Iron Deficiency in Pregnancy: Part One

Note: this post was written for Hellobee when I was about 18 weeks pregnant. I’ll post a follow up in a couple of days, from 38 weeks.

Iron deficiency is something that over half of women will deal with at some point in their lives. For me, the anemia hit as a teenager; I was put on an iron supplement as well as a birth control pill in order to control my cycles, and prevent me from losing so much blood each month. For many, this is when iron deficiency first rears its ugly head; your periods start, they’re a little out of control, and your body can’t keep up with the deficit. For many, this is also resolved by a few months on an iron supplement.

In my case I assumed my iron deficiency was under control and my doctor stopped following up. I stopped the iron once in university, and turned to coffee to control the tiredness. I never really thought about my low iron again, until I was pregnant with K.

When I hit third trimester with K, I was absolutely exhausted all the time. I had awful headaches, I couldn’t focus, and I felt really foggy. I assumed this was just typical third trimester (in the blazing hot summer). However, routine third tri blood work revealed that not only was I anemic, but my ferritin levels were at a 3. Normal levels for women range from 12-150 ng/mL, so this was really concerning to my midwives (especially for someone about to deliver a baby and lose a lot of blood).
In a drastic attempt to increase my ferritin levels (the protein that helps with iron storage), I started a high-dose iron supplement formulated for pregnant women. I also began adding dark leafy greens, red meats, beans, and fortified protein powder to just about everything I ate. Combining my iron-rich meals with vitamin C also helped increase iron absorption; take your iron supplement with a glass of orange juice to help this, too.

Thanks to my constant monitoring, my iron and ferritin levels came up a fair bit (to about 15-20 pre-delivery). I stayed on my iron supplement until about eight weeks postpartum, when I ran out and really didn’t see a doctor to follow up.

With this pregnancy, the exhaustion hit almost immediately. Again, I assumed it was typical pregnancy exhaustion, until the familiar headaches, fogginess and inability to concentrate began to show up.

I had bloodwork done at 12 weeks, and lo and behold, my ferritin levels were back down to 5. I grabbed the Palafer supplements from the pharmacy, and began pumping iron into my diet, along with vitamin C to help it all absorb. The fogginess faded, the headaches disappeared, and my energy came back by about 16 weeks. I’ll be continually monitored throughout this pregnancy to make sure my levels stay up, but I’m grateful that we caught it early this time.

So, what exactly IS iron deficiency (or iron-deficiency anemia)? Iron-deficiency anemia is a decrease in red blood cells, caused by having too little iron in your body. When you lack iron, your body can’t produce hemoglobin (which helps blood cells carry oxygen). This lack of iron causes you to feel weak, lethargic, foggy and irritable. What I learned, to my surprise, is that over 50% of pregnant women have low iron; compared to about 20% of non-pregnant women. Men tend to have much more iron in their bodies; only about 3% of men have iron-deficiency anemia.

Iron is essential for producing new blood. During pregnancy, a woman’s blood volume increases by almost 50%…if you’re low on iron, this process is much more difficult. Also, babies tend to load up on iron before they are born, taking all of yours; breastmilk is low in iron, so they’re preparing themselves for the first several months.

So how will you know if you should have your iron levels tested? Here are some of the most common symptoms of iron-deficiency anemia:

  • Headaches, worse during exercise
  • Breathlessness
  • Exhaustion
  • Dizziness
  • Difficulty concentrating

One of the easiest ways to boost the iron in your body is to eat iron-rich foods. There are two forms of iron that can be eaten: one is called heme iron (coming from an animal source), and nonheme iron (which comes from plant sources). Your body absorbs the most iron from heme sources. When pregnant, you should be aiming for about 30 mg of iron per day through a combination of food, prenatal vitamins, and an iron supplement if prescribed/given by your doctor.

Here’s a list of some amazing iron-rich foods, from both the heme and nonheme categories:

Animal sources:

  • 3 oz clams – 24 mg
  • 3 oz organ meats – 5-9 mg
  • 3 oz beef – 3-5 mg
  • 3 oz duck, lamb or chicken – 3 mg

Vegan/Vegetarian sources (average 5-8 mg per serving):

  • 1 cup spinach – 5mg
  • Fortified instant oatmeal – up to 20mg
  • Dried apricots – 3 mg per 6 apricots
  • 1 cup swiss chard or other leafy green
  • 1/2 cup kidney beans – 3mg

Note: cooking iron-rich veggies can leach some of the iron, so don’t boil them. Steaming is preferable, or sautéing in a cast iron skillet, which will actually boost the iron content.

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