Are the New Iron Deficiency Guidelines Enough?

By Andrea Bartels CNP NNCP RNT Registered Nutritional Therapist 17 Sep 2024

Are the New Iron Deficiency Guidelines Enough?

Last week Ontario Health announced that effective September 9^th, the new iron deficiency guidelines for clinicians changed from a ferritin level of 15 ug/L to 30 ug/L. In comparison, the province of British Columbia uses 30ug/L as the lower range end for diagnosing iron deficiency, yet recommends a more respectable target value of more than 100 ug/L. Why is Ontario being so cautious, and at the expense of the health of its citizens? While a step in the right direction, is this modest improvement enough to change the quality of life for millions of Canadians suffering from iron-deficiency anemia? 

Could the new guidelines reflect over-concern for the potential for iron toxicity? Iron is actually one of the hardest minerals to absorb from the digestive tract, because its absorption is affected by a number of factors such as stomach acid levels and fibre intake. So unless you are one of the rare individuals who have a genetically inherited condition called hemochromatosis, iron toxicity cannot be achieved by following label dosing instructions. 

The new recommendations are based on a statistically normal level of ferritin -- an iron storage protein. In other words, they’re based on average ferritin—not optimal ferritin levels. But just because something is common doesn’t make it healthy. For example, even though it has become statistically ‘normal’ in our society to have a body mass index of 30 or more, most clinicians agree that obesity is not healthy. So if the ‘average’ female is deficient in iron, then this skews the recommended reference range to one that is unacceptably low, and fails to effectively treat a large percentage of the iron-deficient population. 

How many females in your life complain of fatigue, depression, anxiety, thinning hair, lack of endurance and productivity? Females of childbearing age are the highest risk group for iron deficiency, largely due to monthly blood loss through menstruation. In fact, the World Health Organization (WHO) declares iron deficiency to be the world’s top nutritional deficiency. Iron is essential to the health and maintenance of our red blood cells, which transport oxygen to the body’s tissues. It’s also important to the production of serotonin and dopamine - neurotransmitters that have a great influence on our mood and motivation levels.  But without adequate iron, we lack energy, stamina and zest. 

Why shouldn’t health care practitioners recommend aiming for mid-range results, instead of still barely creeping into range at a ferritin of 30?  In an era in which Canada finds itself in a health care crisis, iron deficiency anemia is a highly treatable condition with only one cure: iron. That’s right; no pharmaceutical drug can replenish iron levels. 

This recent update in guidelines by Ontario is not a Health Canada recommendation. But why wait years for the federal government to update its recommendations when millions of people could be helped with an inexpensive, safe, nutritional cure for fatigue and all of its repercussions? Waiting too long to treat iron deficiency is expensive for the health care system, with health complications. Plus, severely affected patients requiring iron infusions by IV are then exposed to an array of potential risks. 

Perhaps our governments don’t yet realize that well-tolerated, effective over-the-counter iron supplements exist.  When it comes to resolving iron deficiency, absorption is everything---but so is compliance. With low risk of side effects, Pure Lab’s Carbonyl Iron enjoys a high rate of compliance and better results than commonly prescribed iron supplements.  With an absorption rate better than other available iron compounds, Pure Lab’s Carbonyl Iron is absorbed 3 times better than heme (blood-sourced) iron.  That’s because carbonyl iron is a metallic iron prepared in a way that reduces its particle size and increases its surface area. 

With 22.5 mg per capsule, Pure Lab’s Carbonyl Iron you can absorb more elemental iron per dose so that you don’t need to take hundreds of milligrams per day to get results. This means the chance of side effects is greatly reduced. The result is a safer, better-absorbed and better-tolerated iron supplement capable of restoring the body’s iron levels more quickly and more comfortably than ferrous fumarate, ferrous sulfate and ferrous gluconate can. 

Don’t wait until you need an iron infusion. Rather than living by your testing lab’s new reference range, pay close attention to your well-being. Aiming for higher ferritin levels could make a huge difference to your energy, mood, productivity, and enjoyment of life. 

References

British Columbia. “Iron Deficiency – Diagnosis and Management”. April 17, 2019.  Accessed online Septembe 17, 2024.

Kumar A, Sharma E, Marley A, Samaan MA, Brookes MJ. Iron deficiency anaemia: pathophysiology, assessment, practical management. BMJ Open Gastroenterol. 2022 Jan;9(1):e000759.  

Mayo Clinic. “Hemochromatosis”. Accessed online September 17, 2024. 

National Institutes of Health, Office of Dietary Supplements. “Iron: Fact Sheet for Health Professionals”. Accessed online September 17, 2024. 

Piskin E, Cianciosi D, Gulec S, Tomas M, Capanoglu E. Iron Absorption: Factors, Limitations, and Improvement Methods. ACS Omega. 2022 Jun 10;7(24):20441-20456.  

Sunnybrook Hospital. “Intravenous iron therapy for patients with anemia”. Accessed online September 17, 2024. 

World Obesity. “Obesity Classification”. Accessed online September 17, 2024. 

Zafar, Amina. “How redefining ‘normal’ iron levels could help women’s health”. CBC News September 14, 2024.