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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Popcorn vs Peanuts – Which is Healthier
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Our Verdict
When comparing air-popped popcorn to peanuts (without an allergy), we picked the peanuts.
Why?
Peanuts, if we were to list popular nuts in order of healthfulness, would not be near the top of the list. Many other nuts have more nutrients and fewer/lesser drawbacks.
But the comparison to popcorn shines a different light on it:
Popcorn has very few nutrients. It’s mostly carbs and fiber; it’s just not a lot of carbs because the manner of its consumption makes it a very light snack (literally). You can eat a bowlful and it was perhaps 30g. It has some small amounts of some minerals, but nothing that you could rely on it for. It’s mostly fresh air wrapped in fiber.
Peanuts, in contrast, are a much denser snack. High in calories yes, but also high in protein, their fats are mostly healthy, and they have not only a fair stock of vitamins and minerals, but also a respectable complement of beneficial phytochemicals: mostly assorted antioxidant polyphenols, but also oleic acid (as in olives, good for healthy triglyceride levels).
Another thing worth a mention is their cholesterol-reducing phytosterols (these reduce the absorption of dietary cholesterol, “good” and “bad”, so this is good for most people, bad for some, depending on the state of your cholesterol and what you ate near in time to eating the nuts)
Peanuts do have their clear downsides too: its phytic acid content can reduce the bioavailability of iron and zinc taken at the same time.
In summary: while popcorn’s greatest claim to dietary beneficence is its fiber content and that it’s close to being a “zero snack”, peanuts (eaten in moderation, say, the same 30g as the popcorn) have a lot to contribute to our daily nutritional requirements.
We do suggest enjoying other nuts though!
Read more: Why You Should Diversify Your Nuts!
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The Hormone Therapy That Reduces Breast Cancer Risk & More
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The Hormone Balancing Act
We’ve written before about menopausal HRT:
What You Should Have Been Told About Menopause Beforehand
…and even specifically about the considerations when it comes to breast cancer risk:
Menopausal Hormone Replacement Therapy
this really does bear reading, by the way—scroll down to the bit about breast cancer risk, because it’s not a simple increased/decreased risk; it can go either way, and which way it goes will depend on various factors including your medical history and what HRT, if any, you are taking.
Hormone Modulating Therapy
Hormone modulating therapy, henceforth HMT, is something a little different.
Instead of replacing hormones, as hormone replacement therapy does, guess what hormone modulating therapy does instead? That’s right…
MHT can modulate hormones by various means, but the one we’re going to talk about today does it by blocking estrogen receptors,
Isn’t that the opposite of what we want?
You would think so, but since for many people with an increased breast cancer risk, the presence of estrogen increases that risk, which leaves menopausal (peri- or post) people in an unfortunate situation, having to choose between increased breast cancer risk (with estrogen), or osteoporosis and increased dementia risk, amongst other problems (without).
However, the key here (in fact, that’s a very good analogy) is in how the blocker works. Hormones and their receptors are like keys and locks, meaning that the wrong-shaped hormone won’t accidentally trigger it. And when the right-shaped hormone comes along, it gets activated and the message (in this case, “do estrogenic stuff here!” gets conveyed). A blocker is sufficiently similar to fit into the receptor, without being so similar as to otherwise act as the hormone.
In this case, it has been found that HMT blocking estrogen receptors was sufficient to alleviate the breast cancer risk, while also being associated with a 7% lower risk of developing Alzheimer’s disease or related dementias, with that risk reduction being even greater for some demographics depending on race and age. Black women in the 65–74 age bracket enjoyed a 24% relative risk reduction, with white women of the same age getting an 11% relative risk reduction. Black women enjoyed the same benefits after that age, whereas white women starting it at that age did not get the same benefits. The conclusion drawn from this is that it’s good to start this at 65 if relevant and practicable, especially if white, because the protective effect is strongest when gained aged 65–69.
Here’s a pop-science article that goes into the details more deeply than we have room for here:
Hormone therapy for breast cancer linked with lower dementia risk
And here’s the paper itself; we highly recommend reading at least the abstract, because it goes into the numbers in much more detail than we reasonably can here. It’s a huge cohort study of 18,808 women aged 65 years or older, so this is highly relevant data:
Want to learn more?
If you’d like a much deeper understanding of breast cancer risk management, including in the context of hormone therapy, you might like this excellent book that we reviewed recently:
The Smart Woman’s Guide to Breast Cancer – by Dr. Jenn Simmons
Take care!
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10,000 Steps, 30 Days, 4 Changes
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Ariel wasn’t the most active person, and took on a “30 day challenge” to do the commonly-prescribed 10,000 steps per day—without adjusting her diet or doing any other exercise. How much of a difference does it make, really?
Stepping onwards
The 4 main things that she found changed for her weren’t all what she expected:
- Weight loss yes, but only marginally: she lost 3 lbs in a month, which did nevertheless make a visible difference. We might hypothesize that part of the reason for the small weight loss and yet visible difference is that she gained a little muscle, and the weight loss was specifically shifting away from a cortisol-based fat distribution, to a more healthy fat distribution.
- Different eating habits: she felt less hungry and craved less sugar. This likely has less to do with calorie consumption, and more to do with better insulin signalling.
- Increased energy and improved mood: these are going together in one item, because she said “4 things”, but really they are two related things. So, consider one of them a bonus item! In any case, she felt more energized and productive, and less reliant on caffeine.
- Improved sleep: or rather, at first, disrupted sleep, and then slept better and stayed better. A good reminder that changes for the better don’t always feel better in the first instance!
To hear about it in her own words, and see the before and after pictures, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
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Migraine Mythbusting
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Migraine: When Headaches Are The Tip Of The Neurological Iceberg
Yesterday, we asked you “What is a migraine?” and got the above-depicted, below-described spread of responses:
- Just under 46% said “a headache, but above a certain level of severity”
- Just under 23% said “a headache, but caused by a neurological disorder”
- Just over 21% said “a neurological disorder that can cause headaches”
- Just under 10% said “a headache, but with an attention-grabbing name”
So… What does the science say?
A migraine is a headache, but above a certain level of severity: True or False?
While that’s usually a very noticeable part of it… That’s only one part of it, and not a required diagnostic criterion. So, in terms of defining what a migraine is, False.
Indeed, migraine may occur without any headache, let alone a severe one, for example: Abdominal Migraine—though this is much less well-researched than the more common with-headache varieties.
Here are the defining characteristics of a migraine, with the handy mnemonic 5-4-3-2-1:
- 5 or more attacks
- 4 hours to 3 days in duration
- 2 or more of the following:
- Unilateral (affects only one side of the head)
- Pulsating
- Moderate or severe pain intensity
- Worsened by or causing avoidance of routine physical activity
- 1 or more of the following:
- Nausea and/or vomiting
- Sensitivity to both light and sound
Source: Cephalalgia | ICHD-II Classification: Parts 1–3: Primary, Secondary and Other
As one of our subscribers wrote:
❝I have chronic migraine, and it is NOT fun. It takes away from my enjoyment of family activities, time with friends, and even enjoying alone time. Anyone who says a migraine is just a bad headache has not had to deal with vertigo, nausea, loss of balance, photophobia, light sensitivity, or a host of other symptoms.❞
Migraine is a neurological disorder: True or False?
True! While the underlying causes aren’t known, what is known is that there are genetic and neurological factors at play.
❝Migraine is a recurrent, disabling neurological disorder. The World Health Organization ranks migraine as the most prevalent, disabling, long-term neurological condition when taking into account years lost due to disability.
Considerable progress has been made in elucidating the pathophysiological mechanisms of migraine, associated genetic factors that may influence susceptibility to the disease❞
Source: JHP | Mechanisms of migraine as a chronic evolutive condition
Migraine is just a headache with a more attention-grabbing name: True or False?
Clearly, False.
As we’ve already covered why above, we’ll just close today with a nod to an old joke amongst people with chronic illnesses in general:
“Are you just saying that because you want attention?”
“Yes… Medical attention!”
Want to learn more?
You can find a lot of resources at…
NIH | National Institute of Neurological Disorders & Stroke | Migraine
and…
The Migraine Trust ← helpfully, this one has a “Calm mode” to tone down the colorscheme of the website!
Particularly useful from the above site are its pages:
Take care!
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10 Tips To Reduce Morning Pain & Stiffness With Arthritis
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Physiotherapist and osteoarthritis specialist Dr. Alyssa Kuhn has professional advice:
Just the tips
We’ll not keep them a mystery; they are:
- Perform movements that target the range of motion in stiff joints, especially in knees and hips, to prevent them from being stuck in limited positions overnight.
- Use relaxation techniques like a hot shower, heating pad, or light reading before bed to reduce muscle tension and stiffness upon waking.
- Manage joint swelling during the day through gentle movement, compression sleeves, and self-massage .
- Maintain a balanced level of activity throughout the day to avoid excessive stiffness from either overactivity or, on the flipside, prolonged inactivity.
- Use pillows to support joints, such as placing one between your knees for hip and knee arthritis, and ensure you have a comfortable pillow for neck support.
- Eat anti-inflammatory foods prioritizing fruits and vegetables to reduce joint stiffness, and avoid foods high in added sugar, trans-fats, and saturated fats.
- Perform simple morning exercises targeting stiff areas to quickly relieve stiffness and ease into your daily routine.
- Engage in strength training exercises 2–3 times per week to build stronger muscles around the joints, which can reduce stiffness and pain.
- Ensure you get 7–8 hours of restful sleep, as poor sleep can increase stiffness and pain sensitivity the next day. 10almonds note: we realize there’s a degree of “catch 22” here, but we’re simply reporting her advice. Of course, do what you can to prioritize being able to get the best quality sleep you can.
- Perform gentle movements or stretches before bed to keep joints limber, focusing on exercises that feel comfortable and soothing.
For more on each of these plus some visual demonstrations, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
- Avoiding/Managing Osteoarthritis
- Avoiding/Managing Rheumatoid Arthritis
- Managing Chronic Pain (Realistically!)
Take care!
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What are heart rate zones, and how can you incorporate them into your exercise routine?
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If you spend a lot of time exploring fitness content online, you might have come across the concept of heart rate zones. Heart rate zone training has become more popular in recent years partly because of the boom in wearable technology which, among other functions, allows people to easily track their heart rates.
Heart rate zones reflect different levels of intensity during aerobic exercise. They’re most often based on a percentage of your maximum heart rate, which is the highest number of beats your heart can achieve per minute.
But what are the different heart rate zones, and how can you use these zones to optimise your workout?
The three-zone model
While there are several models used to describe heart rate zones, the most common model in the scientific literature is the three-zone model, where the zones may be categorised as follows:
- zone 1: 55%–82% of maximum heart rate
- zone 2: 82%–87% of maximum heart rate
- zone 3: 87%–97% of maximum heart rate.
If you’re not sure what your maximum heart rate is, it can be calculated using this equation: 208 – (0.7 × age in years). For example, I’m 32 years old. 208 – (0.7 x 32) = 185.6, so my predicted maximum heart rate is around 186 beats per minute.
There are also other models used to describe heart rate zones, such as the five-zone model (as its name implies, this one has five distinct zones). These models largely describe the same thing and can mostly be used interchangeably.
What do the different zones involve?
The three zones are based around a person’s lactate threshold, which describes the point at which exercise intensity moves from being predominantly aerobic, to predominantly anaerobic.
Aerobic exercise uses oxygen to help our muscles keep going, ensuring we can continue for a long time without fatiguing. Anaerobic exercise, however, uses stored energy to fuel exercise. Anaerobic exercise also accrues metabolic byproducts (such as lactate) that increase fatigue, meaning we can only produce energy anaerobically for a short time.
On average your lactate threshold tends to sit around 85% of your maximum heart rate, although this varies from person to person, and can be higher in athletes.
Wearable technology has taken off in recent years. Ketut Subiyanto/Pexels In the three-zone model, each zone loosely describes one of three types of training.
Zone 1 represents high-volume, low-intensity exercise, usually performed for long periods and at an easy pace, well below lactate threshold. Examples include jogging or cycling at a gentle pace.
Zone 2 is threshold training, also known as tempo training, a moderate intensity training method performed for moderate durations, at (or around) lactate threshold. This could be running, rowing or cycling at a speed where it’s difficult to speak full sentences.
Zone 3 mostly describes methods of high-intensity interval training, which are performed for shorter durations and at intensities above lactate threshold. For example, any circuit style workout that has you exercising hard for 30 seconds then resting for 30 seconds would be zone 3.
Striking a balance
To maximise endurance performance, you need to strike a balance between doing enough training to elicit positive changes, while avoiding over-training, injury and burnout.
While zone 3 is thought to produce the largest improvements in maximal oxygen uptake – one of the best predictors of endurance performance and overall health – it’s also the most tiring. This means you can only perform so much of it before it becomes too much.
Training in different heart rate zones improves slightly different physiological qualities, and so by spending time in each zone, you ensure a variety of benefits for performance and health.
So how much time should you spend in each zone?
Most elite endurance athletes, including runners, rowers, and even cross-country skiers, tend to spend most of their training (around 80%) in zone 1, with the rest split between zones 2 and 3.
Because elite endurance athletes train a lot, most of it needs to be in zone 1, otherwise they risk injury and burnout. For example, some runners accumulate more than 250 kilometres per week, which would be impossible to recover from if it was all performed in zone 2 or 3.
Of course, most people are not professional athletes. The World Health Organization recommends adults aim for 150–300 minutes of moderate intensity exercise per week, or 75–150 minutes of vigorous exercise per week.
If you look at this in the context of heart rate zones, you could consider zone 1 training as moderate intensity, and zones 2 and 3 as vigorous. Then, you can use heart rate zones to make sure you’re exercising to meet these guidelines.
What if I don’t have a heart rate monitor?
If you don’t have access to a heart rate tracker, that doesn’t mean you can’t use heart rate zones to guide your training.
The three heart rate zones discussed in this article can also be prescribed based on feel using a simple 10-point scale, where 0 indicates no effort, and 10 indicates the maximum amount of effort you can produce.
With this system, zone 1 aligns with a 4 or less out of 10, zone 2 with 4.5 to 6.5 out of 10, and zone 3 as a 7 or higher out of 10.
Heart rate zones are not a perfect measure of exercise intensity, but can be a useful tool. And if you don’t want to worry about heart rate zones at all, that’s also fine. The most important thing is to simply get moving.
Hunter Bennett, Lecturer in Exercise Science, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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