Tori Hudson, N.D.
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 Some researchers have concluded that iron supplementation is essential during pregnancy in order to maintain adequate maternal iron stores. However, because iron supplementation can exacerbate zinc depletion, supplementation is only warranted if iron deficiency is detected and routine iron supplementation during pregnancy is clearly indicated.69
If a woman gets sufficient iron in the first trimester of pregnancy, studies show a definite positive association with infant birth weight and size, although the same is not true for the second and third trimesters. |
Dr. Steve Blake
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 Especially during these weeks, iron supplementation is recommended so that the iron stores of the pregnant woman are not depleted.
Because extra iron supplementation can interfere with the absorption of zinc from foods, zinc supplements may be needed along with iron supplements. Zinc is especially needed during pregnancy and for the first six months of breastfeeding. Four out of five pregnant women worldwide have inadequate zinc levels. Adequate zinc is associated with healthier babies and easier deliveries. |
| With iron deficiency anemia, the combination of iron supplementation with vitamin A supplementation is more effective than either supplement alone. Vitamin A seems to improve the iron status of pregnant women and children.
Copper has been found to assist iron absorption. Copper may assist the transport of iron from the liver to the bone marrow for red blood cell formation. Anemia is one of the clinical signs of both copper deficiency and iron deficiency.
Iron supplementation has been found to interfere with the absorption of zinc supplements, but only on an empty stomach. |
Tori Hudson, N.D.
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| However, because iron supplementation can exacerbate zinc depletion, supplementation is only warranted if iron deficiency is detected and routine iron supplementation during pregnancy is clearly indicated.69
If a woman gets sufficient iron in the first trimester of pregnancy, studies show a definite positive association with infant birth weight and size, although the same is not true for the second and third trimesters.34 Good food sources are almonds, honey, beets (including greens), and high-quality protein foods like egg yolks and organ meats (liver, kidney, heart), preferably organic. |
Gary Null and Amy McDonald
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 Autism Spectrum Disorders_
Children with Autism: Effect of iron supplementation on Sleep and Ferritin. Dosman CF; Brian JA; et al. Pediatric Neurology, 2007 March, 36(3):152-158.
An 8-week open-label trial with oral iron supplementation was conducted to assess the link between low serum ferritin and sleep disturbance in children with autism spectrum disorder. Iron therapy was associated with considerable reduction in restless sleep.
Improvement of Neurobehavioral Disorders in Children Supplemented with Magnesium Vitamin B6. II. Pervasive Developmental Disorder-Autism. |
Ann M. Coulston and Carol J. Boushey
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 Prevention and treatment of iron deficiency may include iron supplementation, with a recommended therapeutic dose of lOOmg/day of elemental iron for 2 to 3 months. However, the management plan should include dietary counseling to increase the intake of bioavailable iron and appropriate strategies to reduce any unwarranted iron loss. Many athletes self-prescribe iron supplements; indeed, mass supplementation of athletes with iron has been fashionable at various times. |
Bill Sardi
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 Journal National Cancer Institute 86: 455, 1994]
Some reports indicate iron supplementation does not increase the risk for colon cancer. For example, the use of iron food supplements has not been found to increase the risk of colon cancer. [Cancer Epidemiology Biomarkers Prevention 6: 1029, 1997]. Another study of iron-fed rats did not show an increased risk for colon cancer. [Journal Nutrition 128: 764, 1998] Iron consumption does not appear to increase the recurrence of colorectal polyps, either. |
Ray D. Strand
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 There is some concern iron supplementation may actually increase oxidative stress.21
Manganese
Manganese taken in supplementation is very safe, although there are reports of people who develop manganese toxicity from their environment. This is usually seen in those who mine manganese or are exposed to high levels in the environment. These individuals may begin to hallucinate and become very irritable.22
Molybdenum
Molybdenum is quite safe. A daily intake of greater than 10-15 meg, however, may lead to goutlike symptoms. |
Bottom Line Health
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| It may take months for iron supplementation to improve this type of RLS. Treatment should be monitored by a doctor to prevent iron overload.
•Peripheral neuropathy. This nerve damage, which often triggers pain in the legs and/ or arms, is caused by chronic diseases, such as diabetes (which constricts the blood vessels that supply the nerves) or alcoholism (because of its toxic effects on the nerves and often an accompanying vitamin deficiency due to poor dietary habits). |
Gary Null and Amy McDonald
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| Randomized Study of Cognitive Effects of iron supplementation in Non-anaemic Iron-deficient Adolescent Girls. Bruner AB; et al. Lancet, 1996 October 12, 348(9033):992-996.
This double-blind, placebo-controlled study examined the effects of 13 mg per day of supplemental iron for 8 weeks on cognitive function in adolescent girls with non-anemic iron deficiency. Results showed that girls receiving iron scored higher on verbal learning and memory tests relative to controls.
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Aged Garlic Extract Prolongs Longevity and Improves Spatial Memory Deficit in Senescence-Accelerated Mouse. |
Dr. Steve Blake
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| Iron overload is very rare in individuals without a genetic predisposition, even with prolonged iron supplementation. The carefully controlled absorption of iron prevents excess in most people. People may have hemochromatosis and not know it. For this reason, adult men and postmenopausal women are normally advised not to take iron supplements.
Children are at risk of accidental overdose from products containing iron. The largest cause of death from poisoning in children under six years of age is accidental iron overdose. |
| Because extra iron supplementation can interfere with the absorption of zinc from foods, zinc supplements may be needed along with iron supplements. Zinc is especially needed during pregnancy and for the first six months of breastfeeding. Four out of five pregnant women worldwide have inadequate zinc levels. Adequate zinc is associated with healthier babies and easier deliveries.
Iodine deficiency can cause brain damage, especially when it occurs in the fetuses of pregnant women after the first trimester and in children of up to three years of age. |
| Potent iron supplements may cause stomach and intestinal irritation and other digestive discomforts. iron supplementation may cause constipation and cause the stools to appear darker. Liquid iron supplements can even stain teeth. Iron supplements should be taken with food to prevent discomfort.
Summary for Iron
Main functions: transportation of oxygen and energy metabolism.
RDA: adults, 7 to 18 mg; pregnant women, 27 mg. Toxicity: only affects those with a genetic disorder. Digestive discomfort may occur if taken on an empty stomach. |
| One of the clinical signs of copper deficiency is anemia that does not respond to iron supplementation. Copper deficiency can also lead to low numbers of white blood cells, which can increase susceptibility to infection. Premature and malnourished infants are vulnerable to copper deficiency if they are fed formula made with cow's milk, which is low in copper. Children with cystic fibrosis may be more vulnerable to copper deficiency.
FOOD SOURCES OF COPPER
Copper is found in high amounts in nuts and seeds, avocados, and green leafy vegetables such as spinach, as seen in Graph 13-2. |
Thomson Healthcare, Inc.
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 A randomized, double-blind, placebo-controlled trial of iron administration among preschoolers aged 3-4 years old (n=49) showed that 15 mg of iron supplementation in iron-deficient anemic subjects resulted in cognitive improvements including discrimination and information processing. Supplemented children exhibited 8% higher accuracy (p<0.05) and were significantly more efficient (mean difference = 1.09, p<0.05) than their untreated anemic counterparts, and made significantly fewer errors of commission (14% higher specificity, p<0.05). |
Ann M. Coulston and Carol J. Boushey
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| In another large population-based study in Hungary of children with in = 781) and without in = 22,843) Down syndrome, the investigators found a protective effect for maternal iron supplementation (150 to 300 mg/d of ferrous sulfate) during the first month of gestation [15]. It should be noted that iron and folate, two nutrients related to LBW, are both depleted in pregnancy and must be replaced [8].
The toxic effects of mercury on the developing fetus are well known [16], and the U.S. |
Thomson Healthcare, Inc.
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| Clinical Management: Patients who need iron supplementation should be advised to separate administration times of these two compounds by one to two hours. dosage
BORAGE OIL
Mode of Administration: In capsules, sometimes in combination with vitamins.
How Supplied.
Capsules - 500 mg, 1000 mg
Atopic Dermatitis/Eczema: 2 to 3 g Borage oil daily in divided doses (Buslau & Thaci, 1996; Bahmer & Schaefer, 1992).
Rheumatoid Arthritis: 6 to 7 g of Borage oil (equivalent to 1.4 g of GLA content) daily in 3 divided doses after meals (Leventhal et al, 1993). |
| Clinical Management: Patients who need iron supplementation should be advised to separate administration times of these two compounds by one to two hours. dosage
Mode of Administration: Available preparations include liquid and dry extracts that are used internally and externally.
How Supplied:
Capsules - 95 mg, 500 mg, 3.5 g Fluid Extract - 1:1 literature
Chung KT, Wong TY, Wei CI et al. Tannins and human health: a review. Crit Rev Food Sci Nutrition; 38:421-464. 1998
Clark A, Jurgens T, and Hufford C. Antimicrobial activity of juglone. Phytotherapy Research; 4(1): 11-14. |
| Clinical Management: Until njore is known, patients who need iron supplementation should be advised to separate administration times of these 2 compounds by 1 to 2 hours. dosage
Mode of Administration: Comminuted herb and other galenic preparations for oral use.
How Supplied:
Capsule-80 mg, 125 mg, 160 mg, 227 mg, 250 mg, 320 mg 450 mg, 500 mg, 565 mg, 570 mg, 585 mg, 600 mg, 1000 mg
Liquid-1:1
Daily Dosage: The average daily dose is 1 to 2 g of the drug or 320 mg of the lipophilic extract (hexane or ethanol 90% v/v). |
Phyllis A. Balch, CNC
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 Iron supplementation appears to be beneficial to some people with Parkinson's disease. The production of tyrosine hydroxylase, an enzyme involved in the production of dopa (the precursor of dopamine), apparently can be stimulated by iron supplementation.
ž A study published in The New England Journal of Medicine concluded that when the drug selegiline (Eldepryl), also known as deprenyl, is taken in the early stages of the disease, the onset of the more disabling symptoms seems to be delayed. |
Thomson Healthcare, Inc.
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| In addition, the metaanalysis revealed that all children >7 years old significantly benefited from iron supplementation, obtained from either oral doses, fortified food and milk, or through parenteral administration. Lower, longer-term doses (2-12 months) seemed to provide greater benefit than very short courses of therapy (Iannotti et al 2006).
One trial in the review cited above bears mention. |
Gary Null and Amy McDonald
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| An 8-week open-label trial with oral iron supplementation was conducted to assess the link between low serum ferritin and sleep disturbance in children with autism spectrum disorder. Iron therapy was associated with considerable reduction in restless sleep.
Improvement of Neurobehavioral Disorders in Children Supplemented with Magnesium Vitamin B6. II. Pervasive Developmental Disorder-Autism. Mou-sain-Bosc M; Roche M; et al. Magnesium Research, 2006 March, 19(l):53-62.
This study concluded that behavioral improvement was achieved in PDD-Autism with the combination vitamin B6-magnesium. |
Thomson Healthcare, Inc.
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| Until more is known, patients who need iron supplementation should be advised to separate administration times of these two compounds by one to two hours.
DRUG-FOOD INTERACTIONS MINOR RISK
Caffeine: Concurrent use of St. John's Wort and caffeine may result in increased caffeine metabolism. St. John's Wort significantly increased metabolism of caffeine, studied as a marker substance for metabolism through cytochrome P450 1A2, after 4 weeks in a randomized, open-label study of 12 healthy subjects (Gurley et al, 2002). In contrast, St. |
Alan R. Gaby, M.D., Jonathan V. Wright, M.D., Forrest Batz, Pharm.D. Rick Chester, RPh., N.D., DipLAc. George Constantine, R.Ph., Ph.D. Linnea D. Thompson, Pharm.D., N.D.
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 Iron supplementation could therefore increase the severity of bacterial infections in people with AIDS. For that teason, people with HIV infection or AIDS should consult a doctor before supplementing with iron.
The amino acid (page 465), glutamine (page 530), is needed for the synthesis of glutathione (page 531), an important antioxidant (page 467) within cells that is frequently depleted in people with HIV and AIDS.53 In well-nourished people, the body usually manufactures enough glutamine to prevent a deficiency. |
Abram Hoffer, PhD, MD, FRCP(C) and Dr. Jonathan Prousjy, DPHE, DSC, ND, FRSH
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 In adults, blood loss can be responsible for the iron deficiency, and needs to be considered prior to the initiation of iron supplementation. Many people treat themselves with extra iron when they are tired, believing that fatigue is caused by anemia. However, it would be wise not to take any extra iron unless it has been shown that iron deficiency is present.
There is a very narrow optimum range for iron therapy. For the correction of diagnosed iron deficiency anemia, the daily replacement dose is 150 to 200 mg of elemental iron each day. |
| Many women continue to have iron deficiency despite having taken high-dose iron supplementation for years. When tested, many of these women have low stomach acid. Only when their stomach acid problems are corrected does their iron status return to normal and their iron deficiency resolve.
Like calcium, the absorption of iron is impaired in a low stomach acid environment. Stomach acid frees the iron bound to food and converts it to the well-absorbed ferrous form of iron. Without adequate acid, iron remains in its poorly absorbed ferric form and cannot be adequately absorbed. |
Alan R. Gaby, M.D., Jonathan V. Wright, M.D., Forrest Batz, Pharm.D. Rick Chester, RPh., N.D., DipLAc. George Constantine, R.Ph., Ph.D. Linnea D. Thompson, Pharm.D., N.D.
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| Taking vitamin A and iron (page 540) together helps overcome iron deficiency (page 278) more effectively than iron supplementation alone.18 Supplementation with zinc (page 614), iron, or the combination has been found to improve vitamin A status among children at high risk for deficiency of the three nutrients.19
What is it?
Vitamin Bj is is a water-soluble vitamin needed to process carbohydrates, fat, and protein. Every cell of the body requires vitamin Bi to form the fuel the body runs on—adenosine triphosphate (ATP). Nerve cells require vitamin Bi in order to function normally. |
James F. Balch, M.D. and Mark Stengler, N.D.
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 Many studies have shown that restless leg sufferers have low or low-normal iron levels. iron supplementation has helped many people, but three months of treatment is usually needed before improvement is noted.
Hormone imbalance can be a root cause of insomnia. This can involve several different hormones. It is common for many women experiencing menopause to develop insomnia. This is generally due to changes in estrogen and progesterone levels. The obvious solution is to follow a hormone-balancing program. See the Menopause section for more information. |
Alan R. Gaby, M.D., Jonathan V. Wright, M.D., Forrest Batz, Pharm.D. Rick Chester, RPh., N.D., DipLAc. George Constantine, R.Ph., Ph.D. Linnea D. Thompson, Pharm.D., N.D.
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| These spells have been associated with iron-deficiency anemia,8 and several studies have reported improvement of breath-holding spells with iron supplementation.9,10, n'12
People who fit into one of these groups, even pregnant (page 363) women, shouldn't automatically take iron supplements. Fatigue, the first symptom of iron deficiency, can be caused by many other things. A doctor should assess the need for iron supplements, since taking iron when it isn't needed does no good and may do some harm.
Which forms of supplemental iron are best?
All iron supplements are not the same. |
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