Iron supplementation may not cure anemia, unless nutrition is also improved

haidut

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As many of my readers know, Peat is against supplementing with isolated iron. Aside from the well-known toxicity risks (e.g. liver damage) multiple studies have shown that in a good portion of the people treated with oral iron supplements, anemia either does not resolve or rapidly returns upon stopping the supplements. This is most likely due to insufficient production of the iron-carrying protein ferritin, which is produced in the liver and its synthesis depends on thyroid hormone, protein availability and estrogenic load (which burdens the liver independently). The study below corroborates that hypothesis by demonstrating that iron supplements on their own often do little to correct the anemia unless overall nutrition is also improved. It is the latter that supports liver function and helps with estrogen excretion, thyroid synthesis, etc thus allowing for proper ferritin synthesis to occur.


"...Anemia, commonly associated with low levels of iron in the body, is also a result of poor quality of diet and socioeconomic factors, a new analysis shows. The pan-India study, conducted by researchers from the National Institute of Nutrition (N.I.N.), included a sample size of 33,000 children and adolescents in urban and rural areas from the Comprehensive National Nutrition Survey of 2016–2018. The study found that children from rich urban backgrounds had iron deficiency but fewer cases of anemia. On the other hand, in poor children from rural areas, despite high iron levels, there was a higher prevalence of anemia. This is because a lack of nutritious diets leads to poor utilization of iron to synthesize hemoglobin in the body, the researchers concluded. “When anemia prevalence increases … Usually, iron supplementation interventions through supplemental iron tablets or iron fortification of foods is intensified. But are these solutions that focus merely on increasing intake of iron enough to reduce anemia prevalence in India? It does not seem so as per this recent study,” said Dr. Hemalatha R., director of the NIN. The findings of the study can help re-evaluate existing approaches to address the condition, which affects over 50% of women and children in India. In children, anemia can have various effects, such as problems with learning and the development of motor skills."
"...This is corroborated by a 2019 study by Cambridge University that drew a similar conclusion: in addition to iron supplements, socioeconomic conditions of households needed to be improved in order to improve maternal health, low birth weight, and other associated problems linked with childhood anemia in India. Researchers in an earlier study by the NIN, in collaboration with the University of Maryland, found that adding a multiple micronutrient powder containing iron, zinc, Vitamin C, Vitamin B12, folic acid, and so on to children’s meals showed a significant reduction of anemia in children aged 3 – 6 years. The study also said that strategies to address anemia can make use of the Anganwadi infrastructure, which covers childcare services for more than 2.5 crore children in this age bracket."
 
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As many of my readers know, Peat is against supplementing with isolated iron. Aside from the well-known toxicity risks (e.g. liver damage) multiple studies have shown that in a good portion of the people treated with oral iron supplements, anemia either does not resolve or rapidly returns upon stopping the supplements. This is most likely due to insufficient production of the iron-carrying protein ferritin, which is produced in the liver and its synthesis depends on thyroid hormone, protein availability and estrogenic load (which burdens the liver independently). The study below corroborates that hypothesis by demonstrating that iron supplements on their own often do little to correct the anemia unless overall nutrition is also improved. It is the latter that supports liver function and helps with estrogen excretion, thyroid synthesis, etc thus allowing for proper ferritin synthesis to occur.


"...Anemia, commonly associated with low levels of iron in the body, is also a result of poor quality of diet and socioeconomic factors, a new analysis shows. The pan-India study, conducted by researchers from the National Institute of Nutrition (N.I.N.), included a sample size of 33,000 children and adolescents in urban and rural areas from the Comprehensive National Nutrition Survey of 2016–2018. The study found that children from rich urban backgrounds had iron deficiency but fewer cases of anemia. On the other hand, in poor children from rural areas, despite high iron levels, there was a higher prevalence of anemia. This is because a lack of nutritious diets leads to poor utilization of iron to synthesize hemoglobin in the body, the researchers concluded. “When anemia prevalence increases … Usually, iron supplementation interventions through supplemental iron tablets or iron fortification of foods is intensified. But are these solutions that focus merely on increasing intake of iron enough to reduce anemia prevalence in India? It does not seem so as per this recent study,” said Dr. Hemalatha R., director of the NIN. The findings of the study can help re-evaluate existing approaches to address the condition, which affects over 50% of women and children in India. In children, anemia can have various effects, such as problems with learning and the development of motor skills."
"...This is corroborated by a 2019 study by Cambridge University that drew a similar conclusion: in addition to iron supplements, socioeconomic conditions of households needed to be improved in order to improve maternal health, low birth weight, and other associated problems linked with childhood anemia in India. Researchers in an earlier study by the NIN, in collaboration with the University of Maryland, found that adding a multiple micronutrient powder containing iron, zinc, Vitamin C, Vitamin B12, folic acid, and so on to children’s meals showed a significant reduction of anemia in children aged 3 – 6 years. The study also said that strategies to address anemia can make use of the Anganwadi infrastructure, which covers childcare services for more than 2.5 crore children in this age bracket."

"If the normal amount of dietary iron causes an increased susceptibility to infections even in children, and if a subnormal amount of iron slows the aging process, I think we are going to have to reconsider our ideas of nutritional adequacy, to look at the long range effects of diet, as well as the immediate effects. My current studies have to do with analyzing our ability to handle stress safely, in relation to our diet. I believe our nutritional recommendations for iron have to be revised sharply downward." -Ray Peat

Are you suggesting that Ray Peat,and previous studies, on anemia are wrong? His many statements about iron and anemia isn't matching up to what you posted from what i am gathering.

"Iron deficiency anemia does exist, in laboratory situations and in some cases of chronic bleeding, but I believe it should be the last-suspected cause of anemia, instead of the first. It should be considered as a possible cause of anemia only when very specific blood tests show an abnormally low degree of iron saturation of certain proteins. Usually, physicians consider the amount of hemoglobin or of red cells in the blood as the primary indicator of a need for iron, but that just isn't biologically reasonable." -Ray Peat

I was diagnosed as having anemia from 7 years old to 15 years old, and though I did have a lot of dizzy and fainting spells, i never had the childhood disease everyone else had during those years, not even the flu.

"In a study of the "malnourished" children of migrant fruit pickers in California, these children who were "seriously anemic" were actually more resistant to infectious diseases than were the "well nourished" middle class children in the same region."- Ray Peat"
 
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