Could You Be Anaemic? Iron Explained
This article outlines the problems with vegetable iron sources – and the solution (and it’s not necessarily meaty).
The science bit:
Iron is a mineral. It’s also an element, which means it’s on the Periodic Table of Chemical Elements. The fact that everything in the universe is made of chemical elements is why it makes me giggle when people come out with all that “it’s natural there’s no chemicals in this product” nonsense. Every atom is a chemical element of some sort, and every molecule is a combination of atoms – a chemical..
Iron has the chemical symbol Fe and is one of the transition metals, it’s moderately reactive, that is to say that it’s not as reactive as the group I and group II metals (zinc, magnesium, potassium, sodium, calcium… you should watch a video about some of these if you haven’t seen them react in water). It’s still fairly reactive though, when compared to copper, gold, silver, or any of the group 4 or group 0 elements (such as carbon, which is in group 4).
The nutritional bit:
We need a small amount of a lot of different metals in our body – we call these minerals, because it sounds nicer than calling them either metals or chemical elements. We need 8-18mg of iron in our bodies every day. That means eating some broccoli on Monday isn’t going to cut it by the time Tuesday rolls round, and it’ll be long used up by Thursday.
The funny thing about dietary iron is that there are two types. Iron likes to behave differently under different circumstances because it does weird stuff (copper is similar in this respect), so it actually does make a difference whether your iron came from an animal or non animal source. In biochemistry, they actually have two different names for these two sources of iron – animal-derived iron is called heme iron (which is what you have in your body after your body has processed it) and plant-derived iron is called non-heme iron. The iron you find in your blood is always heme iron.
Basically, if you eat heme iron, the animal you got it from has already done the hard job of turning the non-heme iron into heme iron, which means you can absorb more of it, and you absorb it faster, and less of it is needed or wasted. If you eat non-heme iron, you are the one who has to do the job of turning it into heme iron before it can get to your blood stream (to make hemoglobin – see how they both have the same word stem). This makes it a slower process, and means you should eat more of it, because its less absorbable.
For vegans, this can pose a problem but being aware of it means that you can easily overcome it. The solution is to just eat more iron-containing foods, such as the ones I’ve listed in my table of vegan nutrition in this article. You do need to be aware of this though, because it means the Recommended Daily Allowance / Daily Value for iron doesn’t give you a true picture of how much iron you need to consume as part of your daily vegan diet. The medical associations who made that stuff up were doing it under the assumption that you eat an “average American/British/Insert Your Country Here diet.” For most vegans, that’s not you, which means you need to fiddle those numbers a bit and get more iron than the omnivores, so you get the same amount of iron in your blood as they get in theirs.
The medical bit:
If you don’t get enough iron, you will become anaemic. Anaemia is a decrease in the amount of red blood cells, because without iron, you can’t make red blood cells. They are the ones that carry oxygen around your body to release energy (which is the whole point of breathing and the process is called respiration). If you don’t have anything to carry the oxygen, you will constantly be tired and weak, and you will probably also be thirsty and dizzy and confused. Contrary to popular belief, you won’t go pale until the anaemia has reached a very severe level, so don’t rely on that as an indicator.
The list of symptoms of anaemia are:
Weakness, fatigue, general malaise, poor concentration, poor temperature regulation (feeling too hot or too cold for no reason). Some people also get depression, shortness of breath and in some cases, palpitations or angina can be present, due to increased heart rate as the body thinks it’s been exercising (anaerobic respiration) due to the lack of oxygen getting around the body.
Eventually, anaemia can kill you. Brittany Murphy and her boyfriend both died from pneumonia, which was a complication of the severe anaemia that they both had.
Not all of these symptoms will affect everybody, and the only reliable way to tell is to go to a doctor and get a blood test done. They will invariably want to put you on iron tablets, but be careful because I was given some last January that were called “Ferrous Fumarate” and they were made with gelatin, so that was a waste of money. Also be aware that in the UK those iron supplements that you get on prescription are also available over the counter, and if you pay for your prescriptions you should ask for the price because they’re usually selling for half the price of the prescription charge (and they’re not the ones you’ll find on the shelf – they’re more effective).
If you have anaemia, it’s a really good idea to take the iron tablets (I have some that are called ferrous sulphate which are vegan, but it will depend on the manufacturer as to which type are ok because different pharmacies use different brands which have different recipes, so always check). Making changes to your diet will help maintain your current iron level, but eating more iron-rich foods won’t be enough to increase your iron levels as much as is needed to overcome anaemia because you’re losing more blood cells by the minute due to the fact that you exist.
Side effects of iron tablets depend on which ones you get but I found the following side effects:
1. Standard off the shelf iron supplements – diarrhea, feeling too hot, stomach discomfort. They also don’t have enough iron in them to resolve anaemia (they have 14mg and the Ferrous Sulphate have 200mg).
2. Ferrous Fumarate – the idea made me feel sick due to the gelatin, so I didn’t actually take any.
3. Ferrous Sulphate – greenish tinge to stools, looser bowel movements, but nothing too spectacular. Sometimes they give me mild headaches.
In the long term, you are better off just eating more iron-rich foods. In the short term, get some supplements until you feel better. To prevent anaemia, always make sure you’ve eaten a bit more iron than you think you need. Remember, it’s not the general vegan diet that’s caused the anaemia, it’s your individual food choices within that vegan diet – so you have the power to fix it without necessarily having to resort to stopping veganism. Don’t deny the problem though if you have one because anaemia is really serious and totally curable.
Obviously doctors (and everyone else) are very quick to blame the vegan diet for anaemia, and for good reason, but do bear in mind that it doesn’t make you exempt from the other causes of anaemia which are more serious, so if your anaemia persists for several months while you’ve been taking supplements, go back to your doctor so he or she can thoroughly investigate the problem and make sure they didn’t overlook a serious blood disorder or something else important. If this is the case, it may be your sad duty to stop being vegan and include some meat in your diet to keep yourself alive.
If that happens, try not to be too hard on yourself. It may be that once you’ve got your iron stores high enough, you can be vegan again.
I was first diagnosed with anaemia in 2010. I spent 3 years in denial of the problem, until in late 2013 I developed a chronic blood loss problem that lasted 3 months. The blood loss caused the doctor to test for anaemia. This time, I eventually had to accept the diagnosis, from a different doctor, based on a different blood test. I was so anaemic that I had to take the iron tablets twice a day and I was also told, in no uncertain terms, that if I did not start including red meat in my diet I would never be able to function normally. For the first six months I made sure I ate red meat every second day. Then I tapered it down to about once a week. Then I left off unless I craved it, because in my experience my body tells me what it needs. Then I stopped completely, on 31st December 2014.
It’s two months since I stopped with the red meat regime and returned to being vegan. I’m now about 60-40 fruitarian to vegan, and I thoroughly researched the sources for nutrients before I considered changing my diets, which is what led to this vegan nutrition food sources table.
I do still take the Ferrous Sulphate when I need it, such as over the past week where the dizziness (technically it’s classed as vertigo, because it’s defined as “the feeling that you or your surroundings are moving” which is coupled with a feeling of disorientation and confusion, and always my first sign of anaemia, along with dry lips and skin) returned and I had to leave school early on Friday, leaving my classes in the hands of a cover teacher and losing half a day’s pay. I hate missing school for both of those reasons. So I’m back on the iron tablets again, due to the return in the last couple of weeks of the chronic blood loss problem, and I’m hoping that by catching it early this time, it will mean I don’t have to eat meat again. I’m also taking Vitamin K to help with the clotting.