Iron deficiency is the most common nutritional deficiency in the world. The major side effect associated with iron deficiency is anemia (i.e. abnormally low red blood cells).
Iron deficiency can also be a significant factor in hair loss, and make all types of hair loss worse. Consequently, any treatment for hair loss will be less effective in patients who are iron deficient. These adverse effects are magnified when the lack of iron is severe enough to cause anemia. When treating hair loss it is therefore important to address iron deficiency, especially in patients who are at increased risk for this prevalent disorder. This is frequently done with a blood test, that measures the serum ferritin level.
Moreover, iron deficiency is especially important to consider in women since female patients with hair loss will frequently have iron deficiency. In our practice we commonly encounter female patients with hair loss and iron deficiency.
Serum Ferritin
Serum ferritin level is blood test used to screen for iron deficiency. Ferritin is a protein that binds to, stores and carries iron. The plasma “ferritin level” is an indicator of total iron stores in most patients. The serum ferritin level is therefore a convenient screening test for iron deficiency.

The iron storage protein

Unfortunately, many primary care physicians interpret the serum ferritin level based on a “normal,” but not “optimal,” reference range, especially when patients are not anemic. (Most labs report normal plasma ferritin levels to be roughly between 30 to 300 in men and 15 to 150 in women). Many researchers and clinicians now believe that the ferritin level should be above 50 in men and women. In patients experiencing hair loss, 80 is probably a more optimal value.
Iron Supplementation Concerns
Please note that individuals should exercise caution when taking iron supplements since excessive iron can be very harmful. Overzealous iron supplementation frequently causes constipation and can even cause “iron toxicity,” when taking a large dose. Iron toxicity occurs when there is excessive unbound, or free iron, since free iron is cytotoxic, (i.e. can damage cells).
Taking iron supplements for too long, (i.e. when no longer needed,) can also be harmful and cause “iron overload.” In iron overload, iron builds up in various organs and tissues, causing damage and leading to serious health problems such as liver disease, heart disease and diabetes.
In general, iron supplements should be used guardedly, in individuals who are iron deficient. Iron levels and dose should be monitored by your physician. In patients with normal iron levels, or who are mildly deficient, iron rich foods are a much better and safer source of iron.
Iron Rich Foods
Some examples of iron rich foods are liver (chicken or beef), bone marrow (i.e. Osso Buco,) mussels, oysters, fish, red meat, legumes, enriched cereals, nuts, raisins, broccoli and of course spinach.

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