1. Lots of women—not just vegetarians and pregnant women—find it hard to get enough iron.
“During pregnancy, your body needs more iron, but it’s hard to meet your increased needs through diet alone,” ob-gyn Nan Schuurmans, MD, co-author of the book Healthy Beginnings. Your healthcare provider may prescribe an iron supplement that you will need to take along with your prenatal vitamins.
As for vegetarians, because they do not eat meat (which is rich in iron), experts recommend that they eat greater amounts of iron-containing fruit, vegetables, grains, nuts and beans in order to get adequate amounts of the nutrient. “However, vegetarians who make proper food choices don’t have a higher incidence of iron deficiency compared to non-vegetarians,” says registered dietitian Vesanto Melina, co-author of a joint position paper on vegetarian diets from the Dietitians of Canada and the American Dietetic Association.
Here are some other common causes of iron deficiency:
Poor iron absorption: This could be due to not eating enough iron-rich foods, or eating foods that can hinder the way your body absorbs this essential mineral. “Because iron is absorbed in the gut, faulty absorption could also be due to a digestive issue such as untreated celiac disease or colitis,” says Ehman. A 2010 study published in the International Journal for Vitamin and Nutrition Research suggested that people who are obese may not be able to absorb iron well. And absorption can be blocked for those taking large amounts of antacids or a proton-pump inhibitor (PPI) medication to treat acid reflux.
Too-vigorous workouts: If you are training extra-hard—for a half-marathon, for example—“you can lose small amounts of iron through sweat and urine,” explains registered dietitian Alex Paton, who specializes in sport nutrition. Running can also cause minor GI bleeds (that the runner may not even notice) simply because the body is being jostled and shaken, she adds.
Another factor is foot strike—literally, red blood cells bursting in the feet when they hit the ground. (You might experience foot pain or extreme fatigue if this is the case.) “Running shoes with firm insoles decrease the amount of blood loss through foot strike,” notes Kamal Janakiraman, a researcher and physiotherapist who co-authored a study in Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology.
Giving blood: Blood donation causes a temporary drop in hemoglobin, but your body makes new red blood cells to replace those lost. It’s a good idea to eat iron-rich foods for a few days after donation, and space out your donations if your levels are in the low-normal range.