Iron: preventing deficiencies in women, athletes and vegetarians

Iron is a vital trace element for the oxygenation of the body. It is involved in the formation of hemoglobin, red blood cells, and the transport of oxygen to cells. A deficiency can cause iron deficiency anemia, associated with fatigue, shortness of breath, pallor, and decreased physical performance [1].

Populations at risk of iron deficiency

According to ANSES, several groups are particularly exposed to iron deficiency:

• Women of childbearing age, due to menstrual losses
• Pregnant or breastfeeding women, whose needs are increased
• Athletes, especially in endurance sports
• Vegetarians and vegans, because non-heme iron from plants is less well absorbed [2][3]

Symptoms and warning signs

The most common clinical signs of a deficiency are:

• Persistent fatigue
• Pallor, brittle nails
• Shortness of breath on exertion
• Frequent dizziness or headaches

A blood test with ferritin level measurement is recommended before any supplementation, on medical advice [4].

Supplementation: forms and uses

The forms often better tolerated digestively are:

• Iron bisglycinate (chelated): good digestive tolerance reported
• Iron fumarate or gluconate: classic forms, sometimes less well tolerated
• Combination with vitamin C to promote the absorption of non-heme iron [5]

Reference intakes are around 14 to 20 mg/day depending on the profile. In case of confirmed deficiency by a blood test, a higher dosage may be prescribed, exclusively under medical supervision [6].

Products available on Pharma+ France

• Iron 18 mg (Ferrochel), Vegetable Capsules – Non-Constipating Iron Bisglycinate (NOW Foods)
• Iron Complex, Capsules – Ferrochel Iron with Cofactors (NOW Foods)
• Iron Complex, Tablets – Ferrochel Iron with Cofactors (NOW Foods)

Official and scientific references

1. ANSES – Opinion on iron nutritional intakes, 2021.
2. Pawlak R, Berger J, Hines I. Iron Status of Vegetarian Adults: A Review of Literature. Am J Lifestyle Med. 2018. (PubMed) — replaces a removed VIDAL reference (not appropriate for a dietary supplement)
3. EFSA – Scientific Opinion on Dietary Reference Values for iron. EFSA Journal. 2015.
4. Haute Autorité de Santé – Management of iron deficiency anemia, recommendation 2019.
5. Hallberg L, Hulthén L. Prediction of dietary iron absorption: an algorithm for calculating absorption and bioavailability of dietary iron. Am J Clin Nutr. 2000;71(5):1147-1160. (PubMed)
6. Haute Autorité de Santé – Management of iron deficiency anemia, recommendation 2019 (therapeutic dosage) — replaces a removed EMA reference (not appropriate for a dietary supplement, EMA regulating medicines).