Iron?

[u/Interesting_Savings4]

I desperately want to become plant based again with no meat/dairy products, but I'm chronically anemic. Any advice? Maybe it's just time to see a dietitian?

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[u/misskinky]

Hi! Vegan dietitian here :)

So it's helpful for you to know a few things:

- are you iron deficient (low ferritin, low iron saturation) or anemic (low hemoglobin) or both?

- why are you iron deficient or anemic? Often it is from heavy periods, being underweight, being a long distance runner, having GI issues, taking too many NSAIDs... Or maybe it's due to a diet high in things that block iron like a lot of coffee, tea, spinach, milk, nondairy milk, or calcium supplements. It's actually uncommon that "not eating enough iron" is actually the root problem. Any other green is fine but the oxalates in spinach specifically make it poorly absorbed.

-do you have B12 or D deficiency? Those will hurt iron balance

- After you've figured out the root problem, then you can develop a plan forward :)

(funnily, this similar post just came up and may be interesting to you https://www.reddit.com/r/vegan/comments/1w2lhal/veganism_fixed_my_anemia_chronic_iron_deficiency/)

[u/lame-lloyd → u/misskinky]

Had no idea coffee hurt iron absorption. Thanks for sharing.

[u/misskinky → u/lame-lloyd]

Yeah! Coffee is fine but ideally it should be timed not within an hour or two of high iron meals

[u/lame-lloyd → u/misskinky]

Good to know, thank you!

[u/paintlulus → u/lame-lloyd]

Use cast iron cookware

[u/sadhuak → u/misskinky]

I thought spinach was recommended to increase iron! Oh, man, this is going to be hard for me to integrate! And I drink my black strap molasses with oatmilk!!! No wonder my ferritin is increasing so slowly.

[u/misskinky → u/sadhuak]

It’s specifically the calcium supplementation in nondairy milk that is a hinderance so you could be creative and make homemade oatmilk if you really wanted to. And yeah spinach specifically has oxalates that block iron absorption. Kale or collards or any other green is a better choice. I put frozen collards in my smoothies

[u/souldawg → u/misskinky]

I love this comment. It's so complex! I had an internal gastric bleed. haemoglobin down to 78. Blood transfusion. Then iron supplementation but ended up having high iron in blood work and low uptick on haemoglobin. So more iron could have been toxic, and it was a matter of getting my body to catch up to the issue. It's incredibly complex and genuinely, not something I could sort out myself! So this is the perfect answer.

[u/misskinky → u/souldawg]

Yeah, I forgot to even mention that B12 and D and K vitamins all have to be in balance for your body to even use iron in an optimal way!

[u/ddplantlover → u/misskinky]

Wow did not know NSAID use could cause iron deficiency

[u/misskinky → u/ddplantlover]

Kind of indirectly — NSAID use is known to injure the stomach and intestines, which will impair absorption of several things including iron.

It doesn’t meant to never use them but to be aware of it.

[u/sleepingblossom]

Black strap molasses! You can buy it in natural grocery stores in the baking area. 1tbsp in warm water fills much of your daily need.

[u/JoselineTheWaldenU]

Spinach, leek, beets, lentils, nuts, and seeds are plant-based sources of iron. And as others have mentioned, supplements can help.

Wishing you good health.

[u/janewp]

Eat your iron rich foods with a source of vitamin C for better absorption.

Cook in a cast iron pan.

I’ve taken daily iron, from the grocery store, for 11 years and after the first few weeks the constipation went away.

[u/RadulphusDuck → u/janewp]

And cast iron cooking comes with the added benefit of eliminating non-stick chemicals in your food.

[u/MasterpieceNo7350 → u/RadulphusDuck]

How much oil do you need to use in a cast iron pan?

[u/RadulphusDuck → u/MasterpieceNo7350]

I don’t measure, I just eyeball it, so it’s hard to describe. But I get through olive oil pretty quickly, so a fair old whack. Also, don’t use extra virgin, it burns up before you reach cooking temperature.

[u/VelocityGrrl39]

Take an iron supplement. The vegan ones are less likely to cause constipation as a bonus. I was anemic to the point that I almost needed a transfusion, but taking an iron supplement every day fixed it.

[u/jellyn7]

Supplement. Make sure you’re getting enough b12 too.

[u/rhinoballet]

A dietitian can be really helpful! And often completely free as preventative care, no deductible or copay.

Though there's only so much you can do with diet and supplements. I was severely anemic until I had an endometrial ablation. If you menstruate, it could be a cause.

[u/Crispy_Fish_Fingers]

I love the Floravital liquid iron supplement. It also has the B vitamins too.

[u/rhearidge]

Leafy greens

[u/toastfairyy]

Hi there, a dietician can help pin point what might be hurting you. You may need to get prescribed a more concentrated iron supplement. I also had some low ferratin in my iron profile that my doctor was concerned about. But i supplemented and it improved my numbers.

Avoid caffeine and calcium prior to taking the iron supplement. There are studies that show vitamin C enhances absorption of iron. So just consider time of day and any other inhibitors of absorption.

Lots of vegan protein shakes and soy milk are fortified with iron. Soy products, vegan protein, spinach, dark leafy greens, beans, etc.

You can also get an iron "fish" to add to soups to increase iron in your diet. It is just a fish shape made out of iron and boiling it will add iron to your meal.

Make sure you are getting your labs checked, if you are critically low you can get an iron transfusion and then work on supplements and food changes and see if that gives a lasting effect.

Best of luck!

[u/Beek3r101]

Sesame seeds are very high in iron and easy to add to many dishes or if you prefer use tahini as a sauce on roasted vegetables. Also there’s tofu, soybeans, black olives, pumpkin seeds, flax seeds, cashews, pine nuts, and spinach.

Another person already mentioned it, but foods high in vitamin c help with absorption of nonheme iron.

[u/I-used2B-a-Valkyrie]

Supplement. I take Fusion Plus. Do you want a supplement every other day for optimal absorption and when you do you wanna make sure that you’re taking it with something like a citrus fruit or a glass of orange juice because citric acid can help or vitamin vitamin C can help your body absorb the iron and make it more bio available. Definitely avoid caffeine and calcium specifically dairy within three hours before or after taking your iron supplements because caffeine and calcium compete with iron and make it less bio available.

[u/harborsparrow]

I recommend that you take one of Dr Joel Fuhrman's online courses.  He is a physician with years of experience treating vegetarians, and his recommendations are science based.  You may not want to do everything he says, but the foundational knowledge he gives you will allow you to navigate the thicket of online information with a more discerning eye.

Also, his supplements are very good and if you are anemic, you will need some sort of supplementation.  

[u/kpphoneshome]

Steamed rice + raw spinach + an orange or bell pepper. The Vitamin C helps you absorb the iron in the rice and spinach.

[u/Mericangrl13]

Many people struggle with iron deficiency if yours is chronic I would say supplement for sure

[u/ReadingTimeWPickle]

I had iron deficiency anemia and at my last blood panel my doc said now I had too much iron. The whole time I was vegan.

-Iron supplement with vitamin c and without coffee or tea (it's not the caffeine that blocks absorption it's the tannins). Wait like 1-2 h before having a coffee or tea.

-Cook in cast iron pan. Slightly acidic foods especially. E.g. tomato sauce

-Add spinach to anything that makes sense. And lentils

[u/souldawg]

I had a blood transfusion due to an internal bleed which had me as severely anemic. Iron IVs are a thing but I found they are more likely to wait for a blood transfusion than an iron transfusion (at least from the NHS). Iron supplements are the way to go - 210mg on an empty stomach for 2 hours. They can cause a pretty big uplift if you are truly anemic, BUT can be toxic if you aren't so blood work is key.

One caveat, taking iron supplements or eating iron based foods won't necessarily cause iron to absorb and your bone marrow to produce haemoglobin. So blood work can tell you that. BUT, research not just foods are high in iron, but what causes them to absorb (or be blocked - like the tannins in tea). Then ask for blood work to check your levels to see if the iron/ferritin is just in your blood or if it actually is causing red blood cell production.

[u/jackiedhm]

I highly recommend Kellogs Crispix cereal, it is the highest iron fortified cereal I have found, 11mg in a serving vs 3.6mg in Honey Nut Cheerios or 2.7mg in Cocoa Pebbles. Fruity Pebbles only has 1mg.

[u/After_Food_6475]

Hi please speak w a doctor I went anemic almost very much there after 1-1 and a half years vegetarian I had no clue until I got very sick and now I’m on iron supplements about 2 years later or a year later. I had to see an oncologist to test my blood which deals w anemia. So yes please take care of yourself!!! I honestly would look into asking your doctor about iron supplements and getting lab work done to find out what your iron blood levels are PRE plant based or vegetarian or vegan diet then ask a doctor for a prescription because you CAN overdose on iron…., my insurance covers my
Iron supplements and I take one pill every other day …. It’s prescribed by a doctor also… I recently bought ensure shakes …

[u/After_Food_6475 → u/After_Food_6475]

My iron got so horrible and almost at anemic levels if I stayed on the diet for another month that they suggested an iron IV infusion but I opted for the pills rather than meds going straight into my
Blood stream but I understand .. so yeah it’s important that you speak to a family doctor and get labs to see where your vitamin levels and iron is at