It may seem that people at risk of iron overload should manage it by avoiding iron-rich foods, but in most cases this is a bad idea. Iron-rich foods are rich in many other nutrients, like copper, zinc, vitamin A, and vitamin B12. Chelators like phytate can induce deficiencies of other minerals, like zinc. In this video, I explain why dietary management should be a last resort for iron overload.
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This is why managing your iron status with dietary restriction should only be a last resort.
Hi. I’m Dr. Chris Masterjohn of chrismasterjohnphd.com. And this is Chris Masterjohn Lite, where the name of the game is “Details? Shmeetails. Just tell me what works!”
And today we’re going to talk about why managing iron status with diet is generally a bad idea.
Now, in the last episode, I talked about why most people who avoid iron in foods don’t actually need to. And I talked about how I need to manage my iron status, and yet with a little bit of blood donation, I can eat all the iron that I want, and I don’t have any problems.
The theme of this episode is a little bit different. This is on the dangers of managing iron with diet. So, I had a consulting client once who was an intermittent client. We met twice separated by a year or two, and in the second appointment, his zinc and copper levels were getting dangerously low. And I said, “What have you been doing differently with your diet?” Turned out really the only thing he had been doing differently with his diet was he started eating less liver, red meat, and shellfish in order to bring his iron levels down.
So what happened? Well, liver, red meat, and shellfish were his most important sources of zinc and copper. And it just so happens that everything that’s high in iron is good for you in some other way. So for example, the red meat is a great source of zinc; the shellfish, great source of zinc, copper, and many other minerals; the liver, great source of copper, especially. Liver is also a great source of vitamin A. Liver is also a great source of vitamin B12. Eating liver once a week can give you a lot of nutrients, insurance against a lot of deficiencies that you can’t get when you remove that liver. We looked in the last episode at my results showing that I was eating 10 ounces of red meat a day, and it was contributing to less than a tenth of my total iron and less than half of the daily requirement that I should eat.
So even eating 10 ounces of red meat is not going to push you over. Liver supplies about three times as much iron as red meat does, but who here is eating 10 ounces of liver a day? I recommend eating liver one to two servings per week. At one to two servings per week, you can afford to get a fairly hefty dose of iron. It’s still not enough to meet the RDA for that day, and it’s certainly not going to meet the RDA for the week. Are you going to cut out the legumes from your diet, which are probably your best source of folate, which are certainly your best source of the mineral molybdenum? Are you going to cut out the vegetables from your diet, which are the best source of polyphenols, which are probably an excellent source of vitamin C, which are probably an excellent source of folate?
We could go on and on and on with these things. There’s no food that you can take out to bring iron down that isn’t going to potentially give you deficiencies of other nutrients. So managing iron status with dietary iron is a bad idea. Now, you could add iron absorption inhibitors. Well, there’s plenty of iron absorption inhibitors in the natural foods that you eat. If you just eat meat, starches, and vegetables you’ll have iron absorption inhibitors. You can add phytate in order to chelate iron, and yes, there are medical contexts where that might be necessary, but as a general principle, that’s a great way to induce a zinc deficiency. Does it help you with iron overload to get a zinc deficiency? Not really, so it’s not a great idea. Adding calcium is a way of reducing some of the iron absorption in your food. I actually do think this is a great idea if you’re adding about 300 milligrams of calcium from food, or if you need to, supplements, per meal. But that’s just meeting your needs for calcium. So yes, you should do that because you don’t want to be deficient in calcium. But you don’t want to start adding grams of calcium to the food as a means to manipulate the iron absorption in the food because then you can not only get too much calcium, which as we talked about in a previous episode, maybe contributes to heart disease in some contexts, but also grams of calcium can inhibit the absorption of a bunch of other minerals in your diet.
So what should you do? Well, unless there is a reason that you need to do more than this, the first line of defense should always be to donate blood. If you’re ineligible to donate blood, you can ask your doctor about phlebotomy. Sometimes that might not be available to you, and in those cases, I can see working on some of these other issues. Sometimes you might be in a medical state where you can’t sacrifice blood to lose. In that case, I see working on this from other angles. But for most people, the first line of defense should always be to donate blood because 90% of the iron in your body is in your red blood ncells. That is absolutely not true for the copper in your body, for the zinc in your body, for the other nutrients in your body. That’s not to say that you don’t lose anything else when you lose blood. It’s just to say that you are highly selectively losing iron far more than anything else when you lose blood in a way that is not true through any of the means that you can manipulate iron absorption from your food or any of the ways it can manipulate the iron content of your diet.
And so this is why, unless there are contravening reasons in specific cases, it is always better to manage iron status with the amount of blood donation needed to bring those numbers into range, which you discover primarily by trial and error and remeasuring the tests, rather than to manipulate it with diet.