Iron Deficiency Info for Dancers
Iron deficiency is fairly common, and dancers are arguably at a greater risk for it because of the sometimes restrictive eating behaviors that dancers engage in to achieve or maintain aesthetic physique goals (source).
Unfortunately, there is a lot of confusion and misinformation out there about iron deficiency and iron deficiency anemia. And of course, there is more to the story than simply taking iron pills indefinitely if you have low iron on blood work. Nutrition plays a BIG role in iron status for dancers!
First and foremost, what even is iron and why is it important for our health?
Iron is a mineral that we use for many things in the body, but most importantly oxygen transfer and metabolism.
Iron is used to transfer oxygen from the lungs to other tissue throughout the body via hemoglobin (a protein in red blood cells). Iron helps make hemoglobin, and hemoglobin transports oxygen. Iron is also used to make myoglobin, which carries oxygen from the lungs to muscles.
Additionally, we need iron to fuel the metabolic pathway that takes nutrients from food and converts it into energy.
These two things are why a common sign of low iron or iron deficiency anemia is muscle fatigue and low energy.
Some key terms:
Iron deficiency = a broader term used to describe low iron stores that do not meet the body’s iron requirements, whether or not anemia is present
Anemia = when there are not enough red blood cells to adequately deliver oxygen to the cells of the body
Iron deficiency anemia = occurs when there is not enough iron to produce enough hemoglobin and healthy red blood cells to carry oxygen throughout the body
*There are other types of anemias, but iron deficiency anemia is the most common
Addressing iron deficiency or iron deficiency anemia is not as straightforward and simplistic as “your iron is low on blood work, therefore you just need to eat more iron and/or take iron supplements.”
It just doesn’t work like that. There are other nutrients involved in iron absorption, recycling, storage, and regulation. The way the iron recycling system works, and how the body absorbs and stores iron, is honestly VERY complex and way beyond the scope of this blog post (we’ll be here all day if I try to explain). I highly recommend listening to this podcast episode if you want the nitty gritty nerd science.
However, I want to highlight a few key points:
Dietary iron comes from heme iron (animal sources, like red meat) and non-heme iron (plant sources). Heme iron is more readily absorbed and utilized by the body than non-heme iron, it’s more “bioavailable.”
Only a small fraction of our iron requirements come from dietary iron that we absorb from food. Most of our iron comes from an innate iron recycling system that produces bioavailable heme iron every day.
Most of our iron is “stored” in the body because it’s toxic to the body in its free state; iron is stored mostly in the liver and skeletal muscle, and is then transported to tissue throughout the body for use.
It’s not always a matter of straight up deficiency (not having enough iron), but rather can be that the body isn’t able to access that iron properly.
Other nutrients that impact our iron status: Copper and Vitamin A
Bioavailable (usable) copper is absolutely essential for iron. Recall that iron is always circulating throughout the body via the iron recycling system. A protein called ceruloplasmin helps control that system, and ceruloplasmin is made from copper and vitamin A.
Copper is required to convert iron from its unusable form (ferric form) to its usable form (ferrous form). Copper is also needed to make ATP (energy), and it transports oxygen. A copper-deficient state can actually mimic signs and symptoms of iron deficiency.
Additionally, in order to make bioavailable copper we need retinol, which is the active form of vitamin A (not the same thing as beta carotene, which the body has to convert to retinol).
There is research that shows vitamin A deficiency is associated with iron deficiency anemia, and that increasing vitamin A status can improve iron status and reduce risk of anemia.
Nutrition for iron deficiency:
Yes, you need to include iron in your diet, ideally from heme sources like red meat, poultry, and seafood. Plant sources of non-heme iron include spirulina, cooked spinach, and cooked lentils and chickpeas.
BUT, it is also essential to regularly incorporate copper and vitamin A rich foods into your diet. When we’re assessing iron status, we have to also think about copper and vitamin A.
Copper rich foods include beef liver, oysters, mushrooms, cashews, potatoes, and dark chocolate.
Vitamin A (the retinol form) foods include beef liver, cod liver oil, fatty fish, full fat dairy (butter, cheese, whole milk), and egg yolks.
I personally love beef liver pills, as they contain copper and a good amount of the retinol form vitamin A (as well as other minerals and B vitamins). You can find them on my Amazon store.
Pro tip: consuming vitamin C rich foods (like citrus and bell peppers) alongside iron rich foods, especially non-heme iron plant sources, can help your body absorb and utilize that iron better.
A note on iron supplementation:
Be very careful with iron supplementation, as too much iron is harmful to the body, and over time excess iron can accumulate in internal organs. I do not recommend blinding supplementing with iron unless you have had lab work done and had your iron status assessed by a doctor. Work closely with your doctor if you’re going to supplement with iron.
Labs to ask your doctor for if you suspect iron deficiency anemia:
Total iron (sometimes called serum iron) = total circulating iron in the blood
Ferritin = a protein that stores iron in the liver; considered most reliable marker to assess the body’s iron stores
Total iron binding capacity (TIBC) = how much iron can be bound to transferrin; can be used as an indirect measure of transferrin
Transferrin = protein that transports iron throughout the body
% saturation = the percentage of serum iron bound to transferrin
Complete blood count (which includes hemoglobin, the oxygen-carrying protein in red blood cells)
I hope this was helpful and insightful, and that you learned something new!
If you’re struggling with iron deficiency, or just fatigue in general, I can help! Schedule your FREE consultation call today!
