, and less when we don’t. And as always, I like to do a quick Cronometer nutrient calculation to see what numbers we can get for a given nutrient in that specific patient’s diet. 

Here is an example of what today’s patient can get in terms of dietary iron:

 
 
 
 
 
 
 
 
 
 
Surprisingly, her animal sourced iron-rich food is half way down the list (based on quantity eaten which in turn is based on her tastes). And with each food, she is being mindful to add a vitamin C-rich pairing (like red peppers with her steak, lemon juice on her spinach).
 
In terms of supplements, there are an array of options. Most family physicians or midwives would suggest something like a ferrous fumarate at 300mg per day, but most patients will have a hard time digesting and absorbing this form and dose. Other options include:
 
Iron bisglycinate
Floradix
Spatone
Heme iron
 
There is a maximum amount of heme iron that we can absorb in a day (~30mg). So I usually calculate how much heme iron a patient is getting in a day already, boost that as much as we can through the diet or using a heme iron supplement, and then top up with a non-heme iron supplement. I prefer 25mg of iron bis-glycinate, as the glycine component of the supplement allows it to sneak into the blood stream via a digestive protein transporter, leaving the iron transporters available for other iron absorption.
 
Sarah Goulding naturopathic doctor

Dr. Sarah Goulding | Naturopathic Doctor

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