“Patients are often surprised when iron stores do not replenish after starting supplements. Iron metabolism in the body is influenced by many factors – it is important how much iron we get from food or supplements, how much the body can absorb, and also how much iron the body uses. Therefore, first of all, it is necessary to try to understand why the iron stores became deficient,” says K. Maneikis in a press release.
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According to the doctor, iron is essential for the production of hemoglobin – a protein that carries oxygen to tissues. When iron stores decrease, general weakness begins to trouble, physical capacity worsens, shortness of breath during physical exertion may occur, dizziness, and difficulty concentrating. However, these symptoms are rarely immediately associated with iron deficiency.
“A person can feel worse for a long time and explain it by stress, tension, or lack of sleep. The body adapts to changes gradually, so symptoms can be subtle for a long time,” explains the hematologist.
Iron deficiency does not necessarily mean anemia
K. Maneikis points out that iron deficiency and anemia are not the same. Initially, iron stores in the body begin to deplete, but hemoglobin levels can still remain normal. Only later, when there is not enough iron for hemoglobin production, iron deficiency anemia develops.
“Patients often think that if hemoglobin is normal, there is no problem. However, iron stores can be significantly reduced even before anemia develops. Therefore, the hemoglobin level alone is not enough – it is necessary to assess ferritin levels and other iron metabolism indicators,” says the “Hila” doctor.
According to him, it is also important to understand that normal complete blood count results cannot rule out iron deficiency. For this reason, people who suffer from fatigue or other characteristic symptoms for a long time sometimes need more detailed laboratory tests.
He also adds that people often focus on serum iron levels, although ferritin testing provides much more information when assessing iron stores.
Daily habits determine iron absorption
According to the “Hila” doctor, to prevent iron deficiency, it is not enough to get iron from food – it must be properly absorbed. Both the origin of food products and daily habits influence this.
“Heme iron found in animal products is absorbed much more easily than trivalent iron found in plant products. Therefore, people who do not consume meat or other animal products should pay more attention to a balanced diet,” says the doctor.
He states that vitamin C improves iron absorption, so it is beneficial to consume iron-containing products or supplements together with fruits or vegetables. Meanwhile, coffee and tea consumed at the same time can reduce iron absorption.
“Coffee and tea can significantly reduce iron absorption, so it is recommended to consume them at least 1–2 hours before or after taking iron supplements,” notes K. Maneikis.
According to the doctor, during consultations, attempts to overcome iron deficiency solely by changing diet or taking over-the-counter supplements are still heard, but such measures do not always help if iron stores in the body are already significantly depleted.
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If supplements do not work, it is necessary to find the cause
According to the hematologist, the problem is not always solved by changing the supplement or increasing its dose. If iron stores do not replenish, it is most important to find out why the treatment does not give the expected result.
“Iron supplements differ in their form, dose, and how well they are tolerated by the body. A supplement suitable for one patient may be less effective or cause adverse reactions in another, so treatment is always selected individually,” says K. Maneikis.
According to him, iron deficiency can be caused by insufficient iron intake in the diet, impaired absorption, heavy menstruation, pregnancy, chronic bleeding from the digestive tract, or certain digestive system diseases.
“When investigating the cause of iron deficiency, we also always assess whether the patient has Helicobacter pylori (H. pylori) infection. It can impair iron absorption because it changes stomach acidity, which is important for the absorption of this microelement, and the bacteria itself uses iron for its growth. If the infection was previously diagnosed, it is important to ensure that the bacteria have been successfully treated, and if the patient has not been tested yet – we refer for testing, especially in cases where iron stores do not replenish despite proper treatment,” emphasizes K. Maneikis.
Treatment of iron deficiency requires consistent monitoring
The doctor notes that in practice, there are still cases when patients consult specialists too late – by then, iron deficiency has already caused significant health disorders and significantly worsened quality of life.
“If iron stores do not replenish or quickly decrease again, simply changing the supplement or increasing its dose is not enough. In such cases, it is necessary to find the cause, as iron deficiency sometimes becomes the first sign of digestive system diseases, chronic bleeding, or absorption disorders,” emphasizes K. Maneikis.
He points out that women, especially those experiencing heavy menstrual bleeding, pregnant women, children and adolescents, as well as people with limited diets or digestive system diseases, are at higher risk of iron deficiency.
According to the doctor, treating iron deficiency often requires more than just prescribing a supplement – it is important to monitor how the indicators change and ensure that the treatment produces the expected result.
“It is often expected that taking iron supplements for a few months will solve the problem. However, treating iron deficiency is a process – it is important to monitor how iron stores replenish and ensure that the cause of their reduction is eliminated. Otherwise, the problem may recur,” says K. Maneikis.
Depending on the identified cause, treating iron deficiency may require cooperation among several specialists. For example, women whose iron deficiency is caused by heavy menstruation may need a gynecologist consultation along with a hematologist, and if bleeding from the digestive tract is suspected – a gastroenterologist examination.
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