Dear Dietitian,

My teenage daughter was recently diagnosed with iron deficiency anemia. She follows a vegan diet and has been taking a vegan supplement. Are these as good as regular iron pills?

Mom

Dear Mom,

It is not uncommon for women of childbearing age to become iron deficient, especially if they have heavy menstrual periods. According to the US Department of Health and Human Services, iron deficiency is the most common nutritional deficiency and the leading cause of anemia in the United States. (1) The RDA of iron is 15 mg per day for women 14-18 years of age, 18 mg for women 19-50 years old, and 8 mg for men 19 years and older. Furthermore, the RDA of iron for vegans­ (those who abstain from all animal products) is 1.8 times more than those who eat meat.

Iron is needed to produce red blood cells, which carry oxygen to our organs and tissues. Without enough iron in our bodies, insufficient oxygen flows throughout, and we may become tired and weak.

Iron is plentiful in our food supply and is found in two forms. Heme iron comes from animal products like beef, poultry, and fish. Non-heme sources are found both in animal products and plant foods. Examples of non-heme iron are beans, spinach, and dried fruits such as apricots, raisins, and prunes. Breakfast cereals, flour, and bread are fortified with iron. Our bodies are estimated to absorb heme iron two to three times more efficiently than non-heme. Iron absorption depends on how much the body needs, and vitamin C aids in this process. Citrus fruits and juices, strawberries, and kiwi are good sources of vitamin C. If excessive amounts of iron are consumed, it will be excreted in the feces. 

Most iron supplements are made in a laboratory and contain an iron salt, such as iron gluconate or iron sulfate. These are absorbable, non-heme sources and are acceptable on a vegan diet. There are iron supplements derived from the curry tree, but studies on absorption rates are limited.

Absorption of iron supplements is best when taken on an empty stomach one to two hours before a meal. If stomach upset occurs, drink water or a cup of orange juice with the iron pill. If nausea or vomiting persists, take iron with a meal.

One last tip: when purchasing any supplement, be sure USP is on the label. The United States Pharmacopeia (USP) tests dietary supplements for quality, safety, and benefit.

References

1. Miller, JL. Iron deficiency anemia: a common and curable disease. Cold Spring Herb Med. 2013 Jul;3(7): a011866. doi: 10.1101/cshperspect.a011866

Until next time, be healthy!

Dear Dietitian