Hi All. Writing this in my capacity as a nutritional therapist. The topic of iron often comes up among kidney patients and here's why. The kidneys produce the hormone erythropoietin which stimulates the production of red blood cells and in turn maintains a healthy level of haemoglobin (Hb). Most of the body's iron is found in red blood cells so if they are low, it is likely your iron levels might also be low. The two usually go together which is why increasing iron tends to increase Hb and increasing Hb tends to raise iron. There are a few issues with a concentrated dose of intravenous iron. I had a bad allergic reaction to it which can be one issue. Another is that it can be too much iron at once and lead to oxidation in the body. We are not looking to increase oxidation in the body as this produces free radical cells which are essentially volatile and disruptive in the body. This is why a diet rich in 'antioxidants' is so important. However that's not to say iron infusion must be avoided, as ever, inform yourself and tune into what feels best for you.
Fatigue can be a big issue with kidney illness due to the iron and haemoglobin status. This is an important way the body carries oxygen which is vital to our energy. The NHS prescribed iron I don't usually recommend and here's why - an example of ferrous sulphate is dosed at 200mg. This is a very high dose and the high dose is due to the low bioavailability of this form, namely not much is absorbed and typically creates black stools and some constipation. I prefer to prescribe a bigylcinate form of iron that is much more bioavailable and comes with no digestive disturb.
So how to raise your iron levels? A good quality and bioavailable supplement is one way. Eating animal foods such as eggs, liver, red meat and chicken is another way but be mindful not to go overboard on these. These contain 'heme' iron which is more bioavailable to the body. For vegetarians however there are still ways to eat iron rich foods - apricots, chick peas, pinto beans, most legumes in fact but make sure they are soaked overnight and cooked well as they are high in lectins which can contribute to inflammation, dark greens with lemon juice squeezed on as the vitamin C in the citrus aids the absorption of iron. Pumpkin seeds are also handy for iron content. Nuts and seeds are a great addition to any diet if you enjoy them, just don't go crazy as they are also high fat foods and there is more research coming out now around high fat leading to dysbiosis (gut flora imbalance).
What not to eat to avoid low iron is avoiding tea and red wine around iron rich foods. The tannins in these interfere with iron absorption. I've had patients who drank a lot of tea and when that was eased off, it helped the iron status.
The other consideration that is rarely spoken of is stomach acid status - stomach acid is key to our digestion and notably with iron it is stomach acid that changes iron into an absorbable form. So you must have sufficient stomach acid and not be taking medications to suppress it.
Some possible symptoms of low iron and low Hb (essentially this is anaemia), are hair loss, shortness of breath on even slight exertion, lack of palor (absence of rosy cheeks!), inability to focus and feeling cold.
So get on some iron rich foods, be interested in your own iron, ferritin and Hb levels so you can explore what levels feel right for you. Again it will vary for everyone.
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