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.

LittlePigPower/Shutterstock

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.

Three pregnant bellies during a stretching class.
Low iron can especially affect people during pregnancy and women who do a lot of sport. Kamil Macniak/Shutterstock

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.

A woman pours orange juice into a glass next to a bowl of strawberries and kiwifruit.
Taking your supplement alongside foods rich in vitamin C, like orange juice or kiwifruit, can help your body absorb the iron. Anete Lusina/Pexels

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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  • Plant vs Animal Protein

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    Plant vs Animal Protein: Head to Head

    Some people will obviously have strong ideological opinions here—for vegetarians and vegans, it’s no question, and for meat-eaters, it’s easy to be reactive to that and double-down on the bacon. But, we’re a health and productivity newsletter, so we’ll be sticking to the science.

    Which is better, healthwise?

    First, it depends how you go about it. Consider these options:

    • A piece of salmon
    • A steak
    • A hot dog
    • A hot dog, but plant-based
    • Textured soy protein (no additives)
    • Edamame (young soy) beans

    Three animal-based protein sources, three plant-based. We could render the competition simple (but very unfair) by pitting the hotdog against the edamame beans, or the plant-based hot dog against the piece of salmon. So let’s kick this off by saying:

    • There are good and bad animal-based protein sources
    • There are good and bad plant-based protein sources

    Whatever you choose, keep that in mind while you do. Less processed is better in either case. And if you do go for red meat, less is better, period.

    Picking the healthiest from each, how do the nutritional profiles look?

    They look good in both cases! One factor of importance is that in either case, our bodies will reduce the proteins we consume to their constituent amino acids, and then rebuild them into the specific proteins we actually need. Our bodies will do that regardless of the source, because we are neither a salmon nor a soy bean, for example.

    We need 20 specific amino acids, for our bodies to make the proteins we will use in our bodies. Of these, 9 are considered “essential”, meaning we cannot synthesize them and must get them from our diet,

    Animal protein sources contain all 9 of those. Plant based sources often don’t, individually, but by eating soy for example (which does contain them all) and/or getting multiple sources of protein from different plants, the 9 can be covered quite easily with little thought, just by having a varied diet.

    Meats are #1!

    • They’re number 1 for nutritional density
    • They’re number 1 for health risks, too

    So while plant-based diet adherents may need to consume more varied things to get all the nutrients necessary, meat-eaters won’t have that problem.

    Meat-eaters will instead have a different problem, of more diet-related health risks, e.g.

    • Cardiovascular disease
    • Metabolic disorders
    • Cancers

    So again, if eating (especially processed and/or red) meat, moderation is good. The Mediterranean Diet that we so often recommend, by default contains small amounts of lean animal protein.

    Which is better for building muscle?

    Assuming a broadly healthy balanced diet, and getting sufficient protein from your chosen source, they’re pretty equal:

    (both studies showed that both dietary approaches yielded results that showed no difference in muscle synthesis between the two)

    The bottom line is…

    Healthwise, what’s more important than whether you get your protein from animals or plants is that you eat foods that aren’t processed, and are varied.

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    ^This is from a review in the Journal of the American College of Cardiology, and in few words, they recommend it very highly

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  • Celery vs Lettuce – Which is Healthier?

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    Our Verdict

    When comparing celery to lettuce, we picked the lettuce.

    Why?

    Let us consider the macros first: lettuce has 2x the protein, but of course the numbers are tiny and probably nobody is eating this for the protein. Both of these salad items are roughly comparable in terms of carbs and fiber, being both mostly water with just enough other stuff to hold their shape. Nominally this section is a slight win for lettuce on account of the protein, but in realistic practical terms, it’s a tie.

    In terms of vitamins, celery has more of vitamins B5 and E, while lettuce has more of vitamins A, B1, B2, B3, B6, B7, B9, C, K, and choline. An easy win for lettuce here.

    In the category of minerals, celery has more calcium, copper, and potassium, while lettuce has more iron, magnesium, manganese, phosphorus, potassium, selenium, and zinc. So, a fair win for lettuce.

    Adding up the sections makes for an overall win for lettuce; of course, enjoy both, though!

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  • Tooth Remineralization: How To Heal Your Teeth Naturally

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    Dr. Michelle Jorgensen, dentist, explains:

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    Teeth cannot be regrown (yet!) but can be remineralized, which simply involves restoring lost minerals. When we’re talking about health, “minerals” is usually used to mean elemental minerals, like calcium, magnesium, phosphorus, etc, but the specific mineral that’s needed here is hydroxyapatite (a calcium phosphate mineral, the same as is found in bones).

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    Dr. Kelly Sturm is a rehab specialist (Doctor of Physical Therapy), and also a certified lymphedema therapist. Here’s what helps her patients with lymphedema and lipedema:

    Don’t fan the flames

    Lymphedema and lipedema are inflammatory lymphatic diseases affecting mostly women. As such, an anti-inflammatory diet will be important, but there are other factors too:

    • Anti-inflammatory diet: this is to reduce the chronic inflammation associated with lymphatic diseases. This means eating plenty of fruit and vegetables, especially berries and leafy greens, and avoiding things like sugar, alcohol, caffeine, and processed foods. And of course, don’t smoke.
    • Intermittent fasting: this also helps by giving the body a chance to correct itself; when the body isn’t digesting food, it has a lot more resources to devote to its favorite activity: maintenance. This results in lower inflammation, and better fat redistribution.
    • Weight loss: not a bandwagon we often get on at 10almonds as it’s rarely the most important thing, but in this case it is of high importance (second only to dealing with the inflammation), as excess weight around the lymph nodes and vessels can lead to dysfunction and swelling. Thus, reducing the weight can ease that and allow the body to heal.

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  • Deskbound – by Kelly Starrett and Glen Cordoza

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    We’ve all heard that “sitting is the new smoking”, and whether or not that’s an exaggeration (the jury’s out), one thing that is clear is that sitting is very bad.

    Popular advice is “here’s how to sit with good posture and stretch your neck sometimes”… but that advice tends to come from companies that pay people to sit for a long time. They might not be the a very unbiased source.

    Starrett and Cordoza offer better. After one opening chapter covering the multifarious ways sitting ruins our health, the rest of the book is all advice, covering:

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      • This is great, because “get a standing desk” tends to present more questions than answers, and can cause as much harm as good if done wrong
      • The authors also cover how to progressively cut down on sitting, rather than try to go cold-turkey.
      • They also recognize that not everyone can stand at all, and…
    • Optimizing the sitting position, for when we must sit
    • Exercises to maintain our general mobility and compensate about as well as we can for the body-unfriendly nature of modern life.

    The book is mostly explanations, so at 682 pages, you can imagine it’s not just “get up, lazybones!”. Rather, things are explained in such detail (and with many high-quality medical diagrams) so that we can truly understand them.

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  • Tasty Hot-Or-Cold Soup

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    Full of fiber as well as vitamins and minerals, this versatile “serve it hot or cold” soup is great whatever the weather—give it a try!

    You will need

    • 1 quart low-sodium vegetable stock—ideally you made this yourself from vegetable offcuts you kept in the freezer until you had enough to boil in a big pan, but failing that, a large supermarket will generally be able to sell you low-sodium stock cubes.
    • 2 medium potatoes, peeled and diced
    • 2 leeks, chopped
    • 2 stalks celery, chopped
    • 1 large onion, diced
    • 1 large carrot, diced, or equivalent small carrots, sliced
    • 1 zucchini, diced
    • 1 red bell pepper, diced
    • 1 tsp rosemary
    • 1 tsp thyme
    • ¼ bulb garlic, minced
    • 1 small piece (equivalent of a teaspoon) ginger, minced
    • 1 tsp red chili flakes
    • 1 tsp black pepper, coarse ground
    • ½ tsp turmeric
    • Extra virgin olive oil, for frying
    • Optional: ½ tsp MSG or 1 tsp low-sodium salt

    About the MSG/salt: there should be enough sodium already from the stock and potatoes, but in case there’s not (since not all stock and potatoes are made equal), you might want to keep this on standby.

    Method

    (we suggest you read everything at least once before doing anything)

    1) Heat some oil in a sauté pan, and add the diced onion, frying until it begins to soften.

    2) Add the ginger, potato, carrot, and leek, and stir for about 5 minutes. The hard vegetables won’t be fully cooked yet; that’s fine.

    3) Add the zucchini, red pepper, celery, and garlic, and stir for another 2–3 minutes.

    4) Add the remaining ingredients; seasonings first, then vegetable stock, and let it simmer for about 15 minutes.

    5) Check the potatoes are fully softened, and if they are, it’s ready to serve if you want it hot. Alternatively, let it cool, chill it in the fridge, and enjoy it cold:

    Enjoy!

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