Question: I am 62 years old and post-menopause. Should I avoid multiple vitamin supplements with iron? I have read conflicting information. Some say that as we age we need iron and others say that iron can damage the heart after menopause.
Dr. Vliet's Answer:
The most important message here is that you will always come across articles that appear to be “conflicting” advice because no one can write a general educational article that applies to every individual. Both articles you mention may be correct for different people. The short answer is, regardless of age, if your blood level of ferritin (measure of iron stores) is low, you take iron. If it is high, you stop taking iron supplements of any kind.
Even if you are not yet anemic, ferritin levels below 60 in women are associated with symptoms like fatigue, hair loss, muscle aches, waking up at night, and restless legs. Ferritin levels above 200 are associated with increased iron deposits in tissues like the liver and with increased risk of heart disease.
I measure blood levels of ferritin for a baseline in all the new patients I see because it gives me important information about factors that cause symptoms my patients are experiencing. It has been very rare, in the thousands of women I have tested, to find a woman with high ferritin.
Better than 90 percent of the women I test have low ferritin because women lose iron every month in menstrual bleeding throughout their reproductive lives. Most of my menopausal patients have low ferritin because of years of menstruation and loss of iron. Yet, because of articles like the ones you mentioned, they stopped taking iron, even though no one had ever checked to see if their ferritin was too high.
Educational articles are designed to teach you what to discuss with your doctor if you are having symptoms. In order to answer your individual medical question about taking iron or not, you need to ask your doctor to measure your actual blood ferritin level.
Once you know your own ferritin level, if it is lower than what we know women need for optimal health, then you take iron either in a multivitamin with iron, or a separate iron supplement. If your ferritin is too high, then you stop iron supplements and talk with your doctor about next steps that may be needed to bring it down into the optimal range of about 60 to 90 or 100.
Since low ferritin can cause a variety of symptoms that mimic other medical problems, it is important to know your number before you just decide to stop multivitamins with iron. It goes back to the fundamental principle I teach every patient, and write about: You must have the right tests done to accurately measure your individual body chemistry and hormone levels.
Then you can make specific decisions based on your body, and don’t just follow general recommendations that don’t take into account your actual test results.
I hope this helps give you a systematic way to approach this, and similar, health questions. Check my website, www.herplace.com for more details.
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