Serum ferritin concentration, a measure of the body's iron stores, is currently the most efficient and cost-effective test for diagnosing iron deficiency [ ]. Because serum ferritin decreases during the first stage of iron depletion, it can identify low iron status before the onset of IDA [ 7 , 9 , 14 ].

However, serum ferritin is subject to influence by inflammation due, for example, to infectious disease , which elevates serum ferritin concentrations [ 16 ].

Hemoglobin and hematocrit tests are the most commonly used measures to screen patients for iron deficiency, even though they are neither sensitive nor specific [ 5 , 7 , 17 ]. Often, hemoglobin concentrations are combined with serum ferritin measurements to identify IDA [ 7 ].

Intake recommendations for iron and other nutrients are provided in the Dietary Reference Intakes DRIs developed by the Food and Nutrition Board FNB at the Institute of Medicine IOM of the National Academies formerly National Academy of Sciences [ 5 ].

DRI is the general term for a set of reference values used for planning and assessing nutrient intakes of healthy people.

These values, which vary by age and gender, include the following:. Table 1 lists the current iron RDAs for nonvegetarians.

The RDAs for vegetarians are 1. This is because heme iron from meat is more bioavailable than nonheme iron from plant-based foods, and meat, poultry, and seafood increase the absorption of nonheme iron [ 5 ]. For infants from birth to 6 months, the FNB established an AI for iron that is equivalent to the mean intake of iron in healthy, breastfed infants.

The richest sources of heme iron in the diet include lean meat and seafood [ 19 ]. Dietary sources of nonheme iron include nuts, beans, vegetables, and fortified grain products. In the United States, about half of dietary iron comes from bread, cereal, and other grain products [ 2 , 3 , 5 ].

Breast milk contains highly bioavailable iron but in amounts that are not sufficient to meet the needs of infants older than 4 to 6 months [ 2 , 20 ]. In the United States, Canada, and many other countries, wheat and other flours are fortified with iron [ 21 , 22 ].

Infant formulas are fortified with 12 mg iron per liter [ 20 ]. Heme iron has higher bioavailability than nonheme iron, and other dietary components have less effect on the bioavailability of heme than nonheme iron [ 3 , 4 ].

In addition to ascorbic acid, meat, poultry, and seafood can enhance nonheme iron absorption, whereas phytate present in grains and beans and certain polyphenols in some nonanimal foods such as cereals and legumes have the opposite effect [ 4 ].

Unlike other inhibitors of iron absorption, calcium might reduce the bioavailability of both nonheme and heme iron. Several food sources of iron are listed in Table 2. Some plant-based foods that are good sources of iron, such as spinach, have low iron bioavailability because they contain iron-absorption inhibitors, such as polyphenols [ 23 , 24 ].

The U. Food and Drug Administration FDA developed DVs to help consumers compare the nutrient contents of foods and dietary supplements within the context of a total diet. The DV for iron is 18 mg for adults and children age 4 years and older [ 26 ].

FDA requires food labels to list iron content. Iron is available in many dietary supplements. Frequently used forms of iron in supplements include ferrous and ferric iron salts, such as ferrous sulfate, ferrous gluconate, ferric citrate, and ferric sulfate [ 3 , 27 ].

Because of its higher solubility, ferrous iron in dietary supplements is more bioavailable than ferric iron [ 3 ]. Other forms of supplemental iron, such as heme iron polypeptides, carbonyl iron, iron amino-acid chelates, and polysaccharide-iron complexes, might have fewer gastrointestinal side effects than ferrous or ferric salts [ 27 ].

The different forms of iron in supplements contain varying amounts of elemental iron. Fortunately, elemental iron is listed in the Supplement Facts panel, so consumers do not need to calculate the amount of iron supplied by various forms of iron supplements. Calcium might interfere with the absorption of iron, although this effect has not been definitively established [ 4 , 31 ].

For this reason, some experts suggest that people take individual calcium and iron supplements at different times of the day [ 32 ]. People in the United States usually obtain adequate amounts of iron from their diets, but infants, young children, teenage girls, pregnant women, and premenopausal women are at risk of obtaining insufficient amounts [ 28 , ].

The average daily iron intake from foods is The average daily iron intake from foods and supplements is The median dietary iron intake in pregnant women is Rates of iron deficiency vary by race and other sociodemographic factors. Deficiency including IDA is more common among children and adolescents in food-insecure households than in food-secure households [ 36 , 37 ].

Among pregnant women, deficiency based on depleted iron stores is more common in Mexican American Some groups are at risk of obtaining excess iron. Individuals with hereditary hemochromatosis, which predisposes them to absorb excessive amounts of dietary iron, have an increased risk of iron overload [ 39 ].

One study suggests that elderly people are more likely to have chronic positive iron balance and elevated total body iron than iron deficiency. The authors did not assess genotypes, so they could not determine whether these results were due to hemochromatosis [ 40 ].

Iron deficiency is not uncommon in the United States, especially among young children, women of reproductive age, and pregnant women. Because iron deficiency is associated with poor diet, malabsorptive disorders, and blood loss, people with iron deficiency usually have other nutrient deficiencies [ 2 ].

The World Health Organization WHO estimates that approximately half of the 1. In developing countries, iron deficiency often results from enteropathies and blood loss associated with gastrointestinal parasites [ 2 ].

Iron depletion and deficiency progresses through several stages [ ]:. In , the WHO characterized IDA as one of the 10 leading risk factors for disease around the world [ 42 ].

Although iron deficiency is the most common cause of anemia, deficiencies of other micronutrients such as folate and vitamin B12 and other factors such as chronic infection and inflammation can cause different forms of anemia or contribute to their severity.

The functional deficits associated with IDA include gastrointestinal disturbances; weakness; fatigue; difficulty concentrating; and impaired cognitive function, immune function, exercise or work performance, and body temperature regulation [ 15 , 43 ].

In infants and children, IDA can result in psychomotor and cognitive abnormalities that, without treatment, can lead to learning difficulties [ 2 , 43 ]. Some evidence indicates that the effects of deficiencies early in life persist through adulthood [ 2 ]. Because iron deficiency is often accompanied by deficiencies of other nutrients, the signs and symptoms of iron deficiency can be difficult to isolate [ 2 ].

Preterm babies often need more iron than full-term babies. Your child needs to be screened for anemia. Connect with Nutrition, Physical Activity, and Obesity. fb icon twitter icon youtube icon alert icon.

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Slow, chronic blood loss within the body — such as from a peptic ulcer, a hiatal hernia, a colon polyp or colorectal cancer — can cause iron deficiency anemia.

Gastrointestinal bleeding can result from regular use of some over-the-counter pain relievers, especially aspirin. A lack of iron in your diet. Your body regularly gets iron from the foods you eat. If you consume too little iron, over time your body can become iron deficient. Examples of iron-rich foods include meat, eggs, leafy green vegetables and iron-fortified foods.

For proper growth and development, infants and children need iron from their diets, too. An inability to absorb iron. Iron from food is absorbed into your bloodstream in your small intestine. An intestinal disorder, such as celiac disease, which affects your intestine's ability to absorb nutrients from digested food, can lead to iron deficiency anemia.

If part of your small intestine has been bypassed or removed surgically, that may affect your ability to absorb iron and other nutrients. Without iron supplementation, iron deficiency anemia occurs in many pregnant women because their iron stores need to serve their own increased blood volume as well as be a source of hemoglobin for the growing fetus.

These groups of people may have an increased risk of iron deficiency anemia: Women. Because women lose blood during menstruation, women in general are at greater risk of iron deficiency anemia. Infants and children. Infants, especially those who were low birth weight or born prematurely, who don't get enough iron from breast milk or formula may be at risk of iron deficiency.

Children need extra iron during growth spurts. If your child isn't eating a healthy, varied diet, he or she may be at risk of anemia. People who don't eat meat may have a greater risk of iron deficiency anemia if they don't eat other iron-rich foods.

Frequent blood donors. People who routinely donate blood may have an increased risk of iron deficiency anemia since blood donation can deplete iron stores.

Low hemoglobin related to blood donation may be a temporary problem remedied by eating more iron-rich foods. If you're told that you can't donate blood because of low hemoglobin, ask your doctor whether you should be concerned. However, left untreated, iron deficiency anemia can become severe and lead to health problems, including the following: Heart problems.

Iron deficiency anemia may lead to a rapid or irregular heartbeat. Your heart must pump more blood to compensate for the lack of oxygen carried in your blood when you're anemic.

This can lead to an enlarged heart or heart failure. Problems during pregnancy. In pregnant women, severe iron deficiency anemia has been linked to premature births and low birth weight babies. But the condition is preventable in pregnant women who receive iron supplements as part of their prenatal care.

Growth problems. In infants and children, severe iron deficiency can lead to anemia as well as delayed growth and development. Additionally, iron deficiency anemia is associated with an increased susceptibility to infections.

You can reduce your risk of iron deficiency anemia by choosing iron-rich foods. Choose iron-rich foods Foods rich in iron include: Red meat, pork and poultry Seafood Beans Dark green leafy vegetables, such as spinach Dried fruit, such as raisins and apricots Iron-fortified cereals, breads and pastas Peas Your body absorbs more iron from meat than it does from other sources.

Choose foods containing vitamin C to enhance iron absorption You can enhance your body's absorption of iron by drinking citrus juice or eating other foods rich in vitamin C at the same time that you eat high-iron foods. Vitamin C is also found in: Broccoli Grapefruit Kiwi Leafy greens Melons Oranges Peppers Strawberries Tangerines Tomatoes.

Preventing iron deficiency anemia in infants To prevent iron deficiency anemia in infants, feed your baby breast milk or iron-fortified formula for the first year. By Mayo Clinic Staff. Jan 04, Show References. Kaushansky K, et al. Iron deficiency and overload. In: Williams Hematology. New York, N.

Accessed Oct. Schrier SL, et al. Treatment of iron deficiency anemia in adults. Iron-deficiency anemia.

Besides tuna, haddock, mackerel, and sardines are a few other examples of iron-rich fish that you can also include in your diet 62 , 63 , Fish is also a good source of several other important nutrients, including omega-3 fatty acids, vitamins, and minerals. Iron is an important mineral that must be consumed regularly as your body cannot produce it on its own.

Yet, it should be noted that some people need to limit their intake of red meat and other foods high in heme iron. Read this article in Spanish. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

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Liver and other organ meats. Red meat. Pumpkin seeds. Dark chocolate. The bottom line. How we reviewed this article: History. Jun 28, Written By Franziska Spritzler. Jan 27, Written By Franziska Spritzler.

Medically Reviewed By Angela M. Bell, MD, FACP. Share this article. Read this next. Back to Vitamins and minerals. Iron is important in making red blood cells, which carry oxygen around the body.

A lack of iron can lead to iron deficiency anaemia. Department of Health and Social Care advice is to limit the amount of red and processed meat you eat.

This is due to the probable link with bowel cancer. Read more about red meat and the risk of bowel cancer. c Some foods or beverages are not appropriate for all ages, particularly young children for whom some foods could be a choking hazard.

d Portions listed are not recommended serving sizes. Standard portions provide at least 1. Smaller portions are generally one half of a standard portion. Data Source: U. Department of Agriculture, Agricultural Research Service. FoodData Central, Iron: Nutrient-dense a Food and Beverage Sources, Amounts of Iron and Energy per Smaller Portion.

Home About About Purpose Who's Involved? CONTACT US FAQS. Dietary Guidelines for Americans Current Dietary Guidelines Dietary Guidelines and Online Materials Food Sources of Select Nutrients Food Sources of Iron.

Food Sources of Iron.

Non-heme iron is found in plant foods. Heme iron is better absorbed in the body than non-heme iron. You can meet all of your iron needs even without animal foods.

Read more about meeting your iron needs if you are vegetarian or vegan. Find out more about reading the nutrition label. If you think you are not getting enough iron from food, speak with your health care provider or dietitian. Iron is important for your health.

Choose iron rich foods from plant and animal sources. Use nutrition labels to help you choose iron-rich foods. If you think you may not be getting enough iron, speak with your health care provider or dietitian. What you need to know about iron Managing iron deficiency.

Dietitians look beyond fads to deliver reliable, life-changing advice. Want to unlock the potential of food? Connect with a dietitian. Home Articles Vitamins and Minerals How To Get More Iron. How much iron do I need? What foods have iron?

Increase the absorption of non-heme iron in foods by eating them with heme iron foods like meat, fish or poultry or foods that contain vitamin C. Vitamin C increases the absorption of non-heme iron. Combine foods that contain non-heme iron with foods that have vitamin C. For example, serve hummus source of iron with red bell pepper slices source of vitamin C.

b Some fortified foods and beverages are included. Other fortified options may exist on the market, but not all fortified foods are nutrient-dense. For example, some foods with added sugars may be fortified and would not be examples in the lists provided here. c Some foods or beverages are not appropriate for all ages, particularly young children for whom some foods could be a choking hazard.

d Portions listed are not recommended serving sizes. Standard portions provide at least 1. Smaller portions are generally one half of a standard portion. Data Source: U. Department of Agriculture, Agricultural Research Service.

FoodData Central, Iron: Nutrient-dense a Food and Beverage Sources, Amounts of Iron and Energy per Smaller Portion. Home About About Purpose Who's Involved? Transferrin is the main protein in the blood that binds iron and transports it around the body.

These tests either indirectly or directly measure the amount. Authors' conclusions: This review is the most comprehensive summary of the evidence assessing the benefits and harms of intermittent iron supplementation in pregnant women on haematological and pregnancy outcomes.

Read more on Cochrane Australia website. Some types of anaemia, thrombocytopenia and platelet function disorders, bleeding disorders and massive transfusion are common clinical indications for blood components.

The zinc protoporphyrin ZPP test is a blood test that can identify a disruption in the formation of haem. Haem is an essential component of haemoglobin, th. Healthdirect Australia is not responsible for the content and advertising on the external website you are now entering.

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Key facts Iron is an important nutrient that you can only get through your diet. Haem iron is found in meat, poultry and fish.

Non-haem iron is found in plants, eggs, and nuts. The amount of iron you need each day depends on your sex and age. If you are concerned about your iron intake, speak to your doctor.

How can I get enough iron in my diet?