Low iron stores in 2yo - Question about supplements

[kinkajoujou]

At my DD's 2yo well visit we did some iron testing and the doctor said she is not anemic but her iron stores are a little low. She suggested giving her a chewable vitamin supplement with iron in it (like the flintstones one).

Any good sources you may have for iron rich foods and optimal iron absorption will be more than welcome. Also, I'm not very keen on giving her a multivitamin, she is an exceptionally good eater, will eat anything, so I think her nutrition is overall balanced and varied so she doesn't need artificial supplements. I would much prefer giving her floradix just for the iron. Any thoughts on that?

[heatherdeg]

I would have her lead level checked.  Low iron and anemia can sometimes be a symptom of an elevated lead level.  It doesn't have to be from paint in your home.  The sources of lead exposure are varied and can even include dirt.

But iron-rich foods include beans, egg yolks, dark leafy greens and red meat.

[kinkajoujou]

Thank you for replying, her lead was tested as below 3. The doc said that means it's practically not detectable but it still concerned me, I'm looking into more ways to limit exposure to it (we switched to bottled water, looking to move into a house built after the 70s, leaving shoes outside etc.).

I'm also trying to find info on what's the best way to boost iron absorption and avoid inhibitors, best cooking methods etc. I'm more inclined to look into her nutrition and see what I can tweak there before resorting to a supplement.

Any thoughts on preferring Floradix to a multi-vitamin? (I don't really know much about supplements in the States but I'm generally not very keen on them).

Also, does anyone know where I can get grass-fed liver in NYC?
 

[heatherdeg]

Look for grassfed stuff at EatWild.com

Cooking in cast iron certainly helps.  Absorption from animal sources of iron aren't affected by diet, but those from vegetable sources can be but they improve when taken with meat sources and vitamin C (sweet potatoes are pretty high in Vitamin C and are easy to get into kids by mashing them with some soaked and boiled lentils if you're opposed to meat).

[sbgrace]

Vitamin C both inhibits lead absorption and increased iron aborption. I would do c in supplement form and in c rich foods both--with each meal and snack if possible as well as with the supplement. As far as prevention take care of any peeling paint, wash hands after coming in from outside and before she eats always, have your water tested, check the tub if she does tub baths--many have lead in the glaze.

The best supplement in my experience is ferrochel/iron bisglycinate. I have to order online. Many health food stores carry Gentle Iron by Solgar which is that form. I have used it for my son by opening the capsule and sprinkling some on some pear sauce and covering it with more pair sauce. I am sure there is a liquid too--I think it's called Natrol Iron. This form is absorbed much better than other forms--this means it corrects levels with less iron and faster and it's easy on the digestive system. My son finally corrected with that supplement and had no constipation or other issues.

As far as nutrition it's hard to get enough iron through food to correct a low level. Calf's liver might do it...but then the child must eat it and you'd want a very safe source as liver stores stuff. I didn't research a lot because my son just wouldn't take it but blackstrap molasses might be a source. Other food sources have problems. Everyone knows to keep dairy and soy from iron supplements (3 hours both before and after is best; I do iron first thing in the morning or last before bed so that part is easier). But there are other things that inhibit iron including things that are iron rich!

Those problem foods include spinach, seeds/nuts, egg yolk (and white), beans, and raisins/prunes/dark red fruits and juices! These are all things I was feeding my son because of iron content and they were making things worse!


Information on the various foods you might run into that can inhibit iron absorption:
Soy (and other beans) it is phytic acid. They (beans) are poor sources for that reason. http://www.ncbi.nlm.nih.gov/sites/en...t=AbstractPlus Not sure if perhaps you can reduce the impact on other iron in the same meal if you give vitamin C. Perhaps; it works for grain phytates reduction on iron. More about that in next link. Oxalates is another issues with beans. More about that in third link. You will run into similar issues with most nuts and seeds I believe. I've not researched this a lot because my son couldn't have the nuts/seeds anyway. You maybe could soak them and perhaps reduce the phytic acid.

Oxalic acid is the issue with spinach. Not all green leafy things contain oxalic acid but spinach does. There is conflicting stuff out there with oxalic acid. Vitamin C helps it. (obviously vitamin C is key in increasing iron absorption!) My take on all this is that when you’re trying to increase iron you avoid foods where the iron is bound by stuff like oxalic acid even if you might be able to help with vitamin C. http://dataguru.org/misc/aquarium/FoodOxalicAcid.html Link with oxalic acid levels of various things and affect on absorption.


the raisin issue is the anti-oxidant factors in dark fruits (red grape, cranberry would likely be the same) block iron. Dark grape juice with iron reduces availability by 67% in one study. Prune juice by 31% (which is why I say prune maybe; any reduction in absorption is bad when you’re trying to raise levels). Light colored fruit juices in the study increased absorption –the vitamin C I’m sure. http://www.ars.usda.gov/research/pub..._no_115=136858

Here’s an article on phytates and dairy effect on absorption http://jn.nutrition.org/cgi/content/abstract/41/3/433 This study uses oat phytates. Grains reduce iron too but you can help that with the addition of vitamin C so I don’t worry too much about it. So with grain based sources use vitamin C in either food or supplement form.

Eggs both yolk and white are an issue if you serve those. One it is physovitin or something; I can't remember the other substance. Here’s a study that mentions soy too I think. http://www.sciencedirect.com/science...b982c5875c081c and ranks the absorption inhibition in the various foods used.

Basically, I would do vitamin C and an iron supplement and avoid really strong iron inhibiting things (like eggs) as much as possible and keep things that block it in general a few hours away from iron.