Iron deficiency is the most prevalent nutritional deficiency, affecting more than 30% of the world’s population. It is also a common cause of fatigue, brain fog, hair loss and insomnia – which is why it’s so important to run frequent lab tests if you experience these symptoms. I’ve been tracking for almost 5 years now and have alarmingly found that over 85% of my female patients have iron levels that are sub-optimal. While your doctor may have told you that your iron levels are “just fine” I highly highly recommend that you get your hands on that ferritin number to see for yourself. Iron deficiency can feel absolutely miserable, and while your doctor may consider a ferritin of 6 to be “fine”, the research overwhelmingly disagrees with their assessment.
In order to determine iron levels your doctor will likely be ordering a ferritin blood test. This test shows us your level of an iron storage protein, which is your most important marker of overall iron status. Unfortunately, the current reference range for ferritin is wildly inappropriate. If you fall anywhere in the reference range of 5 – 275 units you’re considered ‘okay’. I’ve seen hundreds of patients with a ferritin of 5 – 10 that we’re told by their medical doctors that their iron levels were just fine; an assessment that blatantly ignores the evidence which tells us that a ferritin of >70 is ideal for hair growth, while levels <100 are associated with fatigue in women. This under-diagnosis of iron deficiency is a problem due to the simple fact that ferritin stores iron, and iron carries oxygen. This oxygenation of tissues is necessary in order for you to have adequate circulation and optimal cellular function. It’s also critical to your overall energy levels. Considering how important iron is for your circulatory system you can see why these women with low ferritin levels are all exhausted, half bald and freezing cold all the time.
If you’re experiencing these symptoms them it’s time for a ferritin test and iron supplementation. Conventional methods for treating iron deficiency anemia involve supplementation with a form of elemental iron known as ferrous sulfate. This form of iron commonly causes gastro-intestinal upset, meaning it’s difficult for your body to break down and absorb. The different forms of iron in supplements prescribed by your doctor also contain varying amounts of elemental iron. Heme iron, which is rarely prescribed, has higher bioavailability than non-heme iron sources like ferrous sulfate. Even among the iron salts the most commonly prescribed iron source is still not at the top when it comes to bioavailability: ferrous fumarate is 33% elemental iron by weight, whereas ferrous sulfate is only 20% elemental iron. Despite this evidence, ferrous sulfate remains the most commonly prescribed iron supplement by general practitioners.
While it’s no surprise that these diagnostic and prescribing methods have only resulted in a marginal reduction in the global prevalence of iron deficiency, we also have another nutritional deficiency to consider when treating anemia. New studies looking at zinc levels in anemic patients found that this nutrient plays a very important role in iron absorption. Both iron and zinc have similar ionic properties – meaning that they influence the transport and absorption of one another in red blood cells. For a long time scientists believed that zinc and iron competed at for binding at this site but current research proves this assumption to be false and that we actually need zinc to effectively absorb iron.
Given all these complexities in nutritional science it’s no wonder that patients are confused as to why their prescribed iron supplements aren’t improving their symptoms. When it comes to treating iron deficiency I’ve seen the best clinical outcomes when giving bioavailable iron supplements (given every other day) in combination with foods that provide zinc along with the other necessary co-factors for iron absorption. Once iron levels come back to ideal range most women find that they’re just fine using food therapies like this iron-boosting super salad to maintain great iron stores.
My go-to lunch for days when I’m feeling a little anemic is this salad which contains all of the best iron-supportive foods. It’s got spinach and organic steak as a source of iron and pumpkin seeds to increase zinc levels. This salad is also topped with a slightly sweet molasses & citrus dressing which provides vitamin C and additional iron. It’s basically everything you anemic ladies need in one delicious lunch.
This salad is my go-to lunch for days when I'm feeling a little anemic. Featuring spinach, organic steak, molasses and pumpkin seeds it has everything you need to raise iron levels in 1 delicious and satisfying serving.
For The Salad:
- 1-2 lb organic flank steak
- 2 cups spinach
- 2 tbs pumpkin seeds
- 1 handful of chopped cherry tomatoes
- 1 - 2 tbs Orange Molasses dressing (see below)
For The Dressing / Steak Marinade:
- Juice from 1 large orange
- 1/4 cup virgin olive oil
- 2 cloves of garlic, finely chopped
- 2 tbs molasses
- 2 tbs apple cider vinegar
- salt & pepper to taste
Cook Your Flank Steak:
Create the dressing / marinade by combining all of the listed ingredients and mixing well. Lightly salt and pepper your flank steak then cover with most of the marinade (reserving 2 tbs for salad dressing) and let sit for a minimum of 4 hours. Prepare BBQ to medium-high heat. Remove meat from marinade and discard marinade. Grill steak your flank steak to desired doneness (about 4 minutes per side for medium-rare). Remove from heat, let cool, then slice thinly. This amount of steak can serve as your meal prep for an entire week of lunches.
Assemble The Salad:
Lay your washed spinach into a large bowl and top with chopped tomatoes and pumpkin seeds. Toss with the remaining dressing / marinade and top with thinly sliced flank steak.
- Manoguerra AS, Erdman AR, Booze LL, Christianson G, Wax PM, Scharman EJ, et al. Iron ingestion: an evidence-based consensus guideline for out-of-hospital management. Clin Toxicol (Phila) 2005;43:553-70.
- Murray-Kolbe LE, Beard J. Iron. In: Coates PM, Betz JM, Blackman MR, et al., eds. Encyclopedia of Dietary Supplements. 2nd ed. London and New York: Informa Healthcare; 2010:432-8.
- Hurrell R, Egli I. Iron bioavailability and dietary reference values. Am J Clin Nutr 2010;91:1461S-7S.