Low iron intake over a long period can deplete iron stores— especially if your body is losing blood, as in menstruation. Early on, there typically are no symptoms. As iron balance worsens, full-blown iron-deficiency anemia can develop, with symptoms such as weakness, shortness of breath, paleness, poor appetite, poor learning and shortened attention span and increased susceptibility to infection. A healthful diet usually provides ample iron, but some people are at risk for deficiency:
• Premenopausal women, especially those who bleed heavily during menstruation, since blood losses increase iron needs.
• Pregnant women, who have higher iron needs because of the demands for increased blood production by the mother and the needs of the fetus and placenta.
• Dieters, especially premenopausal women. The less you eat, the less likely you are to get enough iron.
• Long-distance runners and other high-impact endurance athletes, especially women and vegetarians. High-impact activities can cause destruction of red blood cells when the feet strike the ground.
An iron-rich diet is especially important for these groups; taking a multivitamin/mineral with 100 percent of the Daily Value for iron is a good idea, too. Your doctor may advise a separate higher iron supplement for a short time, but don’t take high-dose iron on your own—certainly not just because you are tired and think you may be anemic. Weakness and fatigue can be symptoms of many other conditions, including anemia not caused by iron deficiency.
The iron in meat, poultry and fish (heme iron) is best absorbed by the body. Legumes (dried beans, lentils and peas), whole grains, nuts and some vegetables also provide iron, but in a form (nonheme) that is less well absorbed. Consuming foods rich in vitamin C (such as citrus fruits and potatoes) at the same time as plant sources of iron boosts absorption of the iron. Cooking acidic foods, such as tomatoes, in iron pots adds iron to them. Enriched grains and fortified breakfast cereals are other iron sources.