Do you need an iron supplement?

Philip J. Goscienski, M.D.

April 2013

Most of the iron within our bodies — about one-sixth of an ounce — resides in the blood and liver. The red color of blood is due to the presence of hemoglobin, an iron-containing protein that delivers oxygen to every organ.

Back in the Stone Age everyone got all the dietary iron they needed. Meat, eggs and vitamin C-rich plant foods provided adequate iron. When humans became farmers and made iron-poor cereal grains their main source of calories, deficiency of this mineral became widespread. The most common cause of anemia throughout the world is due to iron deficiency, affecting more than one billion people around the globe.

The average American is not likely to become iron-deficient because of our intake of red meat and fortified bread and cereals. Infants whose diet consists mostly of milk sometimes develop a mild iron-deficiency anemia at about the age of one year. The one-year well-child check should include a blood test for anemia. Women of childbearing age lose a little iron during menses and those that are pregnant are encouraged to take an iron supplement. Men don't require a supplement and neither do women beyond menopause.

Starting in middle age, the annual medical check-up should include a blood count that measures red blood cells. A low count may be due to poor diet or to bleeding from the intestine. In either case anemia may develop slowly and be so subtle that symptoms are barely noticed. It's easy to blame the fatigue that is a hallmark of iron-deficiency anemia on the aging process.

Some studies seem to indicate that there is a link between coronary artery disease and too much dietary iron but there is considerable disagreement on this topic. A confounding reason may be that persons who have a high intake of red meat have a higher intake of the saturated fat that constitutes as much as 38 percent of certain cuts of beef.

It is extremely important to keep iron supplements away from children. Iron is one of the most common causes of poisoning in children and it continues to kill toddlers, in whom a toxic dose may be as little as five or six tablets of prescription or over-the-counter forms of iron. Whether or not children are present in the home, iron supplements should always be kept in a child-proof container and far from a child's reach.

Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at