Iron deficiency in pregnancy can be a serious burden on the mother and the baby.  When you get your iron results back and are told you are iron deficient most doctors will immediately prescribe Ferrous sulfate 325mg  (65mg elemental iron) and have you dose it 2-3x per day. 

The problem with ferrous sulfate is that digestive disturbance, nausea, or black stools are almost a guarantee with this form of iron and dosing strategy.

Also, studies dating back to 2015 show that iron uptake in a non-whole food form peaks at 40-80mg of elemental iron per day.  So taking more than one ferrous sulfate a day doesn’t increase iron absorption and causes more side effects.  Neither of which is desirable when you are pregnant. 

I have yet to see a patient in my practice who has not had some kind of side effect from ferrous sulfate. That’s why in my over 10 years of practice I have never prescribed it. 

How to increase iron through diet

The first step in getting your iron levels up while pregnant is to add more iron-rich foods in your diet.  The best sources of iron are animal proteins.

Beef, poultry, pork, salmon, and bison are all great sources of easily accessible iron for the body.  Eating vitamin C rich foods like red bell peppers, citrus fruits, broccoli, strawberries, papaya, and tomatoes along with animal proteins is a great way to help increase your iron absorption.

Many people will tell you to consume soybeans and spinach to increase iron levels via vegetable matter.  However, the type of iron in these foods is called nonheme iron and nonheme iron is very difficult for the body to extract from the foods you eat.    

In fact, less than 2% of the iron consumed in spinach actually ends up being absorbed by your body. So, even though vegetarian sources of iron may be considerably greater than the best animal sources, iron from animal sources is much more bioavailable and we see greater iron increases with meat sources.

Increasing Iron via supplements

When you’re supplementing with iron you want to ensure maximum uptake to overcome iron deficiency without side effects. It is crucial to take your iron supplement away from dairy products, cereal, eggs, coffee, black tea, and calcium supplements as they will hinder iron absorption. 

It should be noted that if you are taking your iron in a prenatal form you will also get less iron absorption as calcium and magnesium compete for absorption with iron. 

It is best to take your iron supplement along with some vitamin C, up to 250mg has been shown to increase iron absorption.

There are many different types of iron available for supplementations.  As, I mentioned earlier ferrous sulfate is the most common and also the most side effect ridden.  

Iron bis-glycinate is another common iron that is an iron molecule chelate to two glycine amino acids.  Unfortunately, this also is not how iron is found in nature and leads to significant digestive disturbance as iron easily breaks free of the glycine bonds in the stomach and is free to oxidize and irritate the stomach lining.

The most consistent iron with the least amount of side effects I have ever used is whole protein hydrolyzed iron chelate.  In this case, the iron is housed within a rice protein and delivered through the digestive tract and directly to the blood.  This whole food iron form has made a huge difference in countless pregnant women’s lives, including my wife’s. 

Seeing iron levels increase rapidly, while taking a low dose of elemental iron and not having side effects is the dream of every pregnant women dealing with iron deficiency. 

Coupling highly bioavailable iron foods with the most bioavailable whole foods iron supplement on the market is sure to get your iron levels up and reduce fatigue, dizziness and headaches.

Have you tried to increase your ferritin levels? If so, have you found something that works?