By far the most common underlying cause of fatigue, anxiety and insomnia that I’ve noticed in clinic is anemia or low iron.  Is this because many people fail to eat regular meals or tend to believe a vegetarian diet is more healthy?  These are contributing factors as is gender and age.

Women in their childbearing years are especially prone to anemia.  More than twice the amount of iron is required per day to that of men.  During pregnancy and breastfeeding this increases to 28 mg/ day. Our male counterparts need only 8 mg/day in comparison.

Clams are the best source of iron with 28 mg per 100 gram serving. Oysters are also high at 12 mg.  Chicken and beef liver are excellent coming in at 13 mg and 7 mg respectively.  Muscle meats are not as effective at raising iron levels which is a little surprising.  For example ground bison has only 3-5 mg of iron per 100 mg serving.

Phytates in grains inhibits absorption of iron.  So do tannins in caffeine beverages and oxalates in some veggies.  Calcium can also pose a problem and shouldn’t be supplemented in any case.  Vitamin C increases availability of iron as does alcohol and hydrochloric acid.  Too much beta carotene consumption can lead to iron overload which we’ll discuss next.

Some people store iron aggressively due to a genetic abnormality. Hemochromatosis is associated with several conditions including liver disease, metabolic syndrome, dementia, Parkinson’s and infertility.  Treatment for this can include a prescription phlebotomy or blood donation. Lactoferrin is a protein used to remove iron from the tissues of the body naturally.  Those with this condition need to monitor levels and be cautious with foods high in iron.

Even mild iron overload can be dangerous. High iron levels are associated with insulin sensitivity and increased risk of mortality due to several causes.  In functional or preventative medicine we test several markers including ferritin, transferrin saturation, TIBC and UIBC (total and unsaturated iron binding capacity).

To understand functional markers better I’ll illustrate the how the levels are different. For ferritin, the Iron Disorders institute suggests a range between 25 to 75 whereas in conventional medicine normal can go much higher and significantly lower.  Checking iron and applying the functional ranges can help maintain optimal health and catch imbalance before it becomes disease.