low iron... would you treat?

[crunchy_mommy]

My 1yo tested very very low for iron (ferritin) but his heme count was great -- so he's not anemic. He also tested low in creatinine.

He has no symptoms of anemia either but the doc was concerned about 6-12 mos down the line... He wanted us to do an iron supplement but I'm not comfortable with supplementing & also not overly concerned, but maybe I *should* be??? We are vegan and he gets tons of iron & vitamin C when he eats but he is still on about 75% breastmilk (which is an improvement from 95% just a few weeks ago!!) I am thinking of buying a cast-iron pot to use occasionally though I have a feeling I'd rarely use it...

From all my research on creatinine it didn't seem like there are any concerns with low levels (in the absence of muscle weakness etc.)... and the same with iron, it didn't seem that low levels were connected to any issues (in the absence of anemia) and actually had some benefits, BUT his level was super low (4, doc would have liked it to be closer to 35 or so).

So I guess I'm just wondering how others would approach this situation... Retesting to confirm is not an option (the first blood draw was really traumatic for him & us so unless there are severe reasons I am not about to put him through that again!) Would you be concerned? Would you supplement? Get him eating more solids & less breastmilk? Cast-iron pots? Something else? Do nothing?

[Marnica]

DS tested low iron when he was 9 mo old. I tried initially to increase his iron naturally, we use cast iron alot anyway, but he still tested low at his 1 yr appt. I chose to supplement. He takes Floravital. If I was in your shoes I may try and do it without supplementaion first and then see how that works. That would mean you would have to retest a few months down the line however.

[tanyalynn]

I'm willing to supplement other minerals, so yeah, I'd supplement iron. I supplemented myself when my ferritin was low but my iron fine, for me it was to see if it was responsible for my fatigue, but for a rapidly growing child, I'd do it. I'd look into the best form, and not necessarily just use whatever was recommended though.

I don't know anything at all about creatinine.

[AllyRae]

Your heme count can be great and you can still be anemic...there are several types of anemia. You'd have to know what his hemocrit, hemoglobin, mcv, mch, mchc, rdw, ferritin, and transfer levels are to make a really good diagnosis about what type of anemia it is.

My hemoglobin level is 12.8...my ferritin level is 6. That's quite a discrepency! If you look closer at my bloodwork, you'll see that my rdw is high and my mch is low...there is still anemia there. All of these things measure something different--rdw measures the variability in your red blood cell size...anemic ones tend to have more variability. I have to supplement because of my very very low ferritin levels and my high variability levels. I would supplement for any vitamin/mineral deficiency.

At 12 months old, you really won't know all of the symptoms since your child can't tell you if he's feeling weak or dizzy or his heart is skipping beats or whatnot.... I'd treat it with a good iron supplement and see if it goes up any.

[Llyra]

What I'd do is buy a cast iron dutch oven. Then make tomato sauce in it once a week, being careful not to let the sauce come to a boil-- simmer the sauce for an hour or two. The tomatoes will leach lots of iron out of the pan, and the vitamin C in the sauce will increase baby's absorption of it. Then I'd find ways to serve the sauce that she will willingly eat, and offer it to her every day in some form.

We eat nearly everything cooked in cast iron, and have never had iron issues since we started doing that.

I started using cast iron because I was horribly anemic after the twins were born, because I have a serious chronic disease that causes bleeding, and that plus the twins' birth depleted my stores almost entirely. I can't tolerate the supplements-- they aggravate my condition. So I had to rebuild my stores entirely with good food.

You can also make fruit sauces in the cast iron-- like applesauce, or raspberry-apple. Just peel the apples and simmer the fruit in a bit of water on low heat until it's nice and soft and yummy. High heat is not good for fruits, so keep the heat below a boil the whole time.

Cooking acid foods in your cast iron will mean reseasoning the pot from time to time. Just smear it with oil-- palm oil works well if you don't use animal fats, don't use something like olive oil with a low smoke point-- and put it in the oven at a medium heat for a few hours.

Then I'd retest in a few months, and at that point I'd consider supplementing if you're not seeing any improvement. I have no argument with supplements but from what I hear they're not absorbed all that well by the body. Neither are plant-based sources like the infamous spinach.

[crunchy_mommy]

Thanks everyone for your input, it's good to get various perspectives!! I will at least get a cast-iron pot (Llyra, the tomato sauce would be perfect, and pasta is one food he'll actually eat!) and keep the supplements an option... He is definitely not anemic (he did have all those other blood tests done etc.) and the only other issue would be his lead test which we're still waiting on the results of. Floravital is actually the supplement his doc recommended so if we decide to go that route it does seem like a good option. He really does eat almost exclusively iron-rich foods so I almost wonder if there is an absorption issue or something (although as I said above, he still relies more on breastmilk than solids for most of his calories). OK thanks again & if anyone has anymore input I'd love to hear it... I'm still researching...

[sbgrace]

There is not a great source of vegetarian iron so I think he definitely needs a supplement. I'd want to fix it because low ferritin is going to go ahead to anemia eventually if he keeps taking in less than he uses and I believe (based on my son and research) that low ferritin has issues all on it's own.


I'd look at iron inhibitors in your food as well. Bright (red/purple) fruits inhibit iron absorption in a major way so prunes, raisins, purple juices, etc. Eggs are major iron inhibitors (yolk and white) so avoid egg if you don't already. Dairy of course too if you do dairy. Soy is a major inhibitor as are all beans, nuts, and seeds. Greens have issues as well (either in oxalate levels or calcium levels or both). Grains have issues but you can fix that with a C supplement or C rich foods (say citrus or green peppers) with meals if you're more comfortable with that.

Cast iron is a supplement of inorganic iron and not a well absorbed one at that but is ok and I'd do it if you're uncomfortable otherwise. I've made a lot of posts about ferrous bis-glycinate. It fixes iron very quickly without the side effects of unabsorbed iron in the body.