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Should Premenopausal Women Take Iron?

Iron is an essential nutrient whose major function is transporting oxygen in the blood, and deficiency can cause fatigue and compromised immunity. There are two types of dietary iron: heme iron, which is found in animal foods, and nonheme iron, which is found in plant foods and supplements. The human body absorbs heme iron from animal foods more readily than nonheme iron from plant foods. As a result, excess iron accumulates over time on a standard American diet and can be problematic in older adults. However, iron is the most common nutrient deficiency, primarily affecting young children, teen girls and women of childbearing age.1 An estimated 18% of pregnant women and 9% of teens and premenopausal women in the U.S. are iron deficient.2, 3 Because of the differences in absorption between plant and animal sources of iron, premenopausal women following plant-based diets are more likely to be low in iron.4 Due to iron losses, women with heavy menstrual bleeding may also be low in iron.5

Pregnant women
During pregnancy, a woman’s iron needs approximately double; adequate iron stores are essential for early infant brain development, are needed to support the large increase in blood volume that occurs during pregnancy, and may also be important for mother-child bonding during infancy. 1, 6-9 This means that iron deficiency in the mother can lead to iron deficiency in their breast-fed infant and such deficiency can impair health and lower future intelligence.10 For these reasons, it is important for pregnant women (and those planning on becoming pregnant) to supplement with iron.

Women of childbearing age
For women of childbearing age who follow a Nutritarian diet, I suggest taking one Women’s Daily +D3 capsule (which does not contain iron) plus one Gentle Prenatal capsule daily, which will supply a small (12.5 mg) dose of iron. For those women who also experience heavy menstrual bleeding, I recommend taking two Gentle Prenatal capsules, for a total of 25 mg iron. These levels of iron supplementation will complement a healthy diet to help protect against deficiency, and will also help to ensure that if a woman does become pregnant, she enters pregnancy in an iron adequate state. It is also wise to monitor your iron levels with blood tests to assure adequacy and adjust supplementation accordingly.

Gentle Prenatal uses Ferronyl® iron, which is highly bioavailable and gentle on the digestive system.11-13 The daily dose of 25 mg iron is split between two capsules to avoid the nausea and constipation commonly associated with iron supplements.


1. Dietary Supplement Fact Sheet: Iron. Office of Dietary Supplements National Institutes of Health. http://ods.od.nih.gov/factsheets/iron. Accessed January 20, 2012.
2. Mei Z, Cogswell ME, Looker AC, et al: Assessment of iron status in US pregnant women from the National Health and Nutrition Examination Survey (NHANES), 1999-2006. Am J Clin Nutr 2011;93:1312-1320.
3. Cogswell ME, Looker AC, Pfeiffer CM, et al: Assessment of iron deficiency in US preschool children and nonpregnant females of childbearing age: National Health and Nutrition Examination Survey 2003-2006. Am J Clin Nutr 2009;89:1334-1342.
4. Waldmann A, Koschizke JW, Leitzmann C, et al: Dietary iron intake and iron status of German female vegans: results of the German vegan study. Ann Nutr Metab 2004;48:103-108.
5. Wang W, Bourgeois T, Klima J, et al: Iron deficiency and fatigue in adolescent females with heavy menstrual bleeding. Haemophilia 2013;19:225-230.
6. Murray-Kolb LE, Beard JL: Iron deficiency and child and maternal health. Am J Clin Nutr 2009;89:946S-950S.
7. Armony-Sivan R, Kaplan-Estrin M, Jacobson SW, et al: Iron-deficiency anemia in infancy and mother-infant interaction during feeding. J Dev Behav Pediatr 2010;31:326-332.
8. Lozoff B, Georgieff MK: Iron deficiency and brain development. Semin Pediatr Neurol 2006;13:158-165.
9. Gautam CS, Saha L, Sekhri K, et al: Iron deficiency in pregnancy and the rationality of iron supplements prescribed during pregnancy. Medscape J Med 2008;10:283.
10. Beard JL: Why iron deficiency is important in infant development. J Nutr 2008;138:2534-2536.
11. Devasthali SD, Gordeuk VR, Brittenham GM, et al: Bioavailability of carbonyl iron: a randomized, double-blind study. Eur J Haematol 1991;46:272-278.
12. Gordeuk VR, Brittenham GM, Hughes M, et al: High-dose carbonyl iron for iron deficiency anemia: a randomized double-blind trial. Am J Clin Nutr 1987;46:1029-1034.
13. Whittaker P, Ali SF, Imam SZ, et al: Acute toxicity of carbonyl iron and sodium iron EDTA compared with ferrous sulfate in young rats. Regul Toxicol Pharmacol 2002;36:280-286.

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