Get your doctor’s advice about possible iron deficiency

Q. How should I change my diet to get more iron? I think I'm a little anemic.

Iron deficiency anemia is the most common form of anemia. About 20 percent of women, 50 percent of pregnant women, and 3 percent of men do not have enough iron in their bodies.

Some biology. If you have anemia, your blood does not carry enough oxygen to the rest of your body. The most common cause of anemia is iron deficiency. You need iron to make hemoglobin. Hemoglobin carries the oxygen from your lungs to the rest of your body.

If you suspect that you are anemic, you should see a doctor and get tested before embarking on a new diet. The following are blood tests you may be given:

• Hematocrit. This is a test for the percentage of your blood volume made up by red blood cells.
• Hemoglobin. Lower-than-normal hemoglobin levels indicate anemia.
• Ferritin. This is a protein that helps store iron in your body. A low level of ferritin usually indicates a low level of stored iron.

If your blood work indicates iron deficiency anemia, your doctor may order additional tests to diagnose the cause. These tests include:
• Endoscopy. A thin tube with a video camera is passed down your throat to your stomach. This allows your doctor to look for internal bleeding.
• Colonoscopy. Another thin tube with a video camera is inserted into the rectum and up to your colon to check for lower-intestinal bleeding,
• Ultrasound. This uses high-frequency sound waves to produce images within your body. Women may have a pelvic ultrasound to look for excessive menstrual bleeding.

The following are some causes of iron deficiency: insufficient iron intake, pregnancy, heavy menstrual flow, frequent blood donation, and hookworms that live in the small intestine.

There are two types of iron that we consume. There is “heme iron,” which comes from meat, fish and poultry. This kind of iron is absorbed more efficiently than “non-heme iron” from plants.

The amount of iron absorbed from plant foods depends on the other types of foods eaten at the same time. Foods containing heme iron enhance iron absorption from foods that contain non-heme iron.

Foods containing vitamin C also enhance non-heme iron absorption. Vegetarian diets are low in heme iron, but careful meal planning can help increase the amount of iron absorbed by vegetarians.

Another cause of iron deficiency is overdosing antacids, and taking medicine for peptic ulcers and acid reflux. These medications can reduce the amount of iron absorbed by your body.

The Recommended Dietary Allowance of iron for men 19 years of age and older is 8 milligrams a day. Women between 19 and 50 need 18 milligrams a day. Women older than 50 need 8 milligrams daily.

The symptoms of iron deficiency include fatigue, difficulty maintaining body temperature, increased susceptibility to infection, an inflamed tongue, blue color to the whites of the eyes, brittle nails, decreased appetite, headache, irritability, pale skin, shortness of breath, and unusual food cravings.

A common treatment for iron deficiency anemia is taking iron supplements. You may also be instructed to eat more iron-rich foods. Taking iron tablets with vitamin C improves the absorption of iron. You may need to take iron supplements for several months or longer to replenish your iron reserves. All of these steps should be taken with the guidance of a physician.