I’m iron deficient. Which supplements will work best for me and how should I take them?
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Iron deficiency is common and can be debilitating. It mainly affects women. One in three premenopausal women are low in iron compared to just 5% of Australian men. Iron deficiency particularly affects teenage girls, women who do a lot of exercise and those who are pregnant.
The body needs iron to make new red blood cells, and to support energy production, the immune system and cognitive function. If you’re low, you may experience a range of symptoms including fatigue, weakness, shortness of breath, headache, irregular heartbeat and reduced concentration.
If a blood test shows you’re iron deficient, your doctor may recommend you start taking an oral iron supplement. But should you take a tablet or a liquid? With food or not? And when is the best time of day?
Here are some tips to help you work out how, when and what iron supplement to take.
How do I pick the right iron supplement?
The iron in your body is called “elemental iron”. Choosing the right oral supplement and dose will depend on how much elemental iron it has – your doctor will advise exactly how much you need.
The sweet spot is between 60-120 mg of elemental iron. Any less and the supplement won’t be effective in topping up your iron levels. Any higher and you risk gastrointestinal symptoms such as diarrhoea, cramping and stomach pain.
In Australia, iron salts are the most common oral supplements because they are cheap, effective and come in different delivery methods (tablets, capsules, liquid formulas). The iron salts you are most likely to find in your local chemist are ferrous sulfate (~20% elemental iron), ferrous gluconate (~12%) and ferrous fumarate (~33%).
These formulations all work similarly, so your choice should come down to dose and cost.
Many multivitamins may look like an iron supplement, but it’s important to note they usually have too little iron – usually less than 20 mg – to correct an iron deficiency.
Should I take tablets or liquid formulas?
Iron contained within a tablet is just as well absorbed as iron found in a liquid supplement. Choosing the right one usually comes down to personal preference.
The main difference is that liquid formulas tend to contain less iron than tablets. That means you might need to take more of the product to get the right dose, so using a liquid supplement could work out to be more expensive in the long term.
What should I eat with my iron supplement?
Research has shown you will absorb more of the iron in your supplement if you take it on an empty stomach. But this can cause more gastrointestinal issues, so might not be practical for everyone.
If you do take your supplement with meals, it’s important to think about what types of food will boost – rather than limit – iron absorption. For example, taking the supplement alongside vitamin C improves your body’s ability to absorb it.
Some supplements already contain vitamin C. Otherwise you could take the supplement along with a glass of orange juice, or other vitamin C-rich foods.
On the other hand, tea, coffee and calcium all decrease the body’s ability to absorb iron. So you should try to limit these close to the time you take your supplement.
Should I take my supplement in the morning or evening?
The best time of day to take your supplement is in the morning. The body can absorb significantly more iron earlier in the day, when concentrations of hepcidin (the main hormone that regulates iron) are at their lowest.
Exercise also affects the hormone that regulates iron. That means taking your iron supplement after exercising can limit your ability to absorb it. Taking your supplement in the hours following exercise will mean significantly poorer absorption, especially if you take it between two and five hours after you stop.
Our research has shown if you exercise every day, the best time to take your supplement is in the morning before training, or immediately after (within 30 minutes).
My supplements are upsetting my stomach. What should I do?
If you experience gastrointestinal side effects such as diarrhoea or cramps when you take iron supplements, you may want to consider taking your supplement every second day, rather than daily.
Taking a supplement every day is still the fastest way to restore your iron levels. But a recent study has shown taking the same total dose can be just as effective when it’s taken on alternate days. For example, taking a supplement every day for three months works as well as every second day for six months. This results in fewer side effects.
Oral iron supplements can be a cheap and easy way to correct an iron deficiency. But ensuring you are taking the right product, under the right conditions, is crucial for their success.
It’s also important to check your iron levels prior to commencing iron supplementation and do so only under medical advice. In large amounts, iron can be toxic, so you don’t want to be consuming additional iron if your body doesn’t need it.
If you think you may be low on iron, talk to your GP to find out your best options.
Alannah McKay, Postdoctoral Research Fellow, Sports Nutrition, Australian Catholic University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Older adults need another COVID-19 vaccine
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What you need to know
- The CDC recommends people 65 and older and immunocompromised people receive an additional dose of the updated COVID-19 vaccine this spring—if at least four months have passed since they received a COVID-19 vaccine.
- Updated COVID-19 vaccines are effective at protecting against severe illness, hospitalization, death, and long COVID.
- The CDC also shortened the isolation period for people who are sick with COVID-19.
Last week, the CDC said people 65 and older should receive an additional dose of the updated COVID-19 vaccine this spring. The recommendation also applies to immunocompromised people, who were already eligible for an additional dose.
Older adults made up two-thirds of COVID-19-related hospitalizations between October 2023 and January 2024, so enhancing protection for this group is critical.
The CDC also shortened the isolation period for people who are sick with COVID-19, although the contagiousness of COVID-19 has not changed.
Read on to learn more about the CDC’s updated vaccination and isolation recommendations.
Who is eligible for another COVID-19 vaccine this spring?
The CDC recommends that people ages 65 and older and immunocompromised people receive an additional dose of the updated COVID-19 vaccine this spring—if at least four months have passed since they received a COVID-19 vaccine. It’s safe to receive an updated COVID-19 vaccine from Pfizer, Moderna, or Novavax, regardless of which COVID-19 vaccines you received in the past.
Updated COVID-19 vaccines are available at pharmacies, local clinics, or doctor’s offices. Visit Vaccines.gov to find an appointment near you.
Under- and uninsured adults can get the updated COVID-19 vaccine for free through the CDC’s Bridge Access Program. If you’re over 60 and unable to leave your home, call the Aging Network at 1-800-677-1116 to learn about free at-home vaccination options.
What are the benefits of staying up to date on COVID-19 vaccines?
Staying up to date on COVID-19 vaccines prevents severe illness, hospitalization, death, and long COVID.
Additionally, the CDC says staying up to date on COVID-19 vaccines is a safer and more reliable way to build protection against COVID-19 than getting sick from COVID-19.
What are the new COVID-19 isolation guidelines?
According to the CDC’s general respiratory virus guidance, people who are sick with COVID-19 or another common respiratory illness, like the flu or RSV, should isolate until they’ve been fever-free for at least 24 hours without the use of fever-reducing medication and their symptoms improve.
After that, the CDC recommends taking additional precautions for the next five days: wearing a well-fitting mask, limiting close contact with others, and improving ventilation in your home if you live with others.
If you’re sick with COVID-19, you can infect others for five to 12 days, or longer. Moderately or severely immunocompromised patients may remain infectious beyond 20 days.
For more information, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Spoon-Fed – by Dr. Tim Spector
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Dr. Spector looks at widespread beliefs about food, and where those often scientifically disproven beliefs come from. Hint, there’s usually some manner of “follow the money”.
From calorie-counting to cholesterol content, from fish to bottled water, to why of all the people who self-report having an allergy, only around half turn out to actually have one when tested, Dr. Spector sets the record straight.
The style is as very down-to-earth and not at all self-aggrandizing; the author acknowledges his own mistakes and limitations along the way. In terms of pushing any particular agenda, his only agenda is clear: inform the public about bad science, so that we demand better science going forwards. Along the way, he gives us lots of information that can inform our personal health choices based on better science than indiscriminate headlines wildly (and sometimes intentionally) misinterpreting results.
Read this book, and you may find yourself clicking through to read the studies for yourself, next time you see a bold headline.
Bottom line: this book looks at a lot of what’s wrong with what a lot of people believe about healthy eating. Regular 10almonds readers might not find a lot that’s new here, but it could be a great gift for a would-be health-conscious friend or relative
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Nicotine pouches are being marketed to young people on social media. But are they safe, or even legal?
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Flavoured nicotine pouches are being promoted to young people on social media platforms such as TikTok and Instagram.
Although some viral videos have been taken down following a series of reports in The Guardian, clips featuring Australian influencers have claimed nicotine pouches are a safe and effective way to quit vaping. A number of the videos have included links to websites selling these products.
With the rapid rise in youth vaping and the subsequent implementation of several reforms to restrict access to vaping products, it’s not entirely surprising the tobacco industry is introducing more products to maintain its future revenue stream.
The major trans-national tobacco companies, including Philip Morris International and British American Tobacco, all manufacture nicotine pouches. British American Tobacco’s brand of nicotine pouches, Velo, is a leading sponsor of the McLaren Formula 1 team.
But what are nicotine pouches, and are they even legal in Australia?
Like snus, but different
Nicotine pouches are available in many countries around the world, and their sales are increasing rapidly, especially among young people.
Nicotine pouches look a bit like small tea bags and are placed between the lip and gum. They’re typically sold in small, colourful tins of about 15 to 20 pouches. While the pouches don’t contain tobacco, they do contain nicotine that is either extracted from tobacco plants or made synthetically. The pouches come in a wide range of strengths.
As well as nicotine, the pouches commonly contain plant fibres (in place of tobacco, plant fibres serve as a filler and give the pouches shape), sweeteners and flavours. Just like for vaping products, there’s a vast array of pouch flavours available including different varieties of fruit, confectionery, spices and drinks.
The range of appealing flavours, as well as the fact they can be used discreetly, may make nicotine pouches particularity attractive to young people.
Vaping has recently been subject to tighter regulation in Australia.
Aleksandr Yu/ShutterstockUsers absorb the nicotine in their mouths and simply replace the pouch when all the nicotine has been absorbed. Tobacco-free nicotine pouches are a relatively recent product, but similar style products that do contain tobacco, known as snus, have been popular in Scandinavian countries, particularly Sweden, for decades.
Snus and nicotine pouches are however different products. And given snus contains tobacco and nicotine pouches don’t, the products are subject to quite different regulations in Australia.
What does the law say?
Pouches that contain tobacco, like snus, have been banned in Australia since 1991, as part of a consumer product ban on all forms of smokeless tobacco products. This means other smokeless tobacco products such as chewing tobacco, snuff, and dissolvable tobacco sticks or tablets, are also banned from sale in Australia.
Tobacco-free nicotine pouches cannot legally be sold by general retailers, like tobacconists and convenience stores, in Australia either. But the reasons for this are more complex.
In Australia, under the Poisons Standard, nicotine is a prescription-only medicine, with two exceptions. Nicotine can be used in tobacco prepared and packed for smoking, such as cigarettes, roll-your-own tobacco, and cigars, as well as in preparations for therapeutic use as a smoking cessation aid, such as nicotine patches, gum, mouth spray and lozenges.
If a nicotine-containing product does not meet either of these two exceptions, it cannot be legally sold by general retailers. No nicotine pouches have currently been approved by the Therapeutic Goods Administration as a therapeutic aid in smoking cessation, so in short they’re not legal to sell in Australia.
However, nicotine pouches can be legally imported for personal use only if users have a prescription from a medical professional who can assess if the product is appropriate for individual use.
We only have anecdotal reports of nicotine pouch use, not hard data, as these products are very new in Australia. But we do know authorities are increasingly seizing these products from retailers. It’s highly unlikely any young people using nicotine pouches are accessing them through legal channels.
Health concerns
Nicotine exposure may induce effects including dizziness, headache, nausea and abdominal cramps, especially among people who don’t normally smoke or vape.
Although we don’t yet have much evidence on the long term health effects of nicotine pouches, we know nicotine is addictive and harmful to health. For example, it can cause problems in the cardiovascular system (such as heart arrhythmia), particularly at high doses. It may also have negative effects on adolescent brain development.
The nicotine contents of some of the nicotine pouches on the market is alarmingly high. Certain brands offer pouches containing more than 10mg of nicotine, which is similar to a cigarette. According to a World Health Organization (WHO) report, pouches deliver enough nicotine to induce and sustain nicotine addiction.
Pouches are also being marketed as a product to use when it’s not possible to vape or smoke, such as on a plane. So instead of helping a person quit they may be used in addition to smoking and vaping. And importantly, there’s no clear evidence pouches are an effective smoking or vaping cessation aid.
A Velo product display at Dubai airport in October 2022. Nicotine pouches are marketed as safe to use on planes.
Becky FreemanFurther, some nicotine pouches, despite being tobacco-free, still contain tobacco-specific nitrosamines. These compounds can damage DNA, and with long term exposure, can cause cancer.
Overall, there’s limited data on the harms of nicotine pouches because they’ve been on the market for only a short time. But the WHO recommends a cautious approach given their similarities to smokeless tobacco products.
For anyone wanting advice and support to quit smoking or vaping, it’s best to talk to your doctor or pharmacist, or access trusted sources such as Quitline or the iCanQuit website.
Becky Freeman, Associate Professor, School of Public Health, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Heavy Metal Detox In A Pill?
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We have previous discussed assorted approaches to “detoxing”:
Detox: What’s Real, What’s Not, What’s Useful, What’s Dangerous?
Today we’re going to be looking at one we didn’t cover there, which is zeolite.
What is zeolite?
Zeolite is a mineral that occurs naturally and can also be synthesized, and it’s famous for absorbing other stuff from around it. Because of this property, it’s used in many things, including:
- Petrochemical catalysis
- Water treatment
- Nuclear waste reprocessing
- Cat litter
- Supplements (for detox purposes)
That’s, uh… An interesting list, isn’t it? So, we were curious as to whether this mineral that’s also used in fish tank filters is, in fact, overpriced gravel being sold to the gullible as a health supplement.
We had to do some digging on this one
Our journey didn’t start well, with this very dubious-looking paper being cited by a company selling zeolite supplements:
This immediately prompted two questions:
- Who is eating graphene?!* That stuff does not occur in nature (or at least; it hasn’t ever been found; the universe is a big place so it might exist elsewhere), has only relatively recently been synthesized, is very difficult to produce, is two-dimensional while being hard as diamonds, and exists only in truly tiny lab-made quantities worldwide. It would be orders of magnitude easier to find and eat uranium.
- Is this a reputable journal? Which question was easier to answer than the former one, and the answer is “no”; we hadn’t heard of this journal (ACTA Scientific), and neither it seems had most of the Internet, but we did find it on a list of predatory journals, here.
*The citation given in the above paper should by rights answer the question of who is eating graphene, since by rights they must have demonstrated it somehow, but it just doesn’t. Instead, it links to what it claims is a paper titled “Oxygenated Zeolite (Clinoptilite) Efficiently Removes Aluminum & Graphene Oxide”, but is in reality just someone’s blog post with a screenshot of an actual paper entitled “Novel, oxygenated clinoptilolite material efficiently removes aluminium from aluminium chloride-intoxicated rats in vivo”). Looking up this real paper in its real journal, it does not mention graphene.
All this to say: sometimes, unscrupulous people will just plain lie to you, which is why peer review is important, as is sourcing data from reputable journals. Which is what we do for you so that you don’t have to 🙂
It does, actually, work though (for heavy metal detox)
Notwithstanding the aforementioned bunk, we found this from a more reputable publisher:
❝In this study, we have presented clinical evidence supporting the use of an activated clinoptilolite (zeolite) suspension to safely and effectively increase the urinary excretion of potentially toxic heavy metals in healthy volunteers without negatively impacting the electrolyte profiles of the participants.
Significant increases in the urinary excretion of aluminum, antimony, arsenic, bismuth, cadmium, lead, mercury, nickel and tin were observed in the subjects participating in the two study groups as compared to placebo controls.❞
Also good for the gut and against inflammation
Specifically, it’s good for gut barrier integrity, i.e., against “leaky gut syndrome”:
❝Twelve weeks of zeolite supplementation exerted beneficial effects on intestinal wall integrity as indicated via decreased concentrations of the tight junction modulator zonulin.
This was accompanied by mild anti-inflammatory effects in this cohort of aerobically trained subjects.❞
May also be good against neurodegenerative diseases
If it is (which is plausible), it’ll probably because of removing heavy metals and improving gut barrier integrity—in other words, the things we just looked at in the two reputable peer-reviewed studies we examined above.
But the science is young for this one; here’s the current state of things:
Zeolite and Neurodegenerative Diseases
Is it safe?
Safety reviews have found it to be safe, for example:
Critical Review on Zeolite Clinoptilolite Safety and Medical Applications in vivo
However, if you are taking regular medications, we recommend checking with your pharmacist or doctor to ensure that zeolite will not also remove those medications from your system!
Want to try some?
We don’t sell it, but here for your convenience is an example product on Amazon 😎
Enjoy!
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Walnut, Apricot, & Sage Nut Roast
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It’s important to have at least one good nut roast recipe in your repertoire. It’s something that’s very good for making a good dish out of odds and ends that are in your house, and done well, it’s not only filling and nutritious, but a tasty treat too. Done badly, everyone knows the results can be unfortunate… Making this the perfect way to show off your skills!
You will need
- 1 cup walnuts
- ½ cup almonds
- ¼ cup whole mixed seeds (chia, pumpkin, & poppy are great)
- ¼ cup ground flax (also called flax meal)
- 1 medium onion, finely chopped
- 1 large carrot, grated
- 4 oz dried apricots, chopped
- 3 oz mushrooms, chopped
- 1 oz dried goji berries
- ½ bulb garlic, crushed
- 2 tbsp fresh sage, chopped
- 1 tbsp nutritional yeast
- 2 tsp dried rosemary
- 2 tsp dried thyme
- 2 tsp black pepper, coarse ground
- 1 tsp yeast extract (even if you don’t like it; trust us; it will work) dissolved in ¼ cup hot water
- ½ tsp MSG or 1 tsp low-sodium salt
- Extra virgin olive oil
Method
(we suggest you read everything at least once before doing anything)
1) Preheat the oven to 350℉ / 180℃, and line a 2 lb loaf tin with baking paper.
2) Heat some oil in a skillet over a moderate heat, and fry the onion for a few minutes until translucent. Add the garlic, carrot, and mushrooms, cooking for another 5 minutes, stirring well. Set aside to cool a little once done.
3) Process the nuts in a food processor, pulsing until they are well-chopped but not so much that they turn into flour.
4) Combine the nuts, vegetables, and all the other ingredients in a big bowl, and mix thoroughly. If it doesn’t have enough structural integrity to be thick and sticky and somewhat standing up by itself if you shape it, add more ground flax. If it is too dry, add a little water but be sparing.
5) Spoon the mixture into the loaf tin, press down well (or else it will break upon removal), cover with foil and bake for 30 minutes. Remove the foil, and bake for a further 15 minutes, until firm and golden. When done, allow it to rest in the tin for a further 15 minutes, before turning it out.
6) Serve, as part of a roast dinner (roast potatoes, vegetables, gravy, etc).
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Why You Should Diversify Your Nuts!
- Chia Seeds vs Pumpkin Seeds – Which is Healthier?
- Apricots vs Peaches – Which is Healthier?
- Goji Berries: Which Benefits Do They Really Have?
- Ergothioneine: “The Longevity Vitamin” (That’s Not A Vitamin)
Take care!
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Fluoride Toothpaste vs Non-Fluoride Toothpaste – Which is Healthier?
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Our Verdict
When comparing fluoride toothpaste to non-fluoride toothpaste, we picked the fluoride.
Why?
Fluoride is indeed toxic; that’s why it’s in toothpaste (to kill things; namely, bacteria whose waste products would harm our teeth). However, we are much bigger than those bacteria.
Given the amount of fluoride in toothpaste (usually under 1mg per strip of toothpaste to cover a toothbrush head), the amount that people swallow unintentionally (about 1/20th of that, so about 0.1mg daily if brushing teeth twice daily), and the toxicity level of fluoride (32–64mg/kg), then even if we take the most dangerous ends of all those numbers (and an average body size), to suffer ill effects from fluoride due to brushing your teeth, would require that you brush your teeth more than 23,000 times per day.
Alternatively, if you were to ravenously eat the toothpaste instead of spitting it out, you’d only need to brush your teeth a little over 1,000 times per day.
All the same, please don’t eat toothpaste; that’s not the message here.
However! In head-to-head tests, fluoride toothpaste has almost always beaten non-fluoride toothpaste.
Almost? Yes, almost: hydroxyapatite performed equally in one study, but that’s not usually an option on as many supermarket shelves.
We found some on Amazon, though, which is the one we used for today’s head-to-head. Here it is:
However, before you rush to buy it, do be aware that the toxicity of hydroxyapatite appears to be about twice that of fluoride:
Scientific Committee on Consumer Safety Opinion On Hydroxyapatite (Nano)
…which is still very safe (you’d need to brush your teeth, and eat all the toothpaste, about 500 times per day, to get to toxic levels, if we run with the same numbers we discussed before. Again, please do not do that, though).
But, since the science so far suggests it’s about twice as toxic as fluoride, then regardless of that still being very safe, the fluoride is obviously (by the same metric) twice as safe, hence picking the fluoride.
Want more options?
Check out our previous main feature:
Less Common Oral Hygiene Options
(the above article also links back to our discussion of different toothpastes and mouthwashes, by the way)
Take care!
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