Iron and Folic Acid–Diet Concerns for Women’s Health

Mother and daughterThe top nutrition/diet concerns we hear from you at your well-woman visits include weight management and bone health (calcium and vitamin D). Occasionally we answer questions about dietary or weight loss supplements. We usually recommend that the best source of the nutrients you need each day is a well-balanced diet! (Read Dr. Stradtman’s past blog about dietary supplements).

We realize, however, that a woman’s typical diet—even when she tries to eat well—may not be meeting the special nutritional needs she has at certain times in her life. Besides calcium and vitamin D (discussed in previous posts), iron and folic acid are two more of these critical nutrients.

Every woman needs folic acid every day in order for the body to produce new cells. Folic acid is a B vitamin. Hopefully, you get this from a well-balanced diet, but to be sure, we recommend that reproductive-age women take a multi-vitamin containing 400 mcg of folic acid each day.

Getting enough folic acid becomes even more critical for women who may become pregnant. Folic acid helps to prevent certain birth defects of the brain and spine. Having enough folic acid is so important during pregnancy that we recommend you begin taking a daily pre-natal vitamin containing 800 to 1000 mcg of folic acid as soon as you begin trying to become pregnant. If you or a close family member has had a previous pregnancy with a neural-tube defect like spina bifida, the recommendation is 4000 mcg of folic acid daily beginning before conception. Read more from the Centers for Disease Control and Prevention in their “Folic Acid Fact Sheet.”

Iron is another nutrient that presents special concerns for women. Your body needs iron to build the red blood cells that carry oxygen and to perform other functions. If your body does not have enough iron to build healthy red blood cells, you will develop a condition called anemia. Some signs of anemia are extreme fatigue, shortness of breath, chest pain, fast heart rate, pale skin, hair loss or brittle nails, restless leg syndrome, and cravings to eat certain non-food substances like dirt, ice, or starch.

Women have a higher risk for iron-deficiency anemia because of the blood loss that occurs during their monthly periods. Your risk increases if you have unusually long or heavy periods. A simple blood test (CBC) at your yearly well-woman visit allows us to check for anemia. We will recommend an iron supplement if your “blood count” is low. Good food sources of iron include red meat, organ meats like liver, egg yolks, and dark green leafy vegetables. For this reason, women who eat a vegetarian diet need to be especially concerned about iron deficiency.

A woman’s need for iron increases during pregnancy as her blood volume expands to support her growing baby. Pregnant women who develop iron-deficiency anemia are at higher risk for having a premature or low-birth weight infant. Checking your CBC (blood count) is a part of your routine prenatal care. We recommend that you take a prenatal vitamin containing iron and folic acid throughout your pregnancy.

Keeping you informed about your nutritional needs at every stage of your life is an important part of women’s preventive healthcare.