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Risk Associated With Iron Supplements

Iron is a double-edged sword. If we don’t absorb enough, we risk anemia, but if absorb too much we may increase our risk of cancer, heart disease, and a number of inflammatory conditions. Because the human body has no mechanism to rid itself of excess iron, one should choose plant-based (non-heme) sources over which our body has some control.

July 27, 2012 |
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Supplementary Info

Risk Associated With Iron Supplements, 4.4 out of 5 based on 8 ratings

Sources Cited

Sharp PA. Intestinal iron absorption: regulation by dietary & systemic factors. Int J Vitam Nutr Res. 2010 Oct; 80(4-5):231-42.

Geissler C, Singh M. Iron, meat and health. Nutrients. 2011 Mar; 3(3):283-316.

West AR, Oates PS. Mechanisms of heme iron absorption: current questions and controversies. World J Gastroenterol. 2008 Jul 14; 14(26):4101-10.

Steele TM, Frazer DM, Anderson GJ. Systemic regulation of intestinal iron absorption. IUBMB Life. 2005 Jul; 57(7):499-503.

Collings R, Fairweather-Tait SJ, Dainty JR, Roe MA. Low-pH cola beverages do not affect women's iron absorption from a vegetarian meal. J Nutr. 2011 May; 141(5):805-8.

Acknowledgements

Image thanks to Albion Europe ApS and Thirteen Of Clubs.

Transcript

Iron is a double edged sword. If we don't absorb enough, we risk anemia, but if absorb too much… we may be increasing our risk of colorectal cancer, heart disease, infection, neurodegenerative disorders and inflammatory conditions. Other conditions that have been associated with high iron intake include Alzheimer's Parkinson's, arthritis, and diabetes. Because the human body has no mechanism to rid itself of excess iron, we evolved to tightly regulate the absorption of iron. If our iron stores are low, our intestines boost the absorption of iron, and if our iron stores are topped off, our intestines block the absorption of iron to maintain us in the sweet spot. But this only works with the primary source of iron in the human diet, the iron found in plant foods. Our digestive system can't regulate the iron in ingested blood—heme iron. The iron in animal foods can just zip right our intestinal barrier even if we already have too much; we have no control over it.
 In fact some guess that iron overload may be a reason meat consumption has been tied to breast cancer risk. Iron is a pro-oxidant, and can induce oxidative stress and DNA damage. “A high intake of iron in developed societies may, over time, lead to a physiologic state of iron overload in postmenopausal women, who are no longer losing blood every month. Iron overload favors the production of free radicals, fat oxidation, DNA damage, and may contribute to breast carcinogenesis independently or by potentiating the effects of other carcinogens.”
Only people with a confirmed diagnosis of iron-deficiency anemia should consider supplementing their iron intake, and even then it can be risky. A recent study this found a significant increase in oxidative stress within the bodies of women on iron supplements, and so before going on iron supplements I would suggest talking to your physician about first trying to treat it through diet alone, by eating lots of healthy iron-rich foods like chickpeas and pumpkin seeds while consuming vitamin C-rich foods at the same meal, such as citrus, tropical fruits, broccoli, or bell peppers, which improve plant iron absorption, while avoiding drinking tea and coffee with your meals, which can impair iron absorption.
Since organic acids like vitamin C can boost iron absorption, the coca cola company commissioned a study to see if drinking coke would do the same thing, and the answer is no.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring watch the above video. This is just an approximation of the audio contributed by Serena

To help out on the site please email volunteer@nutritionfacts.org

Dr. Michael Greger
  • Michael Greger M.D.
    • HemoDynamic, M.D.

      You are becoming the physicians physician.

      This is extremely helpful for anybody in the healthcare industry that deals with iron abnormalities.  A must watch.

      It is fascinating to me that our bodies cannot regulate animal sources of iron but it can plant sources.  I was never taught that in medical school (Am I surprised? No!). 

      Now I may be incorrect but that means to me that we have evolved eating plants and not animals; for if we had been eating animals throughout time, our bodies would have surely created a regulatory mechanism for absorption of animal based sources of iron. 

      I have never tried to treat IDA (Iron Deficiency Anemia) with a plant based diet.  But come to think about it all my patients that are on a plant based diet don’t have IDA.  Interesting!

      • SJ M.D.

        Agree – surprise! ;-) - strong indicator that humans are not built to get iron from meat.

        • Gale

          OK Doctors. I think this topic isn’t so black and white. I wish it was. 

          There really are some people who tend to be anemic–me for one. Northerns European Grandfather/Grandmother the cause? 

          Either way, as a serious runner I can’t stand that feeling of heavy legs while out on a 10 mile run. We don’t know  whether runners tend to be anemic due to sweating or the red blood cells getting beat up in our feet (a couple of theories). I do all the right things–I eat a ton of greens, a ton of beans, pistachio nuts and I include vitamin C foods. And still I am on the low side. (Ferritin levels hover around 20 if no supplement taken.) Even when I take a supplement I am just barely normal. So in cases like my own, one pill a day (taken with Vit. C)  can’t be too much of a concern. Obviously I must have some kind of absorption problem. “Toxins” suggested garlic may help. So one more addition to my morning smoothy! 

          • SJ M.D.

            Gale – sorry – I am just an enthusiastic plantstrong guy….

            Did you have the same problem when you ate meat (if ever)?

            I am from Northern Europe – no problem with hgb

          • Gale

            Yes always. College was a bear. Try sitting down to a neurophysiology test and not be able to concentrate.

          • Lebepotter

             I’m another runner on plant-based diet, also tending toward anemia– even though I’ve been taking iron supplements twice a day for a couple years. I’ve had AIDS for decades, too– so I’m not typical of the general population. I also don’t get to indulge in the sort of plant-strong pride that would let me think I can run this body w/o medicine. I’ve been thinking I need to boost my iron supplementation (Iron sulphate) again– but am a little unhappy about this video’s report of increased oxidative stress apparently resulting from iron supplementation. Maybe it’s back to pumpkin seeds, which I’d cut out owing to their poor omega3/omega 6 fatty acid ratio and the general Esselstyn dietary recommendation to limit nuts and seeds…. (chickpeas are also have a high omega 6 level, compared to other beans).
            I do include vitamin C rich foods at all meals, including those at which I take the iron pills.

            Gale seems so right to me that this topic’s not simple.

          • Thea

             Lebepotter:  I can’t address the main point of your post, but I did want to respond to: “Maybe it’s back to pumpkin seeds, which I’d cut out owing to…”

            I believe that there are several videos on this site concerning nuts which list studies which point to positive benefits of eating nuts and seeds.  I’m familiar with Dr. Esselstyn’s book and really liked it, but I wonder if this particular recommendation of his is still valid. 

            I saw from the table of contents that Dr. Greger will be addressing nuts once again in volume 10/upcoming videos.  I do not yet know the content of those videos, but perhaps all of these videos will put your mind at rest concerning the consumption of nuts.  Maybe?

            Good luck in whatever you decide to do.

          • Lebepotter

             Thea, thanks so much for your thoughtful and exquisitely tactful reply! I have noted Dr. Greger’s consistent nut endorsements. Those help keep me eating a few walnuts– which even Dr. Esselstyn calls okay for patients w/o heart disease. Quite low levels of nut consumption seem to be sufficient to provide the benefits. Maybe that’s the sweet spot. Pumpkin seeds are, of course, not nuts, so who knows where they fit in? They haven’t, on their own, been enough to replete my iron stores in the past. But I’ve just been reading around on iron supplementation and oxidative stress and not at all liking what I see: “Iron supplements: the quick fix with long-term consequences” is a representative title, though that paper’s particular target is combined supplementation with (non-food) iron and (non-food) vitamin C. I’ll be watching for Dr. Greger’s upcoming items on nuts, and listening with mind open. Thanks, thanks again.

          • Thea

            Lebepotter:  You sure do your homework.  I’m impressed.  I admire people who take responsibility for their health *and* go about it in a thoughtful and open-minded manner.  (I also admire people who run.  I’m hopeless…)  Thanks for taking my comments in the spirit in which they were intended.  :-)

            I had to mention: the walnut dressing from Dr. Esselstyn’s book has become one of my parent’s favorites.  They put it over all sorts of things.

          • Lebepotter

            Thea, Yes! that Esselstyn  walnut dressing is delicious . Glad your parents like it and use it. Good w chopped scallions in place of all or part of the garlic, too., too. ons ins using is  is

          • Ginger

             I don’t run but have had lots of trouble with low iron for decades whether eating meat or not. Floridix is a non-heme iron suppliment from 100% plant sources. I take it off and on as need arises.

          • Gale

            If I didn’t eat nuts and seeds and avocado I would be too skinny. I think the idea is that processed foods have high levels of omega 6. Therefore the average SAD is high in omega 6. If you don’t eat that crap I think you are ok adding nuts and seeds. There are plenty of videos by Dr. Greger under topics regarding nuts and seeds. (or google)

            FYI I just read the best books written by athletes (runners) who are also vegans. Eat and Run by Scott Jurek and Finding Ultra by Rich Roll.

          • AlexanderBerenyi

            Say what? Nuts, seeds, and soy are fantastic sources of omega 6—probably why the SAD is so laden with them.

          • Gale

            The SAD is high in refined vegetable oils primarily from soybean oil used in packaged crackers, cookies, sweets, snacks. Therefore Americans get too much omega 6 and not enough omega 3. Does that clarify it for ya?

          • AlexanderBerenyi

            Try to find the greatest imbalance of ω-3/ω-6. Hint: it’s not salmon or grass-fed beef.

            http://paleozonenutrition.com/wp-content/uploads/2011/06/omega-3-and-6-in-fats-oils-nuts-seeds-meat-and-seafood-2.pdf

          • jhnycmltly

            “Hereditary hemochromatosis is the most common inherited single-gene disorder in people of northern European descent.”
            “Secondary iron overload should be suspected in patients with chronic anemia”

          • Gale

            Hi jhnycmitly, (mouth full)

            Man I just came back from the beach working on my vitamin D. What a beautiful day. OK explain that second comment. 

            I am very interested. 

            Gale

      • http://www.facebook.com/darryl.roy.752 Darryl Roy

        “The paradox of anemia with high meat intake: a review of the multifactorial etiology of anemia in the Inuit of North America”
        was on one of Dr. Greger’s prize CDs: http://missclasses.com/mp3s/Prize%20CD%202010/Previous%20years/Fish/anemia%20inuit.pdf

  • BPCveg

    In the sources cited, I could not find support for the claim “our digestive system cannot regulate the iron in ingested blood…” 

    I read the article “Mechanisms of Heme Iron Absorption” by West and Oates and could not find support for this claim.

    Perhaps someone can point out where this claim is specifically made… If anything, it seems to me that all of the cited articles are recommending heme sources (i.e. meat sources) of iron to prevent anemia.

    • Thea

       BPCveg:  Really great question.  Thanks for doing this research.  I hope someone answers your question, because I am interested too.  I often repeat information I learn from this site.  I want to be able to back it up anything I say.  Otherwise if people can say, “prove it” and I can’t to any one thing, then they think that everything I say is of questionable value.  (It is my experience that “throwing the baby out with the bathwater” is human nature.)

      • HemoDynamic, M.D.

        Thea please see my response to BPCveg above.
        ;-}

        • Thea

           Thanks so much for taking the time to answer this question!!  I feel much better when I know these kinds of questions can be answered.  Your help is much appreciated.

        • Micah

          Was your response removed? I would really like to know what was said. This is a very interesting topic!

          • HemoDynamic, M.D.

            No it wasn’t removed it is below because of this thread.  Just look for responses to BPC from me.  My response wasn’t anything special ;-(

      • BPCveg

        Thanks, Thea. I agree with you.

    • HemoDynamic, M.D.

      BPCveg,
      Just a quick response.  I just scanned the “Mechanisms of Heme Iron Absorption”.   The following statement is from the Cartoon caption in the article:

      “Any iron released from heme inside the enterocyte, regardless of the mode of uptake, ultimately joins the labile iron pool and is transferred to the  bloodstream by FPN1 in the same fashion as non-heme iron.”

      This is what Dr. Greger mentioned in his video.  Mouth, to gut, to iron pool.  Our bodies cannot regulate the iron absorbed from animals.
      ;-}

      • BPCveg

        Not so fast, HemoDynamic.

         The sentence that you have cited relates to transport of iron after it is absorbed and does not distinguish between heme (meat-based) and non-heme (plant based) iron! I don’t think it is relevant.

        I think that the article is arguing the exact opposite of what Dr. Greger is claiming.

        Please note that not all heme (i.e. meat-based) iron is absorbed, as explained on page 2, paragraph 3: 

        “up to 19% of an equivalent dose of heme was absorbed[36]. This strongly suggests that heme uptake is a facilitated process, as opposed to simple diffusion. ”

        –> read that again, heme uptake is a FACILITATED process — i.e. it is regulated!

        Furthermore on page. 2, paragraph 2 the author’s state:

        “…the absorption of heme iron cannot upregulate to the same extent as non-heme iron during iron deficiency[14,15,21-25]. This is possibly due to rate limitations at the step of heme catabolism”

        Moreover on page 5, paragraph 2 the author’s state:

        “…the ability to upregulate heme iron absorption is limited compared to non-heme iron[14,15,21-25], and heme splitting is speculated to be rate limiting[67]. ”

        –> clearly even the rate at which meat iron is digested is regulated!

        Overall the authors of this paper very clearly argue in favour of consuming heme iron (i.e. meat-based iron), as they state on page 1,
        paragraph 2-3:

         ” Currently, the importance of heme iron in the diet cannot
        be underestimated. Studies estimate that in Western societies, iron derived
        from heme sources such as myoglobin and hemoglobin make up two thirds of the
        average person’s total iron stores despite only constituting one-third of the
        iron that is actually ingested[4-6]. This likely explains why vegetarians are
        more prone to iron deficiency than those who regularly consume red meat[7]. The
        relative importance of dietary heme is attributable to its high
        bioavailability compared with non-heme iron in the predominantly alkaline
        conditions found in the lumen of the small intestine. ”

        I fail to see the connection that Dr. Greger is trying to make and do not understand why he selected this article.

        I hope that others will be encouraged by my comment to read this article and try to interpret it for themselves.

        • HemoDynamic, M.D.

          BPC,
          I’m not disagreeing with you. And you make a good point that there is some regulation.
          But I’m trying to figure out exactly what Dr. Greger is talking about.  And after watching the video again, he specifically points out the mechanism on the left side of the cartoon in the article showing that ”Intact heme may be transported across the basolateral membrane (going straight into the blood) by FLVCR where it binds circulating hemopexin.” 

          And maybe there is more to this that he understands. 

           It is clear that our bodies uptake more Heme iron than Non-Heme Iron that’s why “myoglobin and hemoglobin make up two thirds of the average person’s total iron stores despite only constituting one-third of the iron that is actually ingested[4-6].”
          And if this is the case does this happen because there is less regulation of Heme iron compared to non-heme iron or is Heme-iron a preferred source by the body?

        • Kate Scott

           BPCveg: I think the confusion arises because Dr Greger is summarising a complicated process in a 2minute video. The sentence you quote from the article that “the ability to upregulate heme iron absorbtion is limited compared to non-heme iron” is consistent with what Dr Greger is saying, because the flip side of that statement is that the ability to downregulate heme iron absorbtion is also limited. Experiements have shown that absorption of non-heme iron is highly sensitive to how deficient the individual is and also to how much iron is in the meal (absorption of non-heme iron goes down with a higher amount of iron in the meal) but heme iron absorption tends to be much less sensitive to these factors. So if you eat a lot of red meat and have quite high iron stores, that is a problem because you will just keep absorbing the heme iron regardless. However, even though non-heme iron absorption is more sensitive to the iron status of individuals, it is still much more poorly absorbed overall relative to heme iron, which is why the authors of the article (and most dieticians) recommend heme iron because it is better able to prevent anemia. 

          For the person who is worried about chickpeas and omega-6 fatty acids, lentils are an even better source of non-heme iron. But really that concern over omega-6 is misplaced. As long as you avoid high omega-6 oils, the consumption of nuts and seeds will not be a problem and they have been shown so consistently to have positive health effects. Just throw in some flax seeds to balance things out.

          • BPCveg

            If possible, please provide some reputable sources to support your claims.

          • Gale

            Hi Kate,

            Ok. As I understand it we have a system that is great at regulating non-heme iron or heme iron. (when ferritin levels are around 60 the uptake stops) However with some people their regulatory system doesn’t work properly. They either absorb too much iron which is stored in different organs (damaging) or not enough is absorbed and then tend towards anemia.

            I think the main point Dr. Greger is trying to make is that taking iron supplements can cause oxidative stress and should be done only as a last resort.

            I couldn’t find any research articles that stated that the absorption of heme iron was not regulated as well. It appears we have an amazing system if it is working properly.

  • Rose

    It is possible that the oxidative effects associated with a higher intake of meat are increased when the meat source itself has been fattened on a corn/grain-based diet high in Omega 6 rather than a natural grass based diet higher in Omega 3s, and has less to do with excess non-heme iron than excess commercially-raised meat.

  • Jans Louis

    Just for everybody’s information concerning the absorption of heme iron.
    http://www.ncbi.nlm.nih.gov/pubmed/9756117 analyses also demonstrated an effective control of iron absorption preventing development of iron overload in otherwise healthy subjects even if the diet is fortified with iron and even if meat intake is high.
    http://www.ncbi.nlm.nih.gov/pubmed/8557018
    The powerful control of iron absorption implies that dietary iron overload cannot develop in normal subjects, even with diets having high iron content or high bioavailabilityhttp://www.ncbi.nlm.nih.gov/pubmed/9250114Iron absorption from the whole diet, which contained a highly bioavailable form of iron, was measured for 5 d in 31 health men, including 12 blood donors. Nonheme iron in all meals was labeled with an extrinsic, inorganic radioiron tracer added in amounts to ensure uniform specific activity in all meals. Heme iron was labeled similarly by using hemoglobin biosynthetically labeled with another radioiron tracer. There was a good inverse relation between total absorption and concentration of serum ferritin up to approximately 60 micrograms/L. In subjects with serum ferritin > 60 micrograms/L there was no relation to iron absorption. At this serum ferritin concentration, absorption decreased to a level just sufficient to cover basal iron losses, implying that at a serum ferritin concentration > or = 60 micrograms/L no further accumulation of iron stores will occur by dietary iron absorption. The findings thus suggest that in normal subjects there is no risk of developing iron overload by iron absorption from the diet even if the diet is fortified. Similar findings were made previously in two studies in women, both of which indicated an effective control of absorption. At the same serum ferritin concentration the absorption per kilogram body weight was the same in men and women served identical diets with a high iron bioavailability. These new observations strongly suggest that translation of serum ferritin concentration into amounts of stored iron should be made with caution and that in subjects with high serum ferritin concentrations, other causes than increased iron stores should be considered. There was effective control of both heme- and nonheme-iron absorption but their relations to iron status were different.

    • Jans Louis

      Bad copy and paste on the last link it seems, sorry: http://www.ncbi.nlm.nih.gov/pubmed/9250114

  • http://profile.yahoo.com/KUSZH4JCJXBWTORBG5T2XTQ5RI Massimo

     Dr. Greger,
    I would very much like to get a definitive (?) word about the absorption of non-heme iron ins omnivorous vs. vegetarians. The only clear statement I have found so far is in an article by C. Kies and L. Mc Endree, titled “Vegetarianism and the Bioavailability of Iron” published in 1982 by ACS (American Chemical Society) in the proceedings of the symposium “Bioavailabilty of Iron”, ed. by C. Kies, ISBN-10: 0841207461, ISBN-13: 978-0841207462. There, I found the statement that vegetarians absorb non-heme iron more efficiently then flesh eaters. It looks like our body boosts the absorption of non-heme iron when it cannot rely on heme iron, while if the latter is present, then it becomes “lazy” at non-heme iron.
    Are you aware of any later studies on this subject?

  • BPCveg

    jhnycmltly,

    Thanks for the abstract, though preferably it would be a peer-reviewed journal article, which is typically a more rigorously performed study.

    I think that the conclusion of this abstract, namely, “unlike nonheme iron, heme iron absorption is not substantially reduced as iron stores increase”, seems at first glance to be consistent with Dr. Greger’s message. However, they do not associate this reduced absorption with iron overload, as implied by Dr. Greger.

    In fact, the peer reviewed articles sent by Jans argue the opposite that:

    “… in normal subjects there is no risk of developing iron overload by iron absorption from the diet even if the diet is fortified.”

    I am still unconvinced that meat-eaters are prone to iron-overload.

    • Gale

      We agree with you. May this topic RIP.

    • jhnycmltly

      Quote: they do not provide evidence that meat consumption leads to iron overload,

      Answer: The body has no way to excrete the iron once it is absorbed.
      “Iron differs from other minerals because iron balance in the human body is regulated by absorption only because there is no physiologic mechanism for excretion”
      Heme iron , as evidenced , is absorbed all the time and you do not believe , “unconvinced” , that heme-iron leads to iron excess.
      “unlike nonheme iron, heme iron absorption is not substantially reduced as iron stores increase”
      You should maybe stay out of medicine.

  • jhnycmltly

    “The observed differences in estimated body iron stores in Greenlanders from the three residential areas can be explained by differences in the dietary intake of haem iron”
    http://www.ncbi.nlm.nih.gov/pubmed/11168519

    • jhnycmltly

      A curious thing about that study. Other researchers went back years later and found those people who DID have the highest iron stores ? they NOW had diabetes.
      “Prevalence of iron load highest in Uummannaq (men, 32.1%; women, 21.1%).”
      “The prevalence of diabetes in Unmmannaq was higher than that in the towns of Nuuk and Qasigiannguit”
      http://tinyurl.com/3xkawm

      http://care.diabetesjournals.org/content/25/10/1766.full.pdf

      Which means , “the dietary intake of haem iron” , predicted the development of diabetes because the FIRST researchers explained the high iron due to meat eating / haem iron.

  • Carlos169

    This seems to be interesting coming from the meat science journal:
    Denis E. Corpet, Red meat and colon cancer: Should we become vegetarians, or can we make meat safer?, Meat Science, Volume 89, Issue 3, November 2011, Pages 310-316, ISSN 0309-1740, 10.1016/j.meatsci.2011.04.009.
    (http://www.sciencedirect.com/science/article/pii/S0309174011001458)

  • BPCveg

    Good find, Carlos.

    Just read the full article, available freely: http://hal.archives-ouvertes.fr/docs/00/59/29/66/PDF/Corpet-meat-cancer-veg-safer-Meat-Sci-2011-Author-version-2011.pdf

    The conclusion made me chuckle:

    ” Our experimental studies in rats provide direct evidence that red meat and processed meat can increase colon carcinogenesis. They also strongly support the hypothesis that heme iron is the major cause of cancer promotion by red meat. Based on works by other researchers, our results add some evidence to two pathways linking dietary heme iron and cancer promotion. Lastly, we are suggesting several ways to prevent the toxic effect of meat, either by increasing the calcium load of the meal, by changing the meat processing, or by choosing new additives. Full demonstration of mechanisms and of chemopreventive substances has not yet been given, but we expect that these studies will lead to a reduction of the risk of colorectal cancer without losing the nutritional benefit and the pleasure of eating meat.”

    I guess we shouldn’t be surprised by the spin they add in the final sentence given the journal’s title. ;)

  • Ellen M Helms

    I understand this is not the forum for a medical diagnosis so I’m just sharing what I was told after various blood tests and “events.”  I’ve had intestinal bleeding four times in the past four years.  Of course, after the bleeding, I became anemic (after two “events”, I needed a blood transfusion).  The follow-up blood tests revealed that my body does not absorb nor store iron well and I was told to take “chronic iron” as my gastroenterologist put.  (all the tests showed no abnormal growths, tumor or anything threatening, though two tests revealed a large blood vessel on the wall of the lower intestine but then after an enteroscopy, there were no large blood vessel found.)  

    I’ve been plant strong for three weeks, with occasional cheese when eating out with friends (that will now stop because my weight loss, 15 pounds so far, may have reached a plateau).  My plan is to have my blood tested again in another month or so to see where my iron levels are, as well as cholesterol.  I’ve also never felt better!!

    My question is about the iron absorption, storing issue…wondering if I should continue taking “chronic iron”.  I appreciate the video on iron being a double-edge sword but I’d like to have more information; what other links should I check out?

    Many thanks for sharing such important information!!

  • Beck

    What information is out there about taking Iron Infusion for anemia.  Does Iron Infusion cause the same risks such as Parkinsons, oxidative stress?

  • Jan P. de Baat Doelman

    What to do when serum iron is far too high and ferritin level far too low?

  • LynnCS

    Glad I had some smart docs when I went through my time of iron deficienanemia, after not getting help from several others. I didn’t understand about the ‘stores.’ I apparently had had a bleeding ulcer which went undiagnosed (a not so smart doc) when I had a lot of gastric symptoms. (to those who are given a diagnosis of GERD…follow your instinct and get a second opinion.) Anyway, the iron thing….I also was diagnosed with a VERY low thyroid. I was eventually put on a triple dose, 180 mgs of Armour Thyroid along with some other supplements and a liquid iron. It was quite a crash. As time went on I was told to stop the iron, that I checked ok and the ‘stores’ issue was explained. I also started to complain of heart palpitations and the thyroid was lowered, and lowered, and lowered. At some point, I couldn’t get the Armour thyroid any more and I just put off getting another product. A couple years later, it happened again. Sleep disorders, cold to the bone, hair falling out, etc. Just felt horrible! This time I checked out ok for both the iron and the TSH. Changed docs again to an ‘alternative’ doc and was getting a more reasonable discussion of the tests. He found it beneficial to prescribe a single dose of the Armour again. ( it had become available again.) There was some suspicion of Hashimoto’s. I wasn’t tested for it because the single dose of Armour and a single cup of coffee (I use the Folger’s singles to limit what I make) in the morning seems to have turned around the ADD, depression/anxiety and sleep problems. Go figure! Don’t know it this makes any sense to anyone but, I am told that the coffee acts as an upper to excite the brain’s centers that in turn put out the necessary chemicals which affect these chronic disabling issues. I have been on Cymbalta for several years after trying several antidepressants/antianxiety meds that made things worse. I was ready to give up and die. Oh, BTW. I was taking it for terrible Fibromialgia too.

    I took up a raw vegan diet and now not as perfectly raw but definitely vegan. High quality/very low fat. (Your videos and articles help) I feel better than I have for a long, long time. Maybe ever. I don’t want to rock the boat but am getting heart palpitations again. I’ve had all available heart checkups and no serious problems found. I can try taking a little less coffee. I have also been using some ‘herbal’ supplements like Ashwaganda, Astragalus, Holy Basil, Reishi Mushroom, and Ho Sho Wu. I also include some Ceylon Cinnamon which helps with blood sugar balance. My BSugar tests are ok, but helps the cold feeling. I also notice, or think I do, that the palpitations are better when I add some vegan protein powder to my green drink.

    I guess that’s a lot of info. I’M confused, so anyone reading this will be too, I’m sure.

    I’m not trying to get any kind of diagnoses here, but you asked about questions, so my question is….

    Do you see anything glaring here that would tell you I’m doing something right or wrong?

    Thanks for all you do. I read most of your posts and certainly go to your site first when I need to look up some info. Lynn

  • Changeisgood

    Dr. Gregor, What are your thoughts and conclusions about the use of Iron infusion? if one’s iron level at 5. It looks almost impossible to get irons levels high enough, quick enough, without Iron infusion. Sincerely, sleepy in Seattle.

    • http://www.DonForresterMD.com/ Don Forrester MD

      If you have a low iron level the most important thing is to find out why. Dietary, menstrual blood loss and losing blood in gastrointestinal tract from a variety of conditions (e.g. ulcers, tumors). Once the underlying cause is determined and treated there are several ways to replenish depleted iron stores and iron levels. In over 30 years of practice I never saw a case where a patient that needed iron infusions even injectable iron can cause problems. I favor gradual resolution through oral supplementation. You need to work with your physicians as each case is individual. If your physician recommends either infusion or intramuscular injection I would have them back up there recommendations with scientific studies as well as full disclosure of the alternatives such as oral therapy. You need to work with your physicians over time as each patients situation is unique.

  • Disa

    Dear Dr Greger. Thank you for providing us with this fantastic source of nutritional information. I just have one question about iron supplements. Are iron supplements coming from a non-animal source also harmful? I’m taking supplements specialized for vegetarians/vegans (containing B12, Iron, Calcium, Zink, among other) so they don’t contain any blood heme. Should I still be cautious about the iron supplement?

    Background: I’m vegan now and I’ve had a tendency to become anemic since high school (when I had an omnivorous diet), so I think that it would be good for me to eat iron supplements.

    • http://www.DonForresterMD.com/ Don Forrester MD

      There is no need to take iron supplements unless you have diagnosed iron deficiency. The same can be said for Calcium and Zinc. Neal Barnard’s new book, Power Foods for the Brain, reviews the risks of exposure to excess metals such as copper, zinc and iron and Alzheimer’s disease…. just another reason to avoid all supplements except vitamin b12 unless diagnosed with deficiency. You need to remember that about 5% of folks are outside the normal range on blood tests normally.

  • http://www.facebook.com/darryl.roy.752 Darryl Roy

    There is one way to reduce excess iron in healthy adults: blood donation.

    Possible association of a reduction in cardiovascular events with blood donation.
    DG Meyers et al. Heart. 1997

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC484902/pdf/heart00009-0106.pdf

    Donation of blood is associated with reduced risk of myocardial infarction the Kuopio Ischaemic Heart Disease Risk Factor study
    JT Salonen et al. American journal of Epidemiology. 1998

    http://aje.oxfordjournals.org/content/148/5/445.full.pdf

    Blood Donations and Risk of Coronary Heart Disease in Men. A Ascherio et al. Circulation. 2001

    http://circ.ahajournals.org/content/103/1/52.full

    Decreased cancer risk after iron reduction in patients with peripheral arterial disease
    LR Zacharskie et al. J. National Cancer Institute. 2008

    http://jnci.oxfordjournals.org/content/100/14/996.long

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