I’ve been a vegetarian for over a decade and have struggled with iron deficiency anemia throughout that time, due to an underlying condition. Iron deficiency is not a given for vegetarians, but it is common.
If you think you may have an iron deficiency, ask your doctor for a simple blood test. Here are common iron deficiency symptoms that indicate you may not be getting enough iron on a vegetarian diet.
What is iron?
Iron is a mineral that is essential for hemoglobin, a protein that carries oxygen to the lungs for breathing and to the muscles for movement.
During exercise, the body sends blood to working muscles to maintain energy levels.
The recommended daily intake of iron is 18 milligrams (mg). This is a little more difficult to achieve with a plant-based diet because iron from plants is not absorbed like iron from animals.
There are two types of iron:
- Blood iron: This is the iron found in meat, such as chicken, beef, pork and seafood. It comes from the blood of these animals and heme iron is more easily absorbed by the body.
- Non-heme iron: This iron is found in plant sources and animal by-products, such as grains, fortified cereals, beans, nuts, seeds, vegetables and dairy. Non-heme iron is not absorbed as well by the body and you need more of it to meet your iron needs.
Can vegans and vegetarians get enough iron from food?
Vegans and vegetarians can only get enough iron through food. There are many iron-rich foods for plant-based eaters. Many vegetables have iron, but you may need to eat more of them to get enough.
THE National Institute of Health (NIH) recommends that vegetarians eat 1.8 times more iron than meat eaters, which is about 32 grams. It never hurts to add more iron-rich foods to your plant-based diet.
You can also increase the absorption of plant-based iron by paying attention to the foods you eat together. Vitamin C enhances the absorption of iron, so eating these two nutrients together can help you absorb this important nutrient. For example, combine iron-rich oats with vitamin C-rich strawberries.
Conversely, calcium reduces the absorption of iron. Therefore, you should be careful about eating high-calcium foods with iron-rich foods.
If you are a vegan or vegetarian and are concerned about other nutrients you may be missing out on, be sure to check out these articles:
Signs of iron deficiency
If you’re not sure if you’re getting enough iron, watch out for these signs and symptoms.
Chewing ice
Doctors aren’t sure why this happens, but people with iron deficiency experience something called PICA – the urge to eat things with non-nutritive properties, such as ice, clay, dirt or paper. If you notice a strong urge to chew ice, be sure to report this symptom to your doctor.
Extreme exhaustion
Iron carries oxygen throughout the body. When people are deficient in iron, they don’t get enough oxygen throughout their bodies and often feel very tired. This is a very difficult symptom to recognize because most people feel tired every day.
But if you are iron deficient, the exhaustion is extreme and can affect your daily life. For example, you may be too tired to go out to dinner with friends or feel completely exhausted after a full night’s sleep.
Feeling cold
If you notice that you’re constantly cold, chances are you don’t have enough iron in your diet. Since iron carries oxygen throughout the body to the extremities, it also helps keep the body warm. Without enough iron, you may have poor circulation, which can make you feel cold.
Brittle nails
People with iron deficiency may have abnormally shaped nails. The nail becomes thin and brittle and has raised ridges and curves inwards.
Pale skin
Iron deficiency means a lack of healthy red blood cells, so people with iron deficiency can be very pale. That said, pale skin isn’t always related to iron deficiency. If your skin color changes over time and you experience other symptoms on this list, talk to your doctor.
Dizziness and headaches
Lack of oxygen circulating in the body can cause problems in your brain. If not enough oxygen reaches the brain, you may experience dizziness and/or headaches.
Restless legs syndrome
While sitting or lying down, you may suddenly feel an unexplained pain in your legs or an overwhelming urge to get up and move your legs. It’s not all in your head and it could be restless leg syndrome.
Lack of iron in the brain can cause this symptom and it is very persistent. Restless legs syndrome often occurs at night or may even wake you up from sleep.
What causes iron deficiency?
If you are experiencing any of these symptoms, you may wonder why this is happening. These are usually the main culprits for iron deficiency:
- You don’t eat enough iron. Quite simply, vegetarians and vegans are at greater risk of iron deficiency because iron in plants is not absorbed like iron in meat.
- It does not absorb iron properly. People with gastrointestinal disorders may have problems absorbing nutrients. If you have an undiagnosed case of celiac disease or Crohn’s disease, this could cause iron deficiency.
- Heavy bleeding, from heavy menstrual cycles or internal bleeding. Blood loss equals iron loss. It’s that simple.
What to do about iron deficiency
If you think you have an iron deficiency, the first thing you should do is talk to your doctor. They can do a simple blood test to check your iron levels. If your doctor detects an iron deficiency, he may tell you to take an iron supplement.
Fortunately, people who are iron deficient absorb 20-30% of dietary iron compared to 5-10% absorbed by those who are not iron deficient. If there are no problems in your digestive system, you will easily absorb the supplements and the problem will be corrected.
But you should NOT take an iron supplement if you don’t need it. Excess iron in the blood can be toxic.
It also never hurts to eat more iron-rich foods. And, combining iron-rich foods with vitamin C foods can enhance iron absorption. Tea and coffee or foods with tannins reduce iron absorption.
