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I’m iron deficient. Which supplements will work best for me and how should I take them?

<a href="https://theconversation.com/profiles/alannah-mckay-1548258">Alannah McKay</a>, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a> Iron deficiency is common and can be debilitating. It mainly affects women. One in three premenopausal women <a href="https://static1.squarespace.com/static/57bfc0498419c24a01318ae2/t/607fc2e06ace2f22d5ca9a43/1618985699483/20210421+-+IDC+-+economic+impact+of+iron+deficiency+-+FINAL.pdf">are low in iron</a> compared to just 5% of Australian men. Iron deficiency particularly affects teenage girls, women who do a lot of exercise and those who are pregnant. The <a href="https://pubmed.ncbi.nlm.nih.gov/11160590/">body needs iron</a> to make new red blood cells, and to support energy production, the immune system and cognitive function. If you’re low, you may experience a range of symptoms including fatigue, weakness, shortness of breath, headache, irregular heartbeat and reduced concentration. If a blood test shows you’re iron deficient, your doctor may recommend you start taking an oral iron supplement. But should you take a tablet or a liquid? With food or not? And when is the best time of day? Here are some tips to help you work out how, when and what iron supplement to take. <h2>How do I pick the right iron supplement?</h2> The iron in your body is called “elemental iron”. Choosing the right oral supplement and dose will depend on how much elemental iron it has – your doctor will advise exactly how much you need. The sweet spot is between <a href="https://www.sciencedirect.com/science/article/pii/S0098299720300364?via%3Dihub">60-120 mg of elemental iron</a>. Any less and the supplement won’t be effective in topping up your iron levels. Any higher and you risk gastrointestinal symptoms such as diarrhoea, cramping and stomach pain. In Australia, iron salts are the most common oral supplements because they are cheap, effective and come in different delivery methods (tablets, capsules, liquid formulas). <a href="https://www.ncbi.nlm.nih.gov/books/NBK557376/">The iron salts</a> you are most likely to find in your local chemist are ferrous sulfate (~20% elemental iron), ferrous gluconate (~12%) and ferrous fumarate (~33%). These formulations <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3867244/">all work similarly</a>, so your choice should come down to dose and cost. Many multivitamins may look like an iron supplement, but it’s important to note they usually have too little iron – usually less than 20 mg – to correct an iron deficiency. <h2>Should I take tablets or liquid formulas?</h2> Iron contained within a tablet is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3867244/">just as well absorbed</a> as iron found in a liquid supplement. Choosing the right one usually comes down to personal preference. The main difference is that liquid formulas tend to contain less iron than tablets. That means you might need to take more of the product to get the right dose, so using a liquid supplement could work out to be more expensive in the long term. <h2>What should I eat with my iron supplement?</h2> Research <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajh.26987">has shown</a> you will absorb more of the iron in your supplement if you take it on an empty stomach. But this can cause more gastrointestinal issues, so might not be practical for everyone. If you do take your supplement with meals, it’s important to think about what types of food will boost – rather than limit – iron absorption. For example, taking the supplement alongside vitamin C improves your body’s ability to absorb it. Some supplements already contain vitamin C. Otherwise you could take the supplement along with a glass of orange juice, or other <a href="https://ods.od.nih.gov/factsheets/VitaminC-HealthProfessional/">vitamin C-rich foods</a>. On the other hand, tea, coffee and calcium all <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajh.26987">decrease the body’s ability to absorb iron</a>. So you should try to limit these close to the time you take your supplement. <h2>Should I take my supplement in the morning or evening?</h2> The best time of day to take your supplement is in the morning. The body can <a href="https://journals.lww.com/acsm-msse/fulltext/2019/10000/the_impact_of_morning_versus_afternoon_exercise_on.20.aspx">absorb significantly more</a> iron earlier in the day, when concentrations of hepcidin (the main hormone that regulates iron) are at their lowest. Exercise also affects the hormone that regulates iron. That means taking your iron supplement after exercising can <a href="https://journals.humankinetics.com/view/journals/ijsnem/32/5/article-p359.xml">limit your ability to absorb it</a>. Taking your supplement in the hours following exercise will mean significantly poorer absorption, especially if you take it between two and five hours after you stop. <a href="https://journals.lww.com/acsm-msse/fulltext/2024/01000/iron_absorption_in_highly_trained_male_runners_.14.aspx">Our research</a> has shown if you exercise every day, the best time to take your supplement is in the morning before training, or immediately after (within 30 minutes). <h2>My supplements are upsetting my stomach. What should I do?</h2> If you experience gastrointestinal side effects such as diarrhoea or cramps when you take iron supplements, you may want to consider taking your supplement every second day, rather than daily. Taking a supplement every day is still the fastest way to restore your iron levels. But a recent study <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00463-7/fulltext#%20">has shown</a> taking the same total dose can be just as effective when it’s taken on alternate days. For example, taking a supplement every day for three months works as well as every second day for six months. This results in fewer side effects. Oral iron supplements can be a cheap and easy way to correct an iron deficiency. But ensuring you are taking the right product, under the right conditions, is crucial for their success. It’s also important to check your iron levels prior to commencing iron supplementation and do so only under medical advice. In large amounts, <a href="https://www.ncbi.nlm.nih.gov/books/NBK430862/">iron can be toxic</a>, so you don’t want to be consuming additional iron if your body doesn’t need it. If you think you may be low on iron, talk to your GP to find out your best options.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/235315/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/alannah-mckay-1548258">Alannah McKay</a>, Postdoctoral Research Fellow, Sports Nutrition, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/im-iron-deficient-which-supplements-will-work-best-for-me-and-how-should-i-take-them-235315">original article</a>.

Body

5 vitamin deficiencies your body is trying to tell you

It’s so common to have marks, bumps or blemishes on our body and just ignore them until they go away. But what if they don’t? What if your eyes, skin or hair is trying to tell you that you are lacking in a specific vitamin or mineral, which could be affecting your health and wellbeing? Speak to your doctor if you have any of these symptoms, and they can help you diagnose and treat any deficiencies. 1. Calcium deficiency Do you have weak or brittle nails, numbness in your extremities, or regular muscle cramps? Calcium deficiency could be a problem for you. It’s not just in dairy (though that is a great source) but also in seaweed, leafy greens, legumes and nuts. You can also find calcium-fortified products such as specific cereals, orange juice and soy milk. 2. Vitamin C deficiency Do you bruise more easily than you used to? Do you have cuts and wounds that seem to take a long time to heal? This could be a sign that you are low in vitamin C. And it’s not just from a lack of oranges. The best places to find this vitamin include strawberries, kiwi, broccoli and red capsicums. 3. Iron deficiency If you look unusually pale, have cold hands and feet, or a swollen tongue, you could be lacking in iron. As well as iron supplements, you can bulk up your iron intake with iron-rich foods such as red meat, fish and legumes. 4. Omega 3 deficiency Do you have bumps on the skin on your upper arms, dandruff, dry hair or dry eyes? You could be low in omega 3. Generally found in fish, seeds and nuts, leafy greens and eggs – it can also be ingested as a supplement from the chemist. 5. B12 deficiency B12 is readily available in meat, so this is a common deficiency in vegetarians and vegans. B12 is also less able to be absorbed from food as we get older. Signs of deficiency include skin irritation and dermatitis, lethargy and unusual weakness, pins and needles, and a smooth red tongue is also common (the little bumps disappear). You can get B12 in tablets or as an injection, but ideally you can get it from your food. Go for meat, leafy greens, mushrooms and nuts. Do you have any of these symptoms? Will this article encourage you to speak to your doctor to get checked out?

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Vitamin C deficiency linked to cognitive impairment

A new study has found a link between poor brain function and how much Vitamin C older people have, and that a deficiency could have some serious effects on the brain. Cognitive impairment is common among older, hospitalised patients, and can result in poor memory and concentration, as well as finding decision-making difficult. The team from Flinders University in Adelaide tested the cognitive function and vitamin C level of 160 people over the age of 75 who were admitted to the university’s medical centre. From this, 91 patients were found to have cognitive impairment, and 42 of this group were found to have such low levels of vitamin C - below 11 micromoles per litre - they were at risk of developing scurvy. “Our findings showed that cognitive function scores were significantly lower among patients who were vitamin C deficient, with further analysis suggesting vitamin C deficiency was almost three times more likely to be associated with cognitive impairment after adjustment for other factors,” Associate Professor Yogesh Sharma, the study’s lead author, <a href="https://www.scimex.org/newsfeed/low-vitamin-c-linked-to-cognitive-impairment-in-older-australians" target="_blank" rel="noopener">said</a>. The researchers stressed that the two were associated, not that vitamin C deficiency causes cognitive impairment. They also noted that many of the symptoms of low vitamin C levels - including skin issues, bruising and bleeding - are common in this age group because of a number of conditions. “It may, therefore, be difficult to diagnose vitamin C deficiency solely on looking for these particular symptoms in older hospitalised patients,” Associate Professor Sharma said. “Given we know vitamin C deficiency is common among older hospitalised patients, medical professionals need to remain vigilant for this condition and confirm a patient’s vitamin C status in suspected cases.” With this link, the researchers said they will need to conduct more studies to confirm the link and determine whether replacing a patient’s vitamin C levels could help prevent or reverse cognitive impairment. The study was published in the journal <a href="https://doi.org/10.3390/antiox11030463" target="_blank" rel="noopener">Antibiotics</a>. Image: Getty Images

Body

Five weird signs you’re iron-deficient

Though iron is one of the most important nutrients that is needed for many functions of the body, many of us don’t get enough of it. “Iron deficiency is the most common micronutrient deficiency worldwide,” said Dr Kelly Prichett, assistant professor of sports nutrition at Central Washington University. The World Health Organisation estimates that nearly half of the world’s 1.62 billion cases of anaemia - where an individual is lacking healthy red blood cells - can be traced back to an iron deficiency. When your body is low in iron, common signs include feeling tired, faint, or becoming breathless more easily. However, there are some more unusual signs that could indicate a dip in your iron levels, including these five. 1. Odd cravings for inedible items While the reasons why are still unknown, people with severe iron deficiencies often crave non-food items including dirt, clay, paint chips, cardboard, and cleaning supplies, according to the <a rel="noopener" href="https://www.nhlbi.nih.gov/health-topics/iron-deficiency-anemia" target="_blank">National Heart, Lung, and Blood Institute</a>. The condition, called pica, can be difficult to identify as many are ashamed to admit they have these unusual addictions. Pica typically occurs in young children or during pregnancy, but <a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2850349/" target="_blank">case studies</a> have shown that older people can experience pica too. 2. Brittle or spoon-shaped nails Fingernails can be a surprisingly good indicator about your health, including when you’re experiencing iron problems. Along with weak and brittle nails, spoon nails can be a sign of iron deficiency. Also called koilonychia, spoon nails occur when the inside of your nail sinks in, leaving your fingernail shaped like a spoon. Since spoon nails can also be caused by exposure to petroleum-based solvents, trauma (such as a jammed finger), and other issues, doctors may need to perform a blood test for iron deficiency anaemia when there aren’t any other obvious causes. 3. Dry and cracked lips While many of us are familiar with chapped lips caused by harsh cold, a dry room, or licking your lips, people with low iron levels may be prone to a more specific kind of cracking that affects the corners of the mouth, called angular cheilitis. These cracks can make it difficult to eat, smile, or even shout. In a study of 82 people with the condition, 32 percent were found to have an iron deficiency. In those cases, creams or ointments won’t do the trick and the underlying iron deficiency must be addressed to stop the cracking from coming back. 4. An oddly swollen tongue Atrophic glossitis, also known as a swollen and tender tongue, is another less-than-obvious symptom of an iron deficiency. In a <a rel="noopener" href="https://www.jfma-online.com/article/S0929-6646(13)00406-3/pdf" target="_blank">2013 study</a> of people with iron deficiency anaemia, nearly 27 percent of the 75 participants were found to have atrophic glossitis, as well as dry mouth, a burning sensation, and other oral health issues. The swelling results in the tongue appearing smooth rather than bumpy, and can cause problems with chewing, swallowing, or talking. 5. A constant craving for ice Craving ice is a specific type of pica <a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/15804997/" target="_blank">called pagophagia</a>, and is one of the most common symptoms of a severe iron deficiency. While the reasons behind this craving are unclear, some experts hypothesise that chewing ice may increase alertness in iron-deficient people - who often feel sluggish and tired - or that it may soothe swollen tongues. What to do about it If you experience several of the above symptoms, booking an appointment with your doctor may be the best next step. If you are feeling more tired than usual, struggle to catch your breath while walking up stairs or exercising, feel dizzy or often feel weak, you may need to check your iron levels with your doctor. In the meantime, eating iron-rich foods such as red meat, poultry, eggs, fish, nuts, or dark leafy green vegetables can help you take in some more iron.

Body

Could you be vitamin C deficient?

Vitamin C is a water-soluble vitamin that your body needs for numerous daily functions. Most of us are aware of vitamin C’s star status at supporting our immune system, over and above any other vitamins or minerals. With winter ills and chills season upon us, a healthy immune system, courtesy of vitamin C, may help support recovery for ills and chills and support your immune defences. But that’s just the start of this vitamin’s powers – vitamin C supports repair and regeneration of tissues, heart health, iron absorption, healthy cholesterol balance and collagen building. It’s also an antioxidant that helps protect cells and DNA against free radicals and other harmful agents that can cause damage to cells. Do you need a supplement? Since your body doesn’t create it or store it, developing a vitamin C deficiency is easier than you might expect. Certain fruits and vegetables are high in vitamin C but if you’re not getting enough of these foods in your daily diet, a supplement is the way to go. Here are some more signs that you could be deficient in vitamin C: Susceptibility to ills and chills. Vitamin C is needed for the production of white blood cells that are a vital part of your immune response. As an antioxidant, vitamin C also helps protect the health of immune cells so that they can work efficiently to support your immune defences for ills and chills. <img style="width: 500px; height:324.67532467532465px;" src="https://oversixtydev.blob.core.windows.net/media/7842566/rdvitamincbody_770x500-1.jpg" alt="" data-udi="umb://media/6158511ab40b49079fb87f95f03b1bae" /> Fatigue, moodiness Vitamin C plays a key role in energy production and mood stabilisation, so a lack of vitamin C can throw both your energy and mood out of balance. Weight management When fatigue from low vitamin C sets in, it’s also a sign that vitamin C’s support of energy production is flagging, and your metabolism suffers. When your metabolism slows, you’re more likely to start adding kilos. Healthy Gums Your gums are made up partially of collagen, which is why they tend to be more sensitive when your vitamin C levels dip. They can bleed more, as well. Weak blood vessels in the nose Since vitamin C supports collagen in strengthening blood vessels, having a vitamin C deficiency can result in weakened blood vessels, causing them to burst more frequently. Dry, split hair Hair depends on collagen for strength and health: When you’re low on C your collagen production can pay the price, leading to weak and brittle hair that falls out easily. Slow wound healing and easy bruising Your body’s ability to heal is dependent, in part, on vitamin C, which not only supports the formation of collagen to strengthen the scar tissue that forms over wounds, but also supports the immune response that works to repair wounds. With a vitamin C deficiency, this process is less efficient, causing slower healing. If you bruise easily, it could be a sign that your blood vessel walls – which are made largely from collagen – are weak. Dry, red, or wrinkled skin Collagen keeps your skin supple and free from wrinkles, so it’s no surprise that a lack of vitamin C is associated with wrinkled skin – or that adequate amounts of vitamin C can keep your skin looking young. As an antioxidant, vitamin C reduces damage caused to the skin by UV light exposure, reducing your risk of sunburn. Stiff joints Since the cartilage in your joints is largely made of collagen, low vitamin C levels can result in less padding between bones, as well as stiff joints. Consuming enough vitamin C allows your body to produce the collagen it needs to have healthy, strong joints. A daily fix is essential As vitamin C gets excreted in urine, you need to consume it daily to get all the benefits, not just in times of need. Most people think of oranges as the vitamin C saviours – and they are a great source – but many other fruit and vegetables contain this nutrient such as blackcurrants, strawberries, kiwi, papaya, broccoli, capsicum, cauliflower and tomatoes. If you’re not getting enough of these foods in your daily diet, a supplement is the way to go. <img style="width: 500px; height:281.8181818181818px;" src="https://oversixtydev.blob.core.windows.net/media/7842565/liposachetvitaminc_packshot_770.jpg" alt="" data-udi="umb://media/d838ba33411d4a40a10e80e6e73afbbf" /> Why you should try VITAMIN C LIPO-SACHETS® <a rel="noopener" href="https://liposachet.co.nz/" target="_blank">Vitamin C Lipo-Sachets®</a> use patented technology to deliver a high dose of new generation liposomal vitamin C, proven to deliver 80% higher absorption than standard vitamin C1. Suitable for vegans and with no artificial flavours, colours, alcohol, added sugars2 or gluten, the single dose sachets make taking vitamin C daily easy and convenient. Make sure your immune system is fighting fit this winter and beyond, by taking control of your vitamin C intake. Reference: 1 Based on a clinical study comparing 10g Vitamin C Lipo-Sachets to 10g standard vitamin C. Maciej Lukawski (2019). 2. Contains naturally occurring sugars. Always read the label. Use only as directed. If symptoms persist consult your healthcare professional. Vitamins are supplementary to, and not a replacement for, a balanced diet. AFT Pharmaceuticals Ltd, Auckland. TAPS PP7732 This is a sponsored article produced in partnership with <a rel="noopener" href="https://liposachet.co.nz/" target="_blank">Vitamin C Lipo-Sachets.</a>

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7 signs you’re protein deficient

Whether you’re a vegetarian or an avid meat eater, protein is essential for your health. Composed of amino acids, protein is necessary for building and maintaining muscle mass, which is important whether you’re a gym junkie or a couch potato. If you’ve noticed any of the following signs, it may be time to pop more protein on your plate. <ol start="1"> <li>You’re craving food – if you find yourself desperate for a snack between breakfast, lunch and dinner, you may be eating too many carbs and sugars and not enough protein, which is essential for balancing blood sugar levels.</li> <li>You have pain in your muscles and joints – noticed you’re a bit weaker these days? Your muscles may be breaking down or joints releasing fluids to supplement the protein you’re not eating.</li> <li>You take ages to recover from injuries – protein is highly important to rebuild and mend damaged cells and tissue, so if you’re not eating enough, you may find your body takes longer to heal.</li> <li>You have weak hair, skin and nails – thinning hair, dry, cracked skin and weak, dented-looking nails are often the first signs of protein deficiency.</li> <li>You’re retaining lots of fluid – edema (fluid retention) can occur when you don’t eat enough protein, as it is responsible for preventing the accumulation of fluid in tissues, especially in the ankles and feet.</li> <li>You’re always sick – your immune cells are made from proteins, so if you’ve noticed you’re constantly sick, your immunity may have been compromised thanks to a lack of protein.</li> <li>Your mind is foggy – getting too many of your kilojoules from carbs can cause massive fluctuations in blood sugar, impeding your ability to focus. Protein helps restore the balance of blood sugar levels and removes that foggy feeling.</li> </ol> So, how much protein should you actually be eating? The recommended dietary requirement for men between 51 and 70 is 64 grams and 81 grams after the age of 70. For women, it’s 46 grams between the ages of 51 and 70 and 57 grams beyond 70. This means around 2 and a half to 3 serves of protein each day, which can come from lean meat, poultry and fish, dairy, seeds and nuts, beans and legumes, or soy products such as tofu. How do you incorporate enough protein into your diet? Tell us your tips in the comments below. Related links: <a href="/health/mind/2016/06/alzheimers-first-warning-sign/">The first warning sign of Alzheimer’s might surprise you</a> <a href="/news/news/2016/05/healthy-foods-that-are-bad-for-you/">8 “healthy” foods that are anything but</a> <a href="/news/news/2016/05/your-brain-when-you-quit-sugar/">What happens to your brain when you quit sugar</a>

Body

The long-term problems with a B12 deficiency

Vitamin B12 deficiency can cause a range of symptoms such as tiredness, weakness, constipation, loss of appetite, weight loss and megaloblastic anaemia. Nerve problems, such as numbness and tingling in the hands and feet, can also occur. Other symptoms of vitamin B12 deficiency can include problems with balance, depression, confusion, dementia, memory and soreness of the mouth or tongue. Vitamin B12 deficiency can damage the nervous system even in people who don't have anaemia, so it is important to treat a deficiency as soon as possible. From a biochemical perspective vitamin B12 plays a critical role in keeping the body's nerve and blood cells healthy and helps make DNA, the genetic material in all cells. It is absorbed in a completely different way from most nutrients, in what is essentially a two-step process. Firstly, hydrochloric acid in the stomach separates vitamin B12 from the protein to which vitamin B12 is attached in food. After this, vitamin B12 combines with a protein made by the stomach called instrinsic factor and is absorbed by the body. Pernicious anaemia is a condition where the body cannot make intrinsic factor, subsequently these people have trouble absorbing vitamin B12 from all foods and even dietary supplements. You can also see how making good levels of stomach acid is essential to vitamin B12 status, and this is becoming a problem for more and more people. Vitamin B12 is found naturally in all animal foods and is added to some vegetable-based processed foods. Plant foods do not contain vitamin B12 unless they are fortified. If you believe your vitamin B12 deficient seek the advice of your GP, as often a regular B12 injection is required. You can also help to stimulate stomach acid production with apple cider vinegar before eating to see if this assists vitamin B12 levels. Did you learn something from “Dr Libby” that you didn’t know before? Let us know in the comments below. Written by Libby Weaver. First appeared on <a href="http://Stuff.co.nz" target="_blank">Stuff.co.nz</a>. Related links: <a href="/health/body/2016/06/does-cold-weather-cause-the-flu/">Does cold weather actually cause the flu?</a> <a href="/health/body/2016/06/colorectal-surgeon-on-why-over60s-need-to-screen-for-bowel-cancer/">A colorectal surgeon on why over-60s need to screen for bowel cancer</a> <a href="/health/body/2016/06/simple-yoga-moves-to-improve-circulation/">Simple yoga moves to improve circulation</a>

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I’m iron deficient. Which supplements will work best for me and how should I take them?

5 vitamin deficiencies your body is trying to tell you

Vitamin C deficiency linked to cognitive impairment

Five weird signs you’re iron-deficient

Could you be vitamin C deficient?

7 signs you’re protein deficient

The long-term problems with a B12 deficiency