Giving your child an iron supplement is not something to do without solid data to say that it is required.

Iron is an essential mineral that plays numerous roles in the body.

It is most commonly known for its job in making red blood cells.

Iron is used to make haemoglobin, the part of red blood cells that carries oxygen from the body. Without enough iron we are unable to carry enough oxygen to every cell in our body for energy production. When we become deficient in iron, we can experience increasingly greater symptoms of physical and mental fatigue.

Iron is also a key player in immunity. It helps our body make white blood cells- our immune fighters.

It is involved in making important brain chemicals needed for optimal cognition supporting your child’s attention, concentration and memory.

It helps regulate mood.

It supports healthy skin, hair and nails.  

Iron is particularly important during periods of growth such as pregnancy and adolescence, and for kids aged 6 months to 4 years old. If iron is insufficient at these times, it can mean sub-optimal growth and development.

In a child, signs and symptoms can include

• Pale complexion
• Dark circles under the eyes
• Physical fatigue
• Shortness of breath
• Cold intolerance
• Restless legs
• Mental fatigue and difficulty with concentration and memory
• Mood swings
• Poor immunity
• Poor growth
• Brittle hair and nails

If your child has displayed a number of these signs and symptoms, you may have checked their iron levels via a blood test.

Based on these results your health care provider may have decided to put your child on iron supplementation.

A few months down the track, you may be feeling that things are not improving very fast or not at all. You go for a blood retest and iron levels have hardly budged.

Why is the iron supplement not working?

GPs typically choose ‘Maltofer’ or ‘Ferrograd-C’ when treating iron deficiency. The problem with these is that it they are not very bioavailable forms of iron and will require a high dosage to have an effect.

Higher doses of iron are terrible on our little one’s guts. A lot of it goes unabsorbed and can upset tummies causing discomfort and constipation. On top of that, unfriendly bugs love gobbling up iron so the more there is floating around in the gut and in stool, the higher the potential for unfavourable changes in your gut bug environment.

So, this is one of the top reasons why iron supplementation may not be working.

1. Not using bioavailable forms of an iron supplement

If you look at the ingredients list of your supplement you will notice that the iron will be written in two words such as Iron bis-glycinate or ferrous sulphate.

These are different forms of iron. The key point here is that each form will have a different level of bioavailability. This is important as the higher the bioavailability, the greater the amount of iron absorption and the lesser the amount becomes expensive poo.

Bioavailability is also important as some of the lesser forms, such as ferrous sulphate, can lead to digestive upsets and constipation. In fact, ferrous sulphate has an iron bioavailability of 26.7%.

So, what form of iron has the highest bioavailability?  

Iron bis-glycinate at 90%.

2. Not dosing every second day

Other than menstruation, there is no active process by which iron can be excreted to keep levels balanced in the body. Balancing iron levels is important because too much in our system is pro-oxidative and can cause damage and inflammation.

Our clever little bodies have a safeguard. Systematic checks are placed at the absorption level to determine how much iron is needed to satisfy the body’s stores. The liver will release a hormone called hepcidin that will order the little buses to stop transporting iron into the blood.

Studies have shown that a daily iron supplement can signal the release of hepcidin and shut down those buses. Intermittent dosing, such as every second day, can be more effective than daily dosing. Allowing for a longer time between doses maximises absorption and avoids iron lost out the other end.

3. Not correcting other deficiencies

Nutrients work synergistically to keep things running well. Just adding iron to the supplement regime is not always the only consideration. A child may be deficient in other nutrients that help with iron absorption, transport and storage.

Low copper and vitamin B2 can negatively impact iron absorption and storage.

Low vitamin A can also reduce absorption as it helps escort iron from the gut across into the blood. Vitamin A is also a really important one in immune health and can keep infections under control. More about infections and iron blockade later.

4. Taking iron supplements at the same time as other mineral supplements

There are some minerals that compete for absorption.

When it comes to iron, we know that it competes with zinc and calcium. These minerals are often included together in a multi-vitamin and mineral supplement but at carefully researched doses of each to ensure they are all well-absorbed.

If your child is on separate doses of zinc and calcium at higher doses then it is best to keep them at the other end of the day away from the iron supplement to maximise absorption.

5. Not using a probiotic to enhance absorption

Probiotics are being utilised as an addition to iron supplements to maximise absorption.

Probiotics are live microorganisms that can be found in fermented foods and supplements. Certain strains have their own unique actions. These are essentially beneficial bacteria that are also abundant in our gut and when in a lovely balance do a whole host of beneficial things.  

Lactobacillus plantarum 299V is particularly good at helping with iron absorption and enhancing an increase in iron stores at a faster rate than iron on its own. It is also able to deal with any gut inflammation that can get in the way of iron absorption.

6. Not finding the root cause

Inflammation and/or infection, gut or systemic, is a big one here.

It can alert the same systematic check at the absorption level with hepcidin and essentially block iron from being absorbed into the blood. The body is trying to prevent any excess iron from contributing to the inflammatory process so it chooses to lock it up in storage and block its absorption from the gut.

If we don’t address the source of the inflammation or get on top of chronic infections, your child will be having a really hard time to get their iron levels up and increasing the dose will only make things worse.

Gut inflammation is a double whammy as not only will the inflammation trigger iron blockage with hepcidin but we know an inflamed gut means damage to the beautiful finger like-projections that line the gut wall needed to absorb all of our beautiful nutrients.

Another consideration is an underlying thyroid problem. Hashimoto’s, an autoimmune condition that results in a sluggish thyroid, can make it really hard to get your iron levels up as sufficient thyroid hormones are needed to make the iron-storage protein, ferritin.

Need help working things out?

Getting your child’s iron levels up is important to support their growth and development, keep their immunity strong and support their learning and mood.

If supplementation is not going the right way and you need help figuring out why, get in touch with one of our practitioners today.