A few weeks ago I got a stomach bug. For some reason it hit me worse than it did my husband or little boy. For days after the vomiting stopped, I felt queasy in the morning for several days (nope, not pregnant–unfortunately). I was also feeling really tired. And my digestion was whacked out. But I also wasn’t getting enough sleep, and after a really good night’s rest, my digestion seemed to finally pick back up. By this time I had been feeling unwell for a whole week. That weekend, I slept A LOT. And despite getting lots of sleep, I was still tired (and no, really, I wasn’t pregnant–dangit). The following Monday we all went for a hike, and I was just pathetic–I could not go uphill at a decent pace without getting winded and light-headed. I wondered how I could be that out of shape, but then I realized I was experiencing symptoms of anemia, which I thought was odd, considering all the iron-rich foods I consume and the fact that I cook on an iron skillet at least once a day.
A couple days later I had some routine lab work done to check on my kidney function, and my doctor had decided to do a ferritin test this time, instead of just the usual serum iron levels. My serum iron turned out to be normal, which means I’m not anemic; however, my ferritin (stored iron) was a bit low (29, while normal is 100-200). I did some investigating on internet health boards and found that symptoms of anemia are common with low ferritin levels. Aha, I had figured out why I was feeling so unusually tired. (And I mean I was really tired–sleeping extra hard at night, feeling extra sleepy upon awakening, feeling blah and tired during the day, and even feeling a bit depressed and moody–seriously, I thought I was pregnant).
I tried having more beef and other iron-rich foods and was being sure to take my liver supplements. I figured the stomach bug must have decreased my iron absorption and caused my iron stores to get low, but I also wondered if there were other factors. I really wanted to hurry up and get my ferritin levels to normal so that I could function normally again. Since I knew calcium can interfere with iron absorption, I considered all the raw milk I was drinking–I had recently gone from consuming about a gallon per week to a gallon and a half–but when I tried to find information on raw milk and iron absorption, I found that raw milk contains an enzyme called lactoferritin that holds onto iron until the body is ready to use it, or something like that. In other words, raw milk, if anything, would actually increase iron absorption. I’ve heard something similar about breastmilk before. Anyway, I just read it on a blog and the author didn’t reference the information, unfortunately. To play it safe, I tried avoiding dairy during my high-iron meals.
But I was still tired! So I did some more researching and I found that egg whites can inhibit iron absorption. I had never heard of this before. I eat two eggs for breakfast every morning (the one meal of the day that I always cook in a cast iron pan), plus egg here and there in baked goods. I also learned that calcium is not the only mineral that negatively affections iron absorption. Zinc does, too. However, I think that is only a concern with zinc supplements since many foods rich in iron are also a good sources of zinc, such as liver, beef, oysters and pumpkin seeds.
Things that help increase iron absorption: vitamin C (which I had known but forgotten); cooking vegetables that contain iron; and eating heme-iron (iron from animal products) with non-heme iron (iron from plants) to increase the absorption of the non-heme iron. For example, my dinner tonight was lentils (rich in non-heme iron) with chicken (source of heme iron) and lightly cooked Swiss chard (good source of vitamin C and source of iron) all cooked in broth, with some juice containing vitamin C as my beverage. Then I had an orange for dessert.
A few days ago I decided that I must not be getting enough vitamin C because I’m not good at getting the recommended 3-5 servings of veggies every day, and since my teeth got sensitive recently, eating apples and oranges is difficult since the juice seeps between my teeth where it’s sensitive, so I’m eating less fruit these days. Over the weekend I tried snacking on dried plums but it wasn’t quite enough. Sunday night I hand-juiced four oranges and the juice was so amazing to me that I could have drank four more oranges. So Monday I decided to break out the juicer (okay, it was already out, I just haven’t been using it), and I made a delicious juice concoction using two large carrots, one medium red beet (apparently beets are good for the blood), one golden delicious apple (extra fancy), and one orange. Just as I was about to text this delicious recipe to my friend, my son decided to climb up on the counter and managed to yank really hard on the juicer plug and I think he accidentally switched it on at the same time, and well, anyway–it broke. Gah! (Okay, really it was more like waaaaahhhhh!!!!) But I had my juice, anyway, and it made me feel pretty good. For dinner I had an iron-rich meal with a spinach salad and grape kombucha for some vitamin C, and I took my liver supplements. I kept dairy two hours away from my iron-rich meal.
I then slept 10 hours (don’t hate me, I need that much), and for the first time in weeks, I felt refreshed when I woke up. My energy has been good all day. I was able to do two loads of dishes, can beef broth, make lunch and dinner. It’s sad to think this much work has been, at best, difficult for me the past month, but suddenly it was no big deal. I think I have figured out my problem! My goal now is to have an iron-rich meal with vitamin C every day, and I think I will continue to keep dairy away from that meal for the time being.
Aside from calcium, zinc and egg whites, there are a few other things that may contribute to iron malabsorption: oxalates, phytates, polyphenols and tannins. Unfortunately these are found in a lot of nutritious foods. We know that phytates–found in seeds, nuts and grains–can be reduced significantly by proper soaking techniques. Oxalates I am less familiar with, but I know they are one of the reasons WAPF does not recommend consuming tea or chocolate. They are also in some vegetables, fruits and herbs, but apparently you can cook them off. Personally, I avoid tea and try to avoid chocolate, but I am not too worried about oxalates in veggies at this point. Cocoa and coffee are foods of concern for polyphenols, as well as some herbs, spices and berries. Again, I’m not worried about the herbs and berries, but for me it is one more good reason to avoid coffee and chocolate. And then there are tannins, found in tea, coffee, cocoa and some herbs and fruit. Cocoa is such a weird food to me. It’s rich in antioxidants, iron, magnesium, copper and other good things, but it’s also got caffeine, phytates, oxalates and other “anti” nutrients. It’s kind of annoying because I’d love to use it as a source for iron and magnesium!
Anyway, my whole take-away from this is that I really need to keep my fresh produce consumption up if I really want to be healthy and feel good and have energy. I have learned to value animal products for my health, but now I need to revisit the importance of plant foods. Maybe I need to go visit a vegan blog or two for some inspiration. 😉
P.S. The herb nettle is supposed to be helpful for raising iron levels, but I had actually been consuming it regularly before I had my blood work done. It contains vitamin C and non-heme iron but also tannic acid, which may interefere with iron absorption. At this point I don’t really know whether to recommend it; I suppose it may work for some but not for others.
Update: I just came across the website Iron Rich Food which is loaded with tips for increasing iron.