Doctor's Note

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  • Michael Greger M.D.

    Please feel free to post any ask-the-doctor type questions here in the comments section and I’d be happy to try to answer them. And check out the other “HHH” videos (Harmful, Harmless, or Helpful?). Also, there are over a thousand subjects covered in the rest of my videos–please feel free to explore them as well!

  • desavov

    What should people with Iron deficiency do, especially when they are prescribed to take Iron pills?


      Hi Desavov,
      There are many causes of iron-deficiency anemia (from intestinal bleeding, menses to insufficient dietary intake or absorption). The most common cause of iron-deficiency anemia in adults (age 50+) is chronic GI bleeding due to gastric ulcer, duodenal ulcer or GI cancer. Also,the following food items can decrease iron absorption: Dairy (irritates stomach lining), eggs, tea,coffee and cocoa taken during meals. A balanced vegetarian diet that includes legumes, fortified grains, and green veggies easily provides adquate iron. Vit. C and A from fruits and veggies appear to enhance iron absorption. People with iron deficiency should discuss their condition carefully with their physician to identify the CAUSE of their deficiency and then rectify that problem in order to circumvent or minimize having to be on iron pills. Here’s a helpful video clip for pregnant women and iron:
      For more info on other forms of supplementation:

  • Watermelon

    At 0:45 he says that you may need to supplement, take iron pills, under certain circumstances. He then says “for most people taking extra iron is a bad idea.”

  • Michael Greger M.D.

    For some context, please check out my associated blog post Multivitamins and Mortality!

  • Michel Voss

    Cheapest first test – after serum ferritin – to identify the CAUSE of  iron deficiency: reticulocytes in blood, normal range 0.5% to 1.5%.

  • Spoday

    My latest blood work showed anemia and the doctor ordered iron supplements.  Based upon these videos, two questions come to mind: (1) is there a separate test to determine if mine is iron deficiency anemia or some other reason for anemia (no sign of ulcers etc. but should I have a test?) and (2) should I take the supplements in the mean time?  I have upped my green leafy veggies (kale, spinach, etc.).  Are there other / better sources or iron for diet?

    •  Anemia can be caused by many conditions. Iron deficiency anemia has low red blood cells that are typically smaller and paler then normal plus the measure of iron in the blood is low. The most common cause in women is due to the loss of blood monthly in their menses and inadequate intake to match the loss. The above post by aguccione helps explain this. So it is not uncommon to have to take iron supplements to catch up and correct your anemia and then given a good diet you should be able to maintain your iron levels unless something else is going on. See the video… So it is important to work with your physician and follow your tests to make sure you don’t take too much iron. Good luck.

  • How increased luminal – but not systemic – iron strongly promotes murine intestinal  tumorigenesis:

  • My friend who is a science teacher tells me that Iron is more easily absorbed from Animal flesh than from any plant based source? He says it’s to do with the types of Iron. I forget the words he used. He also said the vitamin C helps absorption of Iron, in which I said so does eating lemons. However? Is this true? Is the best source of Iron not plant based?

    • Iron is more easily absorbed from Animal flesh ( hemoglobin, myoglobin) than from any plant based source. But Iron is a double-edged sword. It forms hydrogen peroxide (free radical) which is removed by antioxidants – if you have enough in your body from plant-based food.

    • Toxins

      In addition to what Michel Voss said, none heme iron is also absorbed more easily with shallot family vegetables, such as garlic or onions.

      Iron is very easy to get on a whole foods plant based diet so even ignoring the fact that non heme iron is not as easily absorbed is not relevant.

      • Michel Voss

        1978 – 1999 I was blood donor, felt always very tired after donation & had an extreme lack of iron – despite whole foods with plenty shallot vegetables since 1982: Ferritin 2 ng/mL. PMID: 23712019

        • Interesting – thanks for sharing. My husband is on iron supplements because of anemia. Multiple tests including CT scan, colonoscopy, and endoscopy show everything normal. Speculation is blood donations plus near vegan diet (5 years) plus maybe he doesn’t absorb iron well. Any comment or other things you have learned?

  • David

    What about cooking in an iron skillet. I thought you had covered that somewhere along the line but I don’t see it. Concerns, effects????

  • jamie williamson

    Hi, I recently got my blood tests back and am a bit concerned. I have been Vegan for 4 years. I try to keep the fats low but have been known to eat some more processed foods like boca chick’n pattys and potato chips :( Within the last year I started drinking soda and have consistantly had 3-4 beers in the eveninng 5-6 nights a week before bed for the last few years. I am wondering If going back to just drinking water and losing the processed foods could fix my #’s or if the alcohol could be what is making them off.
    Also, I am 31, caucasion, Female, 143 lb., 5’4.
    The things out of wack are:
    Iron 208 ug/dl
    Glucose 100 mg/dl
    SGOT 12 U/L
    SEG 39%
    Lymph 47%

    Thanks in advance for your time. I am very worried. I don’t see my Dr. about this for a month and he is very overweight and unhealthy looking, I would trust your advice much more. From what I see online they may want to remove large amounts of my blood weekly to fix the iron. Should I be worried about this???!!!! thank you Jamie

  • Beth B.

    I’ve just been diagnosed with Anemia, probably due to extremely heavy menstrual periods. Been prescribed iron pills, but would rather treat with diet. Already eating lots of tofu, beans, leafy greens. Advice/suggestions? Should I take the iron?

  • catalinda8

    I am a long-time vegetarian (over 30 years). I feel great. Recently, I went in for a physical and had blood work done. Everything was great, and I’m not anemic, but my ferritin levels are low (7, where the doctor said she likes to see it up around 30). Since then, I’ve upped my bean and pumpkin seed intake. I don’t think I’ll have blood work done for at least six more months, but should these dietary changes be sufficient? Or should I consider a supplement? Although I’m 51, I haven’t hit menopause yet, so that may be a factor.

    • Michel Voss

      I am vegetarian since 1981. 1997 my ferritin level fell below 2 because of blood donations. Although without anemia, at that time I felt really tired. As you feel great, you can eat more pumpkin seeds and wait six more months.

  • RagweedFarmer

    What studies show the health risks of iron fortified foods? It’s unnatural to add iron filings to foods. It seems that it’s always been assumed to be safe, yet the body tries to bind up iron through transferrin. I did come across one study showing it to be harmful, but it does not seem much research has been done in this area. Here’s a link with a story about the study.

      • RagweedFarmer

        Thanks Michel, but this video and the one you linked to are both about iron supplements. My point was that there does not appear to be much study on whether iron filings added to fortified foods may be harmful. We naturally consume plant iron, and some heme iron, but iron filings are unnatural. I’d like to see Dr. Greger make a video addressing iron in fortified foods, maybe using his traffic light.


    What is an acceptable lab value for vegan female 52? Is a lower hgb acceptablefor post menopausal female?


    What is an acceptable lab value for vegan female 52? Is a lower hgb acceptablefor post menopausal female?

  • Valerie

    My recent hemoglobin count was 7.9 when it should be 12 or more. Its always been low but I feel, I guess fine. I am a health consultant so I eat well, but I still don;t yet know the real cause and I don;t want to start taking iron supplements without knowing why it has been low all these years. Any suggestions in what course of action to take first?

    • Same problem as Beth B. • one year ago • Ask for ferritin, which reflects more accurately body’s iron + reticulocytes – Read my answers above + links.”BEFORE commencing treatment, there should be definitive diagnosis of the underlying cause for iron deficiency.”:

  • Tyler

    Regarding the risks exposed in this video, I’m wondering if all iron pills would be similarly dangerous, knowing that some pills contain heme-iron, others contain only iron salts and others are made of the so-called “amino acid chelated iron”

    I ask this question because in another video we learned that the body can regulate the amount of non-heme iron it absorbs, but can’t regulate the amount of heme-iron it absorbs, so I am inclined to believe that using non-heme iron pills would not be problematic.

    Thanks for any explanation!

    • Even non-heme iron pills can cause stomach pain and constipation. Therefore, they should never contain more than 20 mg of iron. This is the maximum amount that can be absorbed from a single dose in the duodenum.

      • Tyler

        Thanks for the quick reply, Michel!

        Would you say that the gravest problems with non-heme iron pills are these very easily identifiable symptoms? Do you think it would be wise of me to conclude that if the person is not experiencing those symptoms, then he shouldn’t worry about more serious problems, such as cancer or brain intoxication, which this video refers to?

        • You should worry about the CAUSE of your iron deficiency. Same problem as Valerie • 23 days ago • Read my answers above + links.”BEFORE commencing treatment, there should be definitive diagnosis of the underlying cause for iron deficiency.”: . Ferrritin is a protein that captures iron. It reflects body’s iron stores. You will not get brain poisoning, as long as your ferritin level is not too high.

  • Taylor

    If I am low in iron and having a hard time getting it in my diet (low appetite), would it be ok to eat Grape Nuts?