I recently saw an online health article which I thought gave rather strange advice. It cautioned that you should look out for multivitamins containing iron and avoid taking them. The author reasons that because too much iron can cause health complications, it follows that you shouldn’t take multivitamins containing iron in order to avoid iron overload.
This reasoning struck me as being a pretty big logical leap, so I decided to look into it further and share what I found.
The first question is, can you get too much iron? Of course you can. Literally any substance is harmful if consumed in excessive amounts, including all essential nutrients and even water. But that doesn’t mean we should avoid them in all circumstances. So before swearing off iron-containing supplements, we need to dig deeper and find out how much iron is too much and whether you should be concerned about iron toxicity.
Iron is important for health.
There is no doubt that iron is critical to human health. This essential micronutrient is needed to build hemoglobin, the protein in red blood cells that carries oxygen to your tissues and organs. If you aren’t getting enough iron or are losing too much, your iron stores become depleted. Over time, this can lead to anemia and symptoms like weakness and fatigue.
It’s also true that iron can be dangerous in large amounts. When an excessive amount of iron is present in the body, it accumulates in the vital organs, which can potentially lead to a long list of complications including heart failure, hypothyroidism, and even death (1).
What you probably want to know is whether iron overload is a significant risk to your health. How common is this condition, and what really causes it? Here is everything you need to know to figure it out.
When and why does iron overload happen?
If iron overload from supplements is a great threat, you might expect it to be easy to find data on this phenomenon. In reality, though, it is difficult to find data on the topic. Iron overload does occur, but it’s usually not from supplements. The most common cause is hemachromatosis, a hereditary disorder which causes iron to accumulate in organs instead of being used in blood. The prevalence of this disorder in the United States is estimated to be 0.2-0.5% (2).
Iron overload can also be associated by some other hereditary disorders that impair red blood cell formation, such as sickle cell disease. The last possible causes are repeated blood transfusions and excessive iron supplements. Iron overload is definitely a serious disorder and can have effects such as cirrhosis, diabetes, hypothyroidism, and occasionally heart failure. But it just isn’t an immediate danger for most of the population. Thankfully for those who are affected, iron overload can be treated by phlebotomy (removing blood) or by chelation (injection of a solution containing molecules that bind to iron ions) (3).
Iron deficiency: a more common concern.
Iron overload is a significant health concern, but iron deficiency and iron deficiency anemia are much more prevalent issues. Worldwide, the statistics are startling. Research has found that up to 80% of people are iron deficient, and up to 30% have iron deficiency anemia. These numbers are higher in developing countries due to lower nutritional quality. Iron deficiency is especially common among pregnant women and young children, and it can cause developmental problems during infancy. But iron deficiency is also a significant problem in developed countries like the United States, where it is the most common nutritional deficiency (4). If you are iron deficient, you might think the fatigue you experience is normal and hesitate to talk to your doctor. As a result, it can easily go undiagnosed for years, and may only be detected with a routine blood test.
Balancing iron intake.
Whether you should be more concerned about iron overload or iron deficiency has a lot to do with sex and life stage. Since iron is eliminated through blood loss, menstruating women are very unlikely to accumulate too much iron and are at a greater risk for iron deficiency. Iron deficiency is also more common in pregnant women and can cause pregnancy complications.
On the other hand, men and post-menopausal women usually can maintain normal iron levels with a healthy diet. Members of these populations are advised to not take iron supplements since it could lead to a buildup of iron. As mentioned before, excess iron is unlikely to be dangerous except when hereditary disorders are involved. However, it is better to be safe and avoid unnecessary supplements.
This brings us back to the iron-containing multivitamins mentioned at the beginning of this article. By now, you know that only certain people need to be concerned about iron overload. Thankfully, this is being accounted for by an increasing number of supplement manufacturers which are producing separate multivitamins for women and men. The biggest difference between these is that only the women’s multivitamins contain iron.
However, some general adult multivitamins also contain iron, and so do some multivitamins targeted toward older women. As always, it’s best to read the ingredients before purchasing a supplement, especially if you are a man or a postmenopausal woman who may be susceptible to iron overload.
Concerned about iron overload? Talk to your doctor.
In summary, iron overload is a real and serious condition. It is typically caused by certain hereditary conditions that lead to iron building up in organs, causing side effects and possible organ damage. For most people, though, iron overload can be easily avoided simply by eating a healthy diet. Statistically, the risk of iron deficiency is greater than the risk of iron overload. Pre-menopausal women especially are more likely to benefit from an iron supplement than be harmed by it.
This doesn’t mean that you should take iron indiscriminately. In fact, some doctors caution against iron supplements, even for women, unless iron deficiency has been diagnosed. Ultimately, the decision is yours. If you are concerned about your iron being too high or too low, you can talk to your doctor and ask for a blood test. From there, will be able to make a more informed decision about the place iron should have in your daily life.