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Iron for women: why is it so important?

Laura Harcourt

Written byLaura Harcourt

Dr Tania Adib

Reviewed byDr Tania Adib

woman doing workout morning routine outdoor at city park
Iron is an essential mineral for everyone, but it’s especially important for women. Discover why and how to elevate your level of iron in our latest article.
Iron is an essential mineral for our health, helping red blood cells to carry oxygen throughout our body. Without enough iron, this can not only cause you to be tired, pale, and breathless but also impact your ability to concentrate.1

Having an iron deficiency can happen for several reasons, including blood loss, a lack of dietary iron and an inability to absorb iron effectively – as is the case of individuals with coeliac disease.1,2,3

Women are also especially susceptible to iron deficiencies, often due to bodily processes like heavy periods and pregnancy.1,3

Luckily, you can address most iron deficiencies through simple dietary adjustments.3,4

Why do women need more iron?

Iron is a key component in haemoglobin, a protein in your red blood cells that carries oxygen to every cell in the body.5

Without sufficient iron, the body cannot produce enough red blood cells to transport oxygen to your organs and cells. Your body’s normal processes, including brain function, energy, and immunity, all require optimal oxygen delivery.2

The most common reason why women need more iron is because of blood loss during periods. Women with heavy periods (also known as menorrhagia) are at a higher risk of losing too much iron through blood loss during menstruation.3,6

Pregnant women also have higher iron needs due to the increased blood volume and blood cell production necessary for a healthy pregnancy, particularly demonstrated during the second and third trimesters.7-9

The NHS recommends different iron requirements depending on your age. For example, women aged between 19 and 49 should get around 14.8mg of iron daily, whereas menopausal women only need 8.7mg because iron requirements drop after menopause.4

Menstruating women aged 50 and over may also require as much iron as those in the 19‒49 age bracket.4

Symptoms of iron deficiency in women

The most common symptom of iron deficiency is often fatigue. When your body’s iron stores have been depleted, there’s a reduced amount of haemoglobin in your red blood cells, meaning your blood cannot effectively deliver enough oxygen throughout the body.3,5
Symptoms of iron deficiency anaemia in women include:1,5
  • weakness
  • fatigue
  • shortness of breath
  • pale skin
  • fast heartbeat
  • dry, brittle nails
  • decreased immune function
Women are at higher risk of having lower levels of iron and developing iron deficiency anaemia because they lose blood through menstruation. This is why women have higher iron requirements relative to their size.4,10,11

If you think you have an iron deficiency, speak to your GP about getting tested. Iron supplementation can help replace the iron that is missing from your body.

Foods that contain iron

Iron is an abundant mineral that can be found in both animal and plant foods. However, there are two types of dietary iron with two different absorption quantities:4,12 haem and non-haem. Haem iron is found in animal sources like offal, red meat and fish, whereas plant sources only contain non-haem iron.12,13

Foods that are rich in iron include:3,4
  • liver (to be avoided during pregnancy due to high vitamin A levels)14
  • red meat
  • fish
  • beans
  • fortified cereals
  • dried fruit
  • chickpeas
  • nuts 
  • seeds
  • quinoa
  • dark green leafy vegetables (kale, spinach, Swiss chard)
  • tofu
  • wholemeal bread
Despite the prevalence of iron in varied food sources, the latest National Diet and Nutrition Survey revealed that nearly 25% of women aged 19-64 in the UK had low iron intakes.15

Dietary factors that affect iron absorption

Our bodies can absorb haem iron with greater efficiency than non-haem iron. This means that vegetarians and vegans who consume non-haem dietary iron only require a little more care to ensure their iron levels are topped up.12,13

Food sources rich in calcium, including milk and dairy products, may affect your body’s ability to absorb iron. A review of research conducted in 2021, for instance, found that although calcium inhibits short-term absorption, it doesn’t appear to have a significant impact on iron stores.7 However, there are some limitations and more research is required.

Polyphenols are antioxidants which can also reduce iron absorption18 and are commonly found in many foods and beverages, including vegetables, cereal, spices, fruits, tea, coffee, and red wine.12

Advice for vegetarians and coffee drinkers

Vitamin C may be essential for the absorption of iron in your body, but data is limited and researchers believe more clinical trials need to be conducted.17

If you’re vegan or vegetarian, you can consider adding a source of vitamin C to each iron-rich meal you eat – whether that’s sipping orange juice after a meal or pairing your food with vitamin C-rich sources like citrus fruits, tomatoes or peppers.19

If you usually drink a cup of tea or coffee with your meals, you may also want to re-think this choice of beverage. Since the polyphenols in tea and coffee can inhibit iron absorption, try to avoid drinking tea or coffee within 30 minutes of your meals. Instead, a glass of vitamin C-rich orange juice or water can be a much better way to help aid iron absorption.12,18,19

The final say

Women, especially during their reproductive years, are thought to have higher iron needs than men and may be at greater risk of becoming iron deficient. This is mainly due to menstruating every month and needing to absorb more iron during pregnancy.3,4,7,10,11

For most women, eating a varied and healthy diet with iron-rich foods is enough to keep iron levels healthy. However, women with heavy periods, pregnant women, and breastfeeding mothers may require iron supplements to maintain healthy levels in the body.3,4,7

If you’re concerned about iron deficiency, consult your GP. They’ll be able to offer tailored advice and help you manage your associated symptoms.

Sources

  1. NHS inform. Iron deficiency anaemia [Internet]. [cited 2924 Feb 23]. Available from: https://www.nhsinform.scot/illnesses-and-conditions/nutritional/iron-deficiency-anaemia.
  2. Stefanelli G., et al. Persistent Iron Deficiency Anemia in Patients with Celiac Disease Despite a Gluten-Free Diet. Nutrients. 2020 Jul 22;12(8):2176. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7468819/. ‌
  3. NHS. Iron deficiency anaemia [Internet]. [cited 2024 Feb 23]. Available from: https://www.nhs.uk/conditions/iron-deficiency-anaemia/.
  4. NHS. Iron – vitamins and minerals [Internet]. [cited 2024 Feb 23]. Available from: https://www.nhs.uk/conditions/vitamins-and-minerals/iron/.
  5. Tardy, A., et al. 'Vitamins and Minerals for Energy, Fatigue and Cognition: A Narrative Review of the Biochemical and Clinical Evidence'. Nutrients. 2020;12(1):228. doi: 10.3390/nu12010228.
  6. Munro MG, et al. The relationship between heavy menstrual bleeding, iron deficiency, and iron deficiency anemia. American Journal of Obstetrics and Gynecology. 2023 Jan. Available from: ‌https://doi.org/10.1016/j.ajog.2023.01.017.
  7. Fisher AL, et al. ‘Iron homeostasis during pregnancy’. The American Journal of Clinical Nutrition. 2017;106(Supplement 6):1567S1574S. Available from: https://www.sciencedirect.com/science/article/pii/S0002916522027253?via%3Dihub.
  8. Bah, A., et al. Serum Hepcidin Concentrations Decline during Pregnancy and May Identify Iron Deficiency: Analysis of a Longitudinal Pregnancy Cohort in The Gambia. The Journal of Nutrition, 2017;147(6), 1131-1137. Available from: https://doi.org/10.3945/jn/116.245373.
  9. van Santen S, et al. The iron regulatory hormone hepcidin is decreased in pregnancy: a prospective longitudinal study. Clinical Chemistry and Laboratory Medicine. 2013 Jan 1;51(7).‌ Available from: https://doi.org/10.1515/cclm-2012-0576.‌
  10. Warner MJ, Kamran MT. Iron deficiency anemia [Internet]. StatPearls Publishing; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448065/. 
  11. Kumar A, et al. Iron Deficiency anaemia: Pathophysiology, assessment, Practical Management. BMJ Open Gastroenterology. 2022 Jan 1;9(1):1–9. Available from: https://bmjopengastro.bmj.com/content/9/1/e000759. ‌
  12. Piskin E, et al. Iron Absorption: Factors, Limitations, and Improvement Methods. ACS Omega. 2022 Jun 10;7(24):20441–56. Available from‌: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9219084/.
  13. Hurrell R, Egli I. Iron bioavailability and dietary reference values. The American Journal of Clinical Nutrition. 2010 Mar 3;91(5):1461S1467S. Available from: https://academic.oup.com/ajcn/article/91/5/1461S/4597424‌.
  14. NHS. Foods to avoid in pregnancy [Internet]. [cited 2024 Feb 23]. Available from: https://www.nhs.uk/pregnancy/keeping-well/foods-to-avoid/. ‌
  15. Public Health England. NDNS: results from years 9 to 11 (combined) – statistical summary [Internet]. [cited 2024 Feb 23]. Available from: https://www.gov.uk/government/statistics/ndns-results-from-years-9-to-11-2016-to-2017-and-2018-to-2019/ndns-results-from-years-9-to-11-combined-statistical-summary#micronutrients-and-blood-or-urine-analytes. 
  16. Abioye, AI., et al. ‘Calcium Intake and Iron Status in Human Studies: A Systematic Review and Dose-Response Meta-Analysis of Randomized Trials and Crossover Studies.’ The Journal of Nutrition. 2021;151(5):1084–101. Available from: https://www.sciencedirect.com/science/article/pii/S0022316622001420.‌
  17. Loganathan V, et al. Treatment efficacy of vitamin C or ascorbate given as co-intervention with iron for anemia – A systematic review and meta-analysis of experimental studies. Clinical Nutrition ESPEN. 2023 Oct 1;57:459–68. Available from: https://doi.org/10.1016/j.clnesp.2023.07.081.
  18. Ma, Q., et al. ‘Bioactive Dietary Polyphenols Inhibit Heme Iron Absorption in a Dose-Dependent Manner in Human Intestinal Caco-2 Cells’. Journal of Food Science. 2011;76(5):H143–50. Available from:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3306181/.
  19. Abdullah, M., et al. 'Vitamin C (Ascorbic Acid). In: StatPearls [Internet]. StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499877/.
 
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