Can a lack of iron cause anemia?

Iron is essential to all body cells. Iron deficiency anemia occurs when there is not enough iron in the red blood cells. This is a common problem often caused by pregnancy, blood loss or a diet low in iron.

The typical symptoms of iron deficiency — lack of energy or tiredness — have many causes.

Diagnosis by a blood test confirms the presence of iron deficiency anemia.

If your blood iron level is low, your health care provider may refer you to a dietitian to discuss a dietary increase in iron-rich foods. Your provider also may recommend a multivitamin pill or prescribe an iron supplement. Although iron is found in a variety of different foods and supplements, its availability to the body varies significantly.

In general, iron is not readily absorbed by the body. Availability is partially determined by whether the iron is found in the form of heme or nonheme iron.

What foods have heme and nonheme iron?

Heme iron (Group A) is found only in meat, fish and poultry and is absorbed much more easily than nonheme iron (Group B), which is primarily found in fruits, vegetables, dried beans, nuts and grain products.

The following factors will increase the iron absorption from nonheme foods:

• A good source of vitamin C (ascorbic acid) — i.e., oranges, grapefruits, tomatoes, broccoli, and strawberries, eaten with a Group B food.
• A Group A food eaten with a Group B food.
• Group B foods cooked in iron pots, such as a cast iron skillet.

The following factors will decrease nonheme iron absorption:

• Large amounts of tea or coffee consumed with a meal (the polyphenols bind the iron).
• Excess consumption of high fiber foods or bran supplements (the phytates in such foods inhibit absorption.
• High intake of calcium — take your calcium supplement at a different time from your iron supplement.

The recommended dietary allowance for iron for nonvegetarian, pre-menopausal women is 18 milligrams per day. The RDA for nonvegetarian men and post-menopausal women is 8 milligrams per day. Because of iron absorption issues in a healthful, high-fiber vegetarian diet, the RDAs for vegetarians are higher — 14 milligrams for vegetarian men and 33 milligrams per day for vegetarian women.

The upper level of intake should not exceed 45 milligrams per day.

The following is a list of iron sources. The first number indicates the serving size in ounces. The second number indicates the milligrams of iron.

Heme iron sources

• beef or liver — 3.0, 7.5.
• corned beef — 3.0, 2.5.
• lean ground beef (10 percent fat) — 3.0, 3.9.
• beef, round — 3.0, 4.6.
• beef, chuck — 3.0, 3.2.
• beef, flank — 3.0, 4.3.
• chicken, breast without bone, 3.0, 0.9.
• chicken, leg with bone — 2.0, 0.7.
• chicken, liver — 3.0, 7.3.
• chicken, thigh with bone — 2.3, 1.2.
• cod, broiled — 3.0, 0.8.
• flounder, baked — 3.0, 1.2.
• pork, lean ham — 3.0, 1.9.
• pork, loin chop — 3.0, 3.5.
• salmon, pink canned — 3.0, 0.7.
• 10 shrimp (2 1/2 inch) — 1.1, 0.5.
• tuna, canned in water — 3.5, 1.0.
• turkey, dark meat — 3.0, 2.0.
• turkey, white meat — 3.0, 1.2.

Nonheme iron sources

• almonds, raw — 10 to 12, 0.7.
• apricots, dried — 10 medium size, 1.7.
• bagel — 1 whole, 1.5.
• baked beans, canned — 1/2 cup, 2.0.
• white bread — 2 slices, 1.4.
• whole wheat bread — 2 slices, 1.7.
• broccoli, cooked — 1/2 cup, 0.6.
• broccoli, raw — 1 stalk, 1.1.
• dates — 10, 1.6.
• kidney beans — 1/2 cup, 3.0.
• lima beans — 1/2 cup, 1.8.
• macaroni, enriched, cooked — 1 cup, 1.9.
• molasses, blackstrap — 1 tablespoon, 2.3.
• peas, frozen and prepared — 1/2 cup, 1.3.
• prune juice — 1/2 cup, 1.5.
• raisins, not packed — 1/4 cup, 1.0.
• brown rice, cooked — 1 cup, 1.0.
• white enriched rice, cooked — 1 cup, 1.8.
• spaghetti, enriched, cooked — 1 cup, 1.6.
• spinach, cooked — 1/2 cup, 2.0.

In addition, many breakfast cereals are iron-fortified. Check nutrition information on package label for specific iron content.

— Susan Krumm is an Extension agent in family and consumer sciences with K-State Research and Extension-Douglas County, 2110 Harper St. She can be reached at 843-7058.