Table 1 from https://ods.od.nih.gov/factsheets/Iron-HealthProfessional/#h2 presents Recommended Daily Intake for...

Originally shared by Alex P

Table 1 from https://ods.od.nih.gov/factsheets/Iron-HealthProfessional/#h2 presents Recommended Daily Intake for Iron ► 8 mg men and non-menstruating women (14 mg for vegan, vegetarian men/non-menstruating women), 18 mg women who menstruate (32 mg if vegan/vegetarian women), 27 mg pregnant women (49 mg for vegan/vegetarian pregnant women). Low iron can decrease IQ by 13 points. Vegans and vegetarians need 1.8 times higher daily intake of iron because meat has blood in it, or heme iron which is easier to absorb than plant iron. Most multivitamins have iron at levels for meat eaters when saying 100%. More on this is explained at the end of the post. You can test if you are low on iron stores (ferritin below 20 ppb, https://en.wikipedia.org/wiki/Ferritin) or have too much iron with just 28 dollars at http://walkinlab.com (no insurance even needed). A blood test will measure dozens of parameters for just 80 dollars, including hemoglobin. For checking hemoglobin levels only, you can use one of the meters, such as the Easy Life one, see youtube about it, similar to glucose testers ► https://www.youtube.com/watch?v=q0fD9joYwFI. Some MDs say ideal ferritin range is 40-60 ppp others say 60-100, 120-150, depending if male or female, but "normal" is 20-300 ppb. Some study below found that ferritin 119-193 is better for men for longevity. Most studies agree though that ferritin below 40 and above 200 is risky.

Maternal iron levels have a huge impact on the birth weight, health and IQ of their kids, and iron deficiency in the first 2 years of life (not just during womb period) can dramatically lower IQ, quality of brain development, telepathy ability. A temporary iron deficiency in infancy can lead to IQ 13 points lower later on ► https://www.ncbi.nlm.nih.gov/pubmed/17691592 ► Arzneimittelforschung. 2007;57(6A):426-30.

Total brain volume doubles during the first year of life (increases by 101% in 1st year and another 15% in second year) and reaches 80–90% of adult volume by age two - the womb and first 2 years of life are the most critical and any deficiency in this period has dramatic consequences that often are irreversible for the rest of one's life as explained at ► https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2884385/.

Iron deficiency at age 1-24 months does irreversible damage and even if iron levels are corrected, those kids will have lower IQ and motor function, more repeated grades, more anxiety/depression, more social problems, and attention problems 10 years later than those who did not have deficiency early on ► https://www.ncbi.nlm.nih.gov/pubmed/10742372 ► Pediatrics. 2000 Apr;105(4):E51.

A study of 110 girls aged 12-15 showed that those who were iron deficient had IQ 11 points lower ► https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3872396/table/tab4/.

Lower serum ferritin rather than serum iron is associated with autism in children. ► https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5207676/ ► PLoS One. 2017; 12(1): e0169145.

"Infants who did not receive supplemental iron had longer looking times on a visual recognition memory task... infants with iron-deficiency anemia received lower motor test scores, averaging 6 to 17 points lower... Virtually every case-controlled study that examined social-emotional behavior found differences in iron-deficient anemic infants (e.g., more wary, hesitant, solemn, unhappy, kept closer to their mothers)... studies reported improvements, sometimes dramatic, in mental and/or motor test scores after iron therapy... higher levels of irritability in infants whose mothers were iron deficient. At 5 years, each 10 g/L increment in Hb at 9 months was associated with a 1.75 point-higher IQ score... iron-deficient anemic group tested lower in IQ, psycho-educational abilities, visual motor integration, and language abilities. formerly anemic kids had IQ 6 points lower years later. Hb less than 105 g/L at 9 months (anemia) predicts lower IQ at 7 years old" ► https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1540447/ ► Nutr Rev. 2006 May; 64(5 Pt 2): S34–S91.

Lower levels of neonatal hemoglobin and serum iron (in pregnant mothers) were related to higher levels of negative emotionality and to lower levels of alertness and soothability (in their children)." ► https://www.ncbi.nlm.nih.gov/pubmed/15732057/ ► Dev Psychobiol. 2005 Mar;46(2):141-53.

Compared with children with cord ferritin in the 2 median quartiles, those in the lowest quartile scored lower on every test and had significantly worse language ability, fine-motor skills, and tractability. They were also 4.8-fold more likely to score poorly in fine-motor skills and 2.7-fold more likely to have poor tractability than children in the median quartiles. ► https://www.ncbi.nlm.nih.gov/pubmed/11865266/ ► J Pediatr. 2002 Feb;140(2):165-70.

►► Giving breastfed newborns iron supplements resulted in higher motor development and visual acuity at 12 months ◄◄ ► https://www.ncbi.nlm.nih.gov/pubmed/14615726/ ► J Pediatr. 2003 Nov;143(5):582-6.

► Iron deficiency in infancy is related to mental retardation at age 10 ► http://ajcn.nutrition.org/content/69/1/115.full ► free full paper ► Am J Clin Nutr January 1999 vol. 69 no. 1 115-119

Iron is present in many vegan foods, such as legumes, seeds, spinach, green leafy greens. Vegans do not have a higher incidence of iron deficiency than do meat eaters and I am a living proof of that, since in August 2017 my hemoglobin came at 13.9 g/dL and serum iron at 127 μg/dL, ferritin 115 ppb, well above the 30 ppb cut off for mild anemia. I still have no clue if 115 is a little high or not since the studies are all over the place with ferritin.

A study in BMC Med. 2012 Oct 10;10:119 found that the more meat (heme iron) iron people ate and the higher the body reserves of iron (as measured by ferritin blood concentration) - the more Type 2 diabetes people got. On the contrary, dietary intake of vegan non-heme iron, or iron from supplements did not correlate with Type 2 diabetes risk. Given this data, I am surprised some companies, like Impossible Foods, are creating vegan burgers with vegan "heme" iron for taste, when several studies have implicated heme iron and heme itself in several diseases, including cancer. Non-heme iron was not related to blood ferritin levels, but heme iron was very related to ferritin levels. ► https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3520769/ - free full paper

Another study found the same thing ► http://care.diabetesjournals.org/content/29/8/1878 - free full paper. ► Diabetes Care 2006 Aug; 29(8): 1878-1883

Research found that when ferritin is only 12 ppb in the blood, people are iron deficient. When ferritin is above 50 ppb, one hypothesis is that people are iron overdosed and start increasing their risk of getting diabetes and cancer significantly. Normally, a value between 12 and 300 is thought of as normal for men (12-150 for women), but some studies found that above 50, problems start to appear. The Iron and Heme-Iron links to IQ seem to be very complex and within certain brackets there is a lot of variability. For example, "Chinese Children who performed the best on IQ tests exhibited low iron levels (compared to the others in the sample, not to anemic children) concurrent with high hemoglobin (iron bound to heme) levels, whereas the group who performed the worst exhibited high iron but low hemoglobin levels." Other studies found the higher the Hb the higher the IQ - so it's Hb that counts more ► https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3404215/ ► Pediatr Int. 2012 Oct; 54(5): 669–675.

On the other hand, a study in India found that "Higher hemoglobin levels were associated with higher IQ in the children who carried the wild-type allele DRD2 (dopamine D2 receptor that is hypothesized to regulate the effect of iron and lead on cognition), but in children homozygous for the variant allele, an increase of 1 g/dL hemoglobin was associated with a decrease in 1.82 points of IQ (95% CI, −5.28 to 1.64; interaction term p-value = 0.02)." ► https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3018494/ ► Environ Health Perspect. 2011 Jan; 119(1): 144–149.

Too much iron causes cancer ► https://www.ncbi.nlm.nih.gov/pubmed/19018762 - Cancer Sci. 2009 Jan;100(1):9-16.

Too much copper and iron causes cancer ► https://www.ncbi.nlm.nih.gov/pubmed/15036223 - Ann Epidemiol. 2004 Mar;14(3):195-201.

Lowering iron lowers cancer rates ► https://www.ncbi.nlm.nih.gov/pubmed/18612130 - J Natl Cancer Inst. 2008 Jul 16;100(14):996-1002.

Higher ferritin means more prostate cancer risk, each 100 ppm increase is 20% increased risk ►https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5392292/ ► Oncotarget. 2017 Mar 14; 8(11): 17862–17872.

Too much iron may even speed up Alzheimer ► https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3918070/. One study found that Vegans have 3 times less Alzheimer than meat eaters, maybe the heme iron causing ferritin levels to climb has something to do with it.

Basal ganglia ferritin iron levels are increased in Alzheimer ► Arch Gen Psychiatry. 2000 Jan;57(1):47-53.► free paper ► http://jamanetwork.com/journals/jamapsychiatry/fullarticle/481553

Brain iron increases with age and is abnormally elevated early in the disease process in several neurodegenerative disorders, including Alzheimer's disease and Parkinson's disease ► Ann N Y Acad Sci. 2004 Mar;1012:224-36. ► https://www.ncbi.nlm.nih.gov/pubmed/15105269

People with higher levels of ferritin - in all groups - had faster declines in cognitive abilities and accelerated shrinking of the hippocampus. They also found that people with the APOE-e4 gene variant, which is known to be the strongest genetic risk factor for the Alzheimer disease, had the highest levels of iron in their brains. ► free paper ► https://www.nature.com/articles/ncomms7760 ► Nature Communications 6, Article number: 6760 (2015)

A study of 5,471 participants aged ≥52 years found that men with ferritin 194-598 had 49% higher mortality risk than men with ferritin 119-193. Women with ferritin 2-44 ppb had 59% higher risk of all cause mortality than women with ferritin 74-115. As the table at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5462410/table/pone.0178994.t002/ shows, the lowest all cause mortality was ferritin 119-193 in men and 74-115 in women, among the 4 ranges they chose. However, in one model, among the 5, the lowest mortality was for men in the 2-69 group, group which was overall the second best using average of all 5 models. So perhaps a ferritin level 50-70 or 120-140 is the lowest mortality for men, if the data is broken down into smaller segments, hard to say from 1 study.* ► https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5462410/ ► PLoS One. 2017; 12(6): e0178994.

A 2015 study of 191902 dialysis patients (cannot extrapolate to healthy patients though) shows that the lowest ferritin levels (below 21) had the lowest mortality as can be seen in this graph of 191902 people (much bigger study than 5471 people study above). The highest mortality was for people with ferritin above 496 who were about 2.5 times more likely to die than the lowest ferritin ones. Could this explain why vegans live longer too? They have the lowest ferritin levels of any group. ► https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4658129/figure/pone.0143430.g002/ ► PLoS One. 2015; 10(11): e0143430. On the other hand hemoglobin lowest levels meant highest mortality and the lowest mortality was for hemoglobin between 107 and 118 (11.8 g/dL) ► https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4658129/figure/pone.0143430.g001/. This is probably not true for healthy people, but it's good to know that the range of ideal ferritin can vary widely depending on what known or unknown conditions or diseases people have.

Hb level, iron intake and mortality in 8291 Chinese adults aged 20-98 over a 10-year study found that for women the lowest mortality Hb was the 2nd quartile (124g/l) which had a mortality risk 2.3 times lower than 1st (105g/l) and 4th quartiles (144g/l). In men, compared with third quartile of Hb (143 g/l), first (122) and fourth quartiles (154) had 61 and 65 % increased risk of all-cause mortality. Both low and high Hb levels are related to increased risk of all-cause mortality, and in women, low or high iron intake is linked to mortality. ► https://www.ncbi.nlm.nih.gov/pubmed/28382896 ► Br J Nutr. 2017 Feb;117(4):572-581.

A 2017 study (https://www.ncbi.nlm.nih.gov/pubmed/27758018) of 6400 people with a mean follow-up of 8 years found no link between ferritin and mortality, but women with higher ferritin got higher heart failure rates. Similarly, https://www.ncbi.nlm.nih.gov/pubmed/11023623 found no relationship between ferritin (< 50, 50-99, 100-199, 200+) and mortality for most people.

A 2014 study of 8988 individuals, 6364 of whom died (median follow-up 23 years - much better for studying mortality), found "Stepwise increasing concentrations of ferritin above 200 were associated with a stepwise increased risk of premature death, with median survival of 55 years at ferritin concentrations ≥600 μg/L, 72 years at 400-599 μg/L, 76 years at 200-399 μg/L, and 79 years at ferritin <200 μg/L." ► https://www.ncbi.nlm.nih.gov/pubmed/25156997 ► Clin Chem. 2014 Nov;60(11):1419-28 ► free paper ► http://clinchem.aaccjnls.org/content/60/11/1419.long

https://ods.od.nih.gov/factsheets/Iron-HealthProfessional/ ► has more on babies ► "Approximately 12% of infants aged 6 to 11 months in the United States have inadequate iron intakes, and 8% of toddlers have iron deficiency... Breastfed infants who receive insufficient iron (less than 1 mg/kg/day) from supplementary foods by age 6 months should receive 1 mg/kg/day of iron drops. The American Academy of Pediatrics recommends 1 mg/kg daily iron supplementation for exclusively or primarily breastfed full-term infants from age 4 months until the infants begin eating iron-containing complementary foods... like iron fortified cereals, etc. The WHO recommends universal supplementation with 2 mg/kg/day of iron in children aged 6 to 23 months whose diet does not include foods fortified with iron". Low birth weight ones 2-4 mg/kg/day. Care should be taken to avoid taking too much iron, as explained at the link, maximum 40 mg a day. Too much iron (iron:zinc in ratio 2:1) lowers the levels of zinc and causes all kinds of problems ► https://www.ncbi.nlm.nih.gov/pubmed/3522825, but most people don't take more than 10 mg for males or 27 mg for pregnant women anyway.

IRON ABSORPTION IN VEGANS AND OMNIVORES

A 2014 review paper https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4179187/ with 117 references explains well the iron uptake "Before it can be absorbed, non-heme iron has to be reduced from ferric (Fe3+) to ferrous (Fe2+) iron by dietary reducing agents, such as ascorbic acid or by endogenous ferri-reductases, such as duodenal cytochrome B (dcytB) [28]. Ferrous iron is transported across the apical membrane of the duodenum by the divalent metal transporter 1 (DMT1), which is localized on the brush border membrane close to dcytB. The uptake of ferrous ions by dcytB is driven by proton co-transport [29], so an acidic duodenal pH facilitates iron uptake, and is competitively inhibited by other divalent cations. Ascorbic acid is the most effective enhancer of non-heme iron absorption. Animal proteins, such as meat, fish, and poultry, enhance iron absorption" Paper goes on to say calcium, some fibers, tea, coffee, polyphenols, eggs, phytates are associated with lower ferritin levels, but cause is not always clear for each food.

On the other hand, the free paper "Iron status of vegetarians" WJ Craig - The American journal of clinical nutrition, 1994 - Am Soc Nutrition ► https://www.researchgate.net/profile/Winston_Craig/publication/15027388_Iron_status_of_vegetarians/links/543ff51a0cf2be1758cff3da.pdf found those eating a lot of phytic acid rich foods (even if they are meat eaters) and polyphenols, further chelate iron preventing its uptake. They found that too much milk, tea, coffee, eggs, calcium antacids, calcium, magnesium, zinc or unfermented soy can diminish iron uptake too. Even so, vegans are as likely as omnivores to get iron anemia (they eat more iron than omnivores per some studies, yet have lower serum ferritin levels), possibly because vegans eat far more vitamin C, fermented soy, citric acid, lactic, malic acid and other organic acids which increase absorption of iron and the fact these days, even more than 10-20 years ago, a lot of packaged food has iron added to it, cereals, breads, pasta especially. Amazingly, hemoglobin concentrations are the same in vegetarians and omnivores. Another interesting paper is this paper on ferritin levels in vegans and omnivores ► https://www.ncbi.nlm.nih.gov/pubmed/10201799 ► Eur J Clin Nutr. 1999 Mar;53(3):189-94.

A study of 50 vegetarian females and 24 omnivore females found much lower ferritin level for vegans, even if they ate slightly more iron ► 25 ppb for vegetarians versus 45 ppb for omnivores ► https://www.ncbi.nlm.nih.gov/pubmed/10479197/ ► Am J Clin Nutr. 1999 Sep;70(3):353-8. ► free paper at ► http://ajcn.nutrition.org/content/70/3/353.long ► 18% of vegetarians and 13% of omnivores had ferritin below 12 ppb.

Serum ferritin concentrations were significantly lower in male vegetarians 37 ppb than omnivores 105 ppb, in female vegetarians 14 ppb vs 34 ppb in female omnivores. 42% of vegetarian females and 39% of omnivore females had ferritin below 12 ppb (the so called warning level). ► https://www.ncbi.nlm.nih.gov/pubmed/7956998/ ► Eur J Clin Nutr. 1994 Aug;48(8):538-46. More of the vegetarian males had ferritin below 12 ppb than omnivores too.

This may sound bad for vegans, but a 2017 study found that ferritin above 100 ppb is linked to diabetes and heart disease ► https://www.ncbi.nlm.nih.gov/pubmed/28474556 and several studies above found other risks of cancer, etc. Some say 70-90 is the best.

Vegans got more iron in the diet, but ferritin level was lower (about half the level of omnivores in this study, explaining why they got lower cancer and diabetes perhaps). Nobody knows exactly if lower ferritin is bad, as long as it doesn't become very low, because too much iron causes cancer as the papers above explain and in some studies higher iron meant lower IQ (as long as it was not heme bound iron, since the higher the heme iron in the blood, the higher the IQ in some studies). Heme iron in blood is not necessarily related to dietary heme iron of course. In another study above those with a gene had lower IQ when heme iron was higher in serum. The relationship is not very uniform, but low ferritin might mean issues in some people at least; on the other hand high ferritin increases diabetes risk, which lowers cognitive performance. Vegans and omnivores have equal rates of deficiency. Human biochemistry is ultra complex.

Most people take a blood test every 10 years at least, if not 5, and it probably tells them if their iron levels are low. There are so many factors at play, that it is hard to know how well one absorbs iron or anything really. That's why people do a blood test once in a while, especially if there seems to be a problem or they are pregnant, etc. It might be free every year to do it on some insurances, not sure. Iron deficiency can lower IQ, brain performance (telepathy too) a lot. A quarter of babies are thought to be iron deficient. It's not clear what the serum ferritin levels mean at times when they are lower, but within an acceptable range. It is a known fact that iron from meat is associated with cancer, but the causation is hard to prove, it may be due to other carcinogenics in meat.

Ferritin levels are thought to be normal between 20 and 300 ppb. When they are below 12 ppb it's not good. Ferritin levels become low before hemoglobin becomes low usually. So a simple iPhone app test indicating hemoglobin is OK doesn't mean ferritin cannot be dangerously low. :)

According to https://medlineplus.gov/ency/article/003645.htm the ideal hemoglobin ranges are Male: 13.8 to 17.2 grams per deciliter (g/dL) or 138 to 172 grams per liter (g/L), Female: 12.1 to 15.1 g/dL or 121 to 151 g/L Newborn: 14 to 24 g/dL or 140 to 240 g/L Infant: 9.5 to 13 g/dL or 95 to 130 g/L. However, others list anything above 12.6 for males as fine.

► VEGANISM ◄

For 100+ reasons I didn't eat meat for 21 years and dairy for 13 years (12% of millennials have already given up meat in America) see ► https://plus.google.com/+AlexPsi/posts/Hz1V4iQUyyJ. Going vegan is like planting 62 trees in your backyard, as far as CO2 emissions reduction.💜😊💜

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