If you’ve determined that your iron levels are low, “we have this approach — we say we have to ‘stop the leak and fill up the tank,’” Munro said. Here’s what that might look like.
Keep menstrual bleeding in check
Many women don’t know whether their menstrual bleeding might be considered heavy, said Dr Angela Weyand, a paediatric haematologist at University of Michigan Medical School.
“I see a lot of adolescents who have very heavy menstrual bleeding and end up having severe anaemia where they have to be admitted to the hospital,” she said. “Oftentimes, these patients hadn’t even recognized that their bleeding was abnormal.”
Soaking through a pad or tampon every two hours, bleeding for more than seven days or needing double coverage (like a tampon and a pad) are all signs that your period is too heavy.
If you have heavy bleeding and are iron-deficient, talk to your gynaecologist to first rule out factors that might be causing the excess bleeding, like endometriosis or fibroids, Munro suggested. From there you might consider approaches to reduce how much you bleed, such as birth control pills or the hormonal intrauterine device.
Taking naproxen or ibuprofen can also help reduce blood loss if taken two days before your period starts and throughout it. Tranexamic acid, a prescription medication, is another option.
Supplement every two days
There are many types of supplements, providing different amounts of iron, but a higher dose is not necessarily better; it’s best to take no more than 100 milligrams per day, Munro said. Exceeding that amount can worsen side effects, like constipation or nausea, and the iron won’t be well absorbed. For example, the most common iron tablets contain 325 milligrams of ferrous sulfate, which provide 65 milligrams of iron, and one of those would be sufficient.
Studies suggest that taking your iron supplement every other day is just as effective as dosing more frequently and has fewer side effects.
Avoid having calcium supplements, milk, coffee, tea or high-fibre foods at the same time as your iron supplement, since these may interfere with your body’s ability to absorb iron.
Consistent supplementation should improve ferritin numbers in about three months, Munro said. Once your ferritin numbers are up and you are not losing as much blood during menstruation, you might be fine relying just on your diet for iron, he added.
Make smart nutritional choices
According to federal recommendations, men of any age and women older than 50 should consume at least 8 milligrams of iron each day, while women ages 19-50 should aim for 18 milligrams. The requirement increases to 27 milligrams during pregnancy.
There are two types of iron found in foods: heme and non-heme. Heme iron is found in any animal-derived source, including meat, poultry and fish; non-heme iron is found in plant-based foods like lentils and beans, some vegetables, grains and nuts, said Elaine McCarthy, a nutrition researcher at the University College Cork in Ireland. Both types of iron can be valuable sources, but your body absorbs heme iron more efficiently, McCarthy said.
That said, plant-based foods can still be great sources of iron. A cup of cooked lentils, for example, contains 6.6 milligrams of iron — more than is found in a serving of beef — but you’ll want to use a few tricks to help your body absorb it, said Diane DellaValle, an associate professor of nutrition science at King’s College in Wilkes-Barre, Pennsylvania.
Drawing up a personalised plan with a registered dietitian is worthwhile, but here are a few of her tips on getting more iron:
- Pair plant-based iron with absorption enhancers: Including a bit of meat or a good source of vitamin C in the same meal will improve your absorption of non-heme iron, DellaValle said. You can add tomato or bell pepper to your lentils, for example, or have strawberries or an orange on the side.
- Avoid absorption blockers: Certain compounds found in tea and coffee can interfere with the absorption of non-heme iron from food and supplements, so avoid having those beverages at the same time as plant-based iron sources, DellaValle said.
- Look for enriched foods: Other good sources of iron include certain fortified foods, like breads and pastas that contain enriched wheat flour, DellaValle said. Enriched rice also contains extra iron, though you’ll lose some of it if you rinse the rice before cooking. And many breakfast cereals are fortified with iron; just be aware that the iron will soak into the milk in your cereal bowl, so you’ll need to drink the milk to get the full dose.
- Cook with special tools: One of DellaValle’s favorite tips is to cook with a Lucky Iron Fish. Place it in your cooking pot along with a couple drops of lemon juice or vinegar, and the product releases 6 to 8 milligrams of iron into whatever you’re preparing, whether it’s rice, oatmeal or soup. Cooking in a cast iron pan can also add iron to your meal. DellaValle often recommends the Lucky Iron Fish to the college athletes she works with, and she gives it as a holiday gift.
This article originally appeared in The New York Times.
Written by: Alisha Haridasani Gupta and Alice Callahan
Photographs by: Marta Monteiro
©2023 THE NEW YORK TIMES
