I will be honest, when my doctor recently told me that my blood test revealed anemia (low iron) I was disappointed. I was in the middle of a 40-day Daniel fast with my church, and I was joyfully eating a more plant-based diet than usual. My anemia was not caused by this fast in the short term, however, but was a cumulative effect of many months even preceding this fast. My first thought was to eat meat. Thankfully, meat is not the only source of iron. In fact, there are many iron rich vegetarian sources that the body can utilize just as well, IF digestion is optimal. And there you have the big IF – it all comes down to gut health once again, and with that realization I let out a big *sigh*.
For those of you who have been following my journey over the years, my gut health has been far from superior, ravaged by parasites years ago and subpar growing up as a kid. I have spent a lot of time and research repairing my gut, so to be at this place again is discouraging. Then I thought, this is the journey many of us are on, and this is the journey with which I MUST have the knowledge to help others. So once again, I am hoping that MY journey will help me help you.
According to the World Health Organization, iron deficiency is the most common and widespread nutritional disorder in the world in both developing and industrialized countries, affecting over 30% of the world’s population and mainly affecting women of reproductive age. Much of this is due to childbearing and menstruation. Some common symptoms of anemia include a lack of energy or fatigue, shortness of breath, headache, irritability, and dizziness. This is because a body lacking in iron cannot carry oxygen to the cells. It also cannot make sufficient ATP, which is our body’s main fuel or energy currency.
On a whole, vegetarians are at more of a risk for anemia than meat eaters. That is not to say you have to eat meat to maintain sufficient iron levels. You do however, need to optimize digestion of the iron you are consuming, be more conscious of getting enough from plant sources, and be aware of what interferes with iron absorption. Let’s address that:
Optimizing digestion: If you are eating a diverse, vegetable rich diet and you are still deficient in essential minerals and vitamins, there is likely something going on with your gut. It is imperative to heal your gut in order to absorb and process your nutrients. Headaches, gas, bloating, belching, and loose watery stools and/or constipation are all indications that something is not working as it should. Iron deficiency occurs in about 60-80% of patients with inflammatory bowel disease (IBD) (1). Low stomach acid (HCl) can also be a cause for poor iron absorption. Taking 1 teaspoon of apple cider vinegar in 8 oz. of water before a meal can help balance stomach acid levels. Bitters (like they put in your cocktails) in a glass of sparkling water also help digestion. This makes a fun mocktail too. Also, poor B12 levels can be indicated with anemia. So check your digestion, absorption and micronutrient levels first to help optimize digestion.
Sources: There are two forms of dietary iron: heme and non-heme. Heme iron is found in meat, fish, and poultry, and is absorbed very efficiently by the body. Non-heme iron, found in plants such as lentils, beans, molasses, leafy greens, flours, cereals and grains (either naturally occurring or fortified), is not as well absorbed as heme iron. In fact, only 1% to 7% of the non-heme iron in staples such as rice, black beans, soybeans and wheat is absorbed when consumed as a single food. Consuming these foods with a small amount of animal protein will increase absorption, as will sources of Vitamin C. Vitamin C is easily obtained by eating ample vegetables and fruits.
Some vegetarian powerhouses for iron include unsulphured dried fruit like peaches or apricots, blackstrap molasses and spirulina. Adding 2 teaspoons of dried thyme to your soup or salad will provide nearly 20% of your daily iron needs.
The good news is all these foods have other health benefits besides just helping your body maintain healthy iron levels. Spirulina for example is a nutritional powerhouse, helping to regulate your mood, hormones and even PMS. Pumpkin seeds are high in zinc, and quinoa is packed with protein.
Interference: Several food components interfere with iron absorption. Grains and beans contain phytate or phytic acid, which significantly reduces iron absorption. Phytate is considered an anti-nutrient. This means it can actually prevent nutrients from being absorbed in the body, resulting in deficiency. To neutralize phytic acid, beans and grains should be soaked overnight or at least for a few hours in water with acid from either lemon or vinegar. You can also purchase sprouted beans and grains. This is a very important step many vegetarians and vegans miss. Another iron inhibitor is tannins, present in coffee and tea. Drinking coffee, black or green tea with a meal may not be a good idea if you are seeking to boost iron levels.
Aside from taking an iron supplement, which can be helpful in getting over the deficiency hump but should not be taken long term, once the gut has been healed, it should be fairly easy to maintain normal iron levels with a diverse diet rich in fruits, vegetables, and vegetarian proteins like legumes and beans. If you are having difficulty on a vegetarian diet, then sustainable sources of meat and/or fish should be considered. Also, if you are a woman who has heavy menstrual periods or just had a baby, you may need additional iron to replenish.
The main takeaway is this: if you feel symptoms of anemia, check with your doctor about a blood test. From there, if you are slightly anemic, start to add in more high iron foods on a daily basis and be aware of the interacting foods. If your doctor recommends a supplement, then this may be the best way to go in the short term, followed by reevaluation in a few months, and then an iron-rich diet after that.