Fatigue may be a sign of anemia. Treat it with iron-rich foods.

Fatigue may be a sign of anemia.  Treat it with iron-rich foods.

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Some people believe that feeling tired is a normal part of aging. But they may not have taken into account a related — and treatable — cause of this fatigue: iron deficiency anemia.

One in 6 adults over the age of 65 have anemia, a condition caused by not having enough healthy red blood cells to carry enough oxygen throughout the body. Most often, this is due to a lack of iron needed to form these cells, leading to iron deficiency anemia.

There are several reasons why this happens.

Digestive problems can prevent your body from getting iron from the foods you eat. “As you get older, cells in your stomach lining can die, so you don’t absorb iron properly,” says Michael Auerbach, MD, a clinical professor of medicine at Georgetown University in D.C.

Some medications, such as acid reflux medications, may interfere with iron metabolism. Taking a low-dose aspirin daily increases the risk of anemia by 20 percent in older adults, according to a 2023 study published in the journal Annals of Internal Medicine. Aspirin can cause gastrointestinal bleeding and reduce iron levels through blood loss.

An underlying health problem can also cause iron deficiency, says Carolyn Cromwell, MD, assistant professor of medicine at the Icahn School of Medicine at Mount Sinai in New York. Some conditions common in older adults — such as ulcers, colon polyps and cancer — can cause internal bleeding, she says.

If you suspect you have iron deficiency or have any signs of anemia, such as fatigue, dizziness, shortness of breath, and cold hands or feet, see your health care provider before taking any action.

Men and women over 50 need 8 milligrams of iron daily. “Most American adults get enough iron through diet,” says Vijaya Surampudi, MD, assistant professor of medicine at the USC Center for Human Nutrition.

She says vegetarians and vegans may need to get up to 15 mg. This is because the body absorbs only 1 to 10 percent of the iron found in plants and iron-fortified foods, called non-heme, compared to 25 to 30 percent of the heme iron found in meat, fish and poultry.

To help absorb iron from plant foods, eat foods that contain vitamin C (such as citrus fruits, tomatoes, bell peppers, and broccoli) at the same meal. Research suggests this can help you get up to seven times more iron from plant sources.

Consider what you drink, too. Coffee and tea reduce iron absorption. Antioxidants in these drinks called polyphenols can bind to iron, preventing it from entering the bloodstream, Surampudi says. Stop drinking these drinks an hour or more before your meal.

Iron is found in both animal and plant foods. Here are some of the most important sources of iron.

  • Fortified breakfast cerealsOne serving: 18 mg.
  • OystersCooked, 3 ounces: 8 mg.
  • White beans– Canned 1 cup: 8 mg.
  • lentilCooked, 1 cup: 6 mg.
  • Tofu-Steady 1 cup: 6 mg.
  • meatTop round, cooked, 4 ounces: 4 mg.
  • potatobaked, 1 medium with skin: 2 mg.
  • pumpkin seeds1 ounce: 2 mg.
  • Stewed tomatoesCanned ½ cup: 2 mg.
  • breadWhite or whole wheat, 1 slice: 1 mg.
  • A chickRoasted, 4 ounces: 1 mg.

Should you take iron supplements?

In light of this information, you may be tempted to take iron pills as insurance. Don’t do it without talking to your doctor, Cromwell says. There are other types of anemia, and supplements can mask the symptoms of iron deficiency anemia. This can delay the diagnosis of any medical problem causing iron deficiency.

What’s more, your body retains iron, so you can get plenty of it. A 2001 study in the American Journal of Clinical Nutrition found that 13% of white Americans ages 67 to 96 had very high iron levels, partly due to taking supplements. An excess of the mineral can lead to digestive problems, such as cramps and nausea, Cromwell says.

In the long term, iron can accumulate and damage the organs in which it is stored, such as the liver or heart. Research has also linked excess iron to an increased risk of type 2 diabetes, some heart diseases, and cancer.

Copyright 2023, Consumer Reports Inc.

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