In this episode of the Trime podcast, we delve into the issue of one of the most important, yet also one of the most problematic minerals for our body – iron. We discuss who should supplement with iron, how to recognize if our body needs it, and which groups are at risk of deficiency. We will also reveal why it is important to approach iron supplementation thoughtfully and what the potential risks are when taking it excessively.
The issue of iron
Iron plays a key role in our body. Its deficiency is very common and is associated with various health complications. On the other hand, an excess of iron can be just as dangerous due to its toxic potential.
Despite the frequent occurrence of iron deficiency, we have not yet included it in our product portfolio, and deliberately so, not even as part of the Daily F20 multivitamin.
Daily F20, containing the most deficient vitamins and minerals, was designed as the foundation of supplementation for almost everyone, compensating for frequent deficiencies from regular diets. However, iron is definitely not a substance that should be universally consumed without proven deficiency!
The reason is its ability to increase oxidative stress, and excessive intake represents a burden for the body that it has to compensate for in a complex manner.
Iron has the potential to affect cellular signaling cascades and damage DNA, which can lead to premature aging, atherosclerosis, and the development of cancerous diseases. Additionally, our body is not equipped with an excretion mechanism to rid itself of excess iron.
Whenever there is a need to supplement iron in the body, it is worth using special supplements that have been developed for this purpose and contain an appropriate and safe form.
We are now introducing a standalone iron supplement in chelated form, and thus, we have dedicated this episode to the issue of this important mineral element.
What will you learn in podcast #36?
→ The importance of iron in the human body
→ How can I tell if I’m lacking iron – the most common signs of iron deficiency
→ Who needs iron – groups at risk of iron deficiency and anemia
→ Iron and women
→ Markers of iron metabolism
→ Laboratory indicators of iron deficiency or excess – optimal values
→ Toxic iron levels and physiological daily losses
→ Biological availability of iron from food and forms of iron
→ Iron excess in the body and toxicity
→ Sources of iron – animal and plant-based
→ Athletes and iron deficiency
→ Endurance sports
→ Iron homeostasis is strictly controlled
→ Iron during pregnancy
→ Excessive iron intake – how to recognize and solutions
→ The influence of genetics
→ Supplements and forms of iron
→ New products in our portfolio – iron and multivitamin for pregnant women
All subtitled episodes of the Trime podcast are available on our YouTube channel
Transkript podcastu:
[00:00:04] Michal
Hello, after our general topic last time, we have another topic today from our field, which is about nutrition and, ultimately, supplementation. So, I welcome Jakub, whom you know, and then Renata Novotná, who you may know from our blog articles, texts, and already from one podcast episode, whom we have here today to help us. At least we'll have one smiling person today, so you won’t have to just look at the two of us.
[00:00:34] Renata
Hello to our listeners.
[00:00:36] Michal
Renata, if you could introduce today’s topic, what are we going to talk about?
[00:00:42] Renata
Today's topic will be iron, and I’ll maybe start by saying a few words about why we decided to talk about iron specifically and why we're dedicating today’s episode to it. Iron deficiency is actually one of the most common nutritional deficiencies, and it’s estimated that up to a quarter of the world’s population suffers from iron deficiency, which is essentially every fourth person. Some statistics say it’s as high as 30%. So these statistics are really unfavorable, and despite these numbers, many people don’t give enough attention to whether they have enough iron in their diet. Meanwhile, iron is crucial for maintaining our health. Iron deficiency has been linked to a number of chronic diseases, it’s associated with intestinal inflammation and heart failure. But generally, I would say it affects the overall quality of life. It contributes to fatigue, absenteeism, and, of course, there are many more effects of iron deficiency.
[00:01:55] Jakub
Maybe let’s skip being too “Wikipedia-like” — the robots will take over that job soon — so let’s focus on why we are discussing this.
[00:02:01] Michal
And can I ask one more question? The statistic “every fourth person” is global, but how much of that applies to developed civilizations? Is it the same or is it different?
[00:02:11] Renata
It’s better in developed countries, but of course, the larger portion affects developing countries.
[00:02:18] Michal
Let’s say in Europe, it’s not every fourth, but rather every sixth.
[00:02:22] Jakub
Don’t worry, it will get worse with the rise of veganism, it’ll be worse for sure.
[00:02:27] Michal
But it’s a bit better. It’s not as catastrophic.
[00:02:30] Jakub
Those statistics mainly affect developing countries, but the reason we want to talk about iron is primarily because, if you follow us, you know that we haven’t had it in our portfolio for a long time. We deliberately excluded it from our multivitamin complexes and insisted that it’s a very problematic element. Of course, it’s an extremely important biogenic element for all organisms, whether unicellular or mammals — that’s undisputed. It has a whole range of functions, it participates in about 200 enzymes, so we could talk about everything it’s important for and what happens when there’s a deficiency. But the problem is that if we supplement it mindlessly, it’s also an element with an extremely toxic potential. And that’s especially true for chronic conditions or situations where you’re dosing it chronically without understanding the broader context. So, that’s what we want to focus on today, explaining for whom it’s beneficial, for whom it’s not. We’ll explain how to figure out if you’re lacking iron, whether it concerns you or not. So, maybe to start, I’ll just briefly say, Renča, that you can tell us why it’s important, and then I’ll get more practical, going through the different groups of people most at risk of iron deficiency, how to diagnose it, what the symptoms are, and for whom it’s risky to dose. And I’d really like to address the issues we deal with on customer care.
How can I find out if I have an iron deficiency?
[00:04:15] Michal
Now, regarding the symptoms — I don’t know if I’m interrupting you — but maybe to start, let’s tell people how they can recognize if they have too much or too little iron without seeing a professional. Can someone subjectively feel it?
[00:04:31] Renata
There are definitely symptoms of iron deficiency, and when we talk about the functions of iron in the body, the symptoms will follow. Iron mainly transports oxygen, 60-70% of iron is found in the form of hemoglobin, which is part of red blood cells and carries oxygen. So when there’s a deficiency, people will get short of breath, feel tired. They’ll also look pale, so that’s something noticeable — pale face, pale conjunctiva. Iron also affects cognitive function, so it’s linked to issues like lack of concentration, depression. It’s something we can almost say, we all need iron. But its functions in the body are really numerous. It also participates, as Jakub mentioned, in many enzymatic reactions as a cofactor. We need it for the proper functioning of the thyroid, which in turn affects metabolism. When there’s not enough iron, women may feel more tired, may gain weight, may lose hair, have cold hands and feet. Another symptom is spoon-shaped nails, meaning the nails have the shape of a spoon and can hold a drop of water — this is another sign of iron deficiency that anyone can assess for themselves. And really, when someone goes up the stairs, they get out of breath, they’re tired...
[00:06:24] Jakub
That’s probably the most common one — fatigue and shortness of breath. And sometimes there’s also the restless leg syndrome. But...
[00:06:34] Michal
What is the restless leg syndrome? I’m just curious if...
[00:06:38] Jakub
Well, you have it. No, it’s more that, at night, when people are falling asleep, they just have to keep tapping their foot most often. Probably to improve circulation. But there are more symptoms, and it’s never really the case that we can say iron is the primary cause. Diagnosing or differentiating anemias is pretty complicated, and I wouldn’t want to dive into that too much. And...
[00:07:03] Michal
So there are some signs, but it doesn’t necessarily mean...
[00:07:07] Jakub
Certainly, and we can focus on what to look for in the iron panel or biochemical screening. Everyone should get this kind of preventive check-up from time to time, which includes a blood test. You can look at it there, and I think we can all agree that the simplest indicator is actually the stored iron, ferritin. While it can be falsely elevated, that doesn’t necessarily mean you’re overdosing on iron. If ferritin is high, we agree that if it’s low below some reference range, it definitely indicates an iron deficiency, and then we look for why.
[00:07:59] Michal
Specifically, so ferritin, once it’s low, that’s already telling us something. I don’t know why though.
[00:08:04] Jakub
Exactly, then we need to figure out why – whether it's occult bleeding, blood loss, or whether it’s due to autoimmune diseases, or maybe increased blood loss in women during menstruation.
[00:08:19] Michal
Let’s maybe start with the population groups that are affected.
[00:08:27] Renata
I’ll start. The most at risk for iron deficiency are women of reproductive age because they menstruate, and every month they lose blood. They lose iron and have higher needs. Then there are definitely pregnant and breastfeeding women – during pregnancy, blood volume increases to supply the fetus, which needs iron. Then we have athletes. And when it comes to diet, people who get little iron from their food are mainly vegetarians and vegans.
[00:09:06] Jakub
Especially vegans.
[00:09:09] Jakub
I wouldn’t forget the senior category either. It’s assumed that there’s already reduced absorption and a worsened state of the gastrointestinal tract, so there’s sometimes a problem with iron absorption. It can be due to missing cofactors, copper, vitamin C, or generally worse GIT health (gastrointestinal tract).
[00:09:35] Michal
So, could I say, if I’m a guy who eats everything and I’m not a professional athlete, that I shouldn't be worried about this problem?
[00:09:46] Jakub
Maybe.
[00:09:46] Michal
Maybe, so it’s not that simple.
[00:09:50] Jakub
You're not in the highest-risk group, so we’re not excluding it, but most commonly, as we put it together, we can repeat it: seniors, pregnant women, athletes – especially performance athletes. It doesn't mean that if I exercise three times a week or go for a bike ride once, it's a risk, but when the stress from training is frequent, with high volume and intensity, then maybe due to cytokine storms or increased interleukins, especially interleukin 6, it causes the key iron transport receptors in the body to become less active. This can lead to iron deficiency. Another issue is that it’s often associated with occult bleeding from the intestines – such as minor bleeding caused by heavy training or repeated intense physical activities.
[00:10:56] Michal
Let’s maybe start with the most important category, and that’s women. How should a young woman navigate this? Again, we always talk about vitamin K2, D3, and so on, but tell me simply, when is it really a problem for her? Can we say it’s a real problem for every woman?
[00:11:17] Renata
It will definitely be for women with heavy menstrual bleeding; they should definitely focus on this, especially if they’re vegans, vegetarians, and don’t eat...
[00:11:28] Michal
So this combination...
[00:11:29] Renata
Definitely, this combination, they should definitely focus on it. I think that once a year, every woman should get her iron panel checked. Not just if she plans to get pregnant, but really every woman, to be sure she’s getting enough iron. And then during pregnancy, as we said, it’s especially important. Maybe I’ll say why or what the risks are if a pregnant woman doesn’t get enough iron. Iron is important for immune system health, so then she’s more prone to infections – not just herself, but also the baby after birth. Iron deficiency during pregnancy has been linked to preterm birth, low birth weight, and postpartum depression. So these complications for women can often be prevented if the woman has enough iron during pregnancy. Iron deficiency is one of the most common deviations leading to complications during pregnancy. This is probably routinely checked based on hemoglobin.
Maybe we should return to testing. You certainly mentioned ferritin, but there are other markers tested when dealing with iron deficiency during pregnancy. Anemia is usually diagnosed based on hemoglobin. There are reference ranges, I think for women, it's below 120 grams per liter, I’m not sure about the unit.
What is the optimal range of iron in the blood?
The optimal range is... because it depends whether you’re looking at the limits or the optimum for body saturation. Of course, neither too little nor too much iron is good. Functional medicine sees the optimum around 140 to 150 grams per liter for women. It’s a little less, so let’s say 135–145 grams per liter. But hemoglobin may not tell you everything because a blood count might be fine. But when the demand for iron increases – a normal demand is around 20–24 mg for a healthy adult, and the reference intake for iron is about 10–15 mg, so you would be in a deficit. Add pregnancy to that and you get pathology. That’s why it’s extremely important, and I think for every woman, as soon as she finds out she’s pregnant, to get a complete iron panel. That means a full blood count, serum iron, iron saturation, transferrin, total bound or saturated transferrin, and ferritin. You can go further, but that’s the basics, which aren’t expensive and as part of routine screening, give a good picture of iron storage status. If the storage iron starts to increase, the woman will go through pregnancy without problems; otherwise, she’ll fall into sideropenic anemia.
[00:15:05] Michal
Regarding these values now – so that people who aren’t actively interested in this or aren’t fans of it know – when they go to the doctor, these numbers, as you’ve described, are safe, right?
[00:15:21] Jakub
It depends on how the doctor approaches it, if they do it responsibly, it’s usually in the self-pay regime. That’s the problem because...
[00:15:31] Michal
My question is directed towards the idea that with vitamin D, they say 50 to 150 is fine, but we know that 60–70 is really not good. So does this mean that the doctor can save you from dying or being taken away by ambulance – I don’t mean it seriously, just imagining it – but could there be something like with vitamin D at 60, that while I’m not dying right now, it could have health consequences?
[00:16:03] Renata
I’ll jump in here that functional medicine has a narrower range than the general one. For example, for ferritin, the range is broader, but the optimum we want to see is around 45 for women, even though the normal range is broader.
[00:16:28] Michal
So you’d recommend for those women – when they go to a general practitioner or anyone else, to check this number, and if it’s within the range you mentioned, they can be at ease?
[00:16:44] Jakub
Yes, you can go by that, it’s basic.
[00:16:46] Michal
Well, basic certainly doesn’t replace individual practice, but people need to take responsibility for their health.
[00:16:56] Renata
Back to ferritin – when ferritin is low, it means an iron deficiency in the body. But when it’s high, it doesn’t mean sufficient iron, it could be an indicator of inflammation. If you have chronic inflammatory conditions, arthritis, celiac disease, or inflammatory bowel disease, ferritin could be elevated, but you might still be iron-deficient. That's why it's good to test the entire panel, as Jakub said, not just hemoglobin. There are cases where doctors supplemented iron based only on low hemoglobin, but ferritin was high because of conditions like celiac disease or systemic inflammatory diseases.
[00:17:56] Michal
When I know my iron panel, can I theoretically detect other problems that might be running in the background without me knowing?
[00:18:04] Jakub
You could say yes.
[00:18:07] Michal
I’m trying to balance what we advise and not confuse people. Maybe some of you used our Omega Index and Vitamin D tests, where the goal was for people to be self-sufficient in dosing because what we advise may not always be taken in the context of individuality. Similarly, we are now trying to prepare more complex markers for interpretation in the app, hopefully we’ll succeed. It’s still in development, because as you said, people need to listen to it a few times, right?
[00:18:47] Jakub
Yes, and we’ll probably only say 10% of what we need to, because without presentation it’s almost impossible, because if I started talking to you about ferroxidase and the luminal and basolateral membranes, we wouldn’t get anywhere. So...
[00:19:02] Michal
For the general population, we have the ferritin marker, and when it’s within the range, that can calm me down, and then I can move forward, if...
[00:19:10] Jakub
It’s more likely to concern you when it’s low; everything else can be interpreted differently. But when it’s low, you have a problem.
[00:19:19] Michal
So I think we’ve finally cleared that up, that it’s manageable, right?
[00:19:22] Renata
Yes.
[00:19:23] Michal
So I hope we won’t get criticized in the comments for making it too complicated, and not simplifying. Whoever turns it off after ten minutes will probably hate us.
[00:19:30] Jakub
No, no, the important points are yet to come. And maybe also to mention that, just as iron is an important biogenic element and often deficient, it is also often in toxic levels. Yes, and this is exactly why there’s no excretion path for iron, how the body would get rid of it.
[00:19:53] Jakub
So the only way is exfoliation – shedding of cells from the intestinal mucosa – or something like venipuncture, bloodletting, blood draw, something like that. Of course, peeling of epithelium – some of it is lost through the skin, hair – but these are really small losses. The daily physiological loss for a healthy person is about 1 to 2 milligrams, for women it’s usually the higher number, let’s say 1.5 mg, for men it’s about 1 mg. So theoretically, since there’s no way to lose iron other than evaporation (which doesn’t exist), and the losses are about 1 mg, it follows that you have no reason to supplement more than 1 mg or add more than 1 mg. The problem, however, is the bioavailability of iron. In general, the biological availability of iron is 0 to a maximum of 40%.
[00:20:48] Michal
Best, so from that diet I’ll theoretically absorb 20 mg.
[00:20:52] Jakub
On average, the absorption rate is about 10%, on average. Then we need to talk about forms, which depends on your dietary profile – what’s your nutritional style, how do you build your plate, how do you prepare it, what types of food do you eat. If it’s a mixed diet, we calculate the low absorbability. If you have a specific style of eating, like carnivorous or vegan, you might achieve higher maximum absorbability because there are no dietary inhibitors. The iron is in its optimal form for absorption, that is, heme iron, which is protected by polyphenols and absorbs almost completely.
[00:21:36] Michal
I’ll stop you at heme iron – then people will read about non-heme iron, and there will be the problem with veganism. So, if we can explain this basic division, I have iron from food, but 10 mg isn’t the same as 10 mg.
[00:21:49] Jakub
I often hear from some “experts” or there were trends that you can get all your iron from almond milk and green leafy vegetables, but that really doesn’t work. The reality is, and I’m not sure how deep we want to go into details, but believe me, we know quite a bit about it.
[00:22:20] Renata
Sorry, I’ll jump in – if Michal meant the division, that iron from plant sources and from animal sources is different. From animal sources, there’s heme iron, which has higher absorbability, let’s say around 10%, and from plant sources, it’s less.
[00:22:40] Jakub
Heme iron is even more than 10%, it’s basically intact against dietary inhibitors and absorbs through a different transporter, it doesn’t require reduction. Then it depends on how the enterocyte lets the iron into the bloodstream – that’s hormonally regulated. But in terms of absorption through the intestinal mucosa through the enterocyte, heme iron is the highest form. The only better form is from breast milk. In breast milk, there’s lactoferrin, there’s little iron, but the bioavailability is up to 70%, showing how extremely valuable it is. You don’t want to overdose iron in babies because it has a pro-oxidative effect, but it maximally utilizes iron. Unlike those who eat predominantly plant-based foods, there the bioavailability is, let’s say, wild.
[00:23:32] Michal
Which is the non-heme iron.
[00:23:34] Jakub
There, the absorbability is highly variable, and you need to understand it.
[00:23:40] Renata
That’s the non-heme iron, and there’s the problem with dietary inhibitors, as you mentioned – absorption is affected by what you eat. If you eat calcium, the iron won’t absorb, and the same goes for grains, leafy vegetables – phytates, oxalates, those substances block iron absorption. That’s why the bioavailability is lower.
[00:24:11] Michal
What’s the percentage variation for heme iron, or is it so varied?
[00:24:17] Jakub
Generally very low. And as a vegan, you need to understand it well and use all strategies to absorb iron. You need to strengthen ferroxidases, have enough copper and other factors.
[00:24:35] Renata
Vitamin C supports the absorption of plant-based iron.
[00:24:38] Jakub
You often hear that you need vitamin C to absorb iron, but no, you don’t. It can also be done by other ferroxidases – like through ceruloplasmin. This relates to trivalent plant iron, which needs to be reduced through duodenal cytochrome to be absorbed via the DMT1 transporter into the intestinal cell. If these factors are missing, the bioavailability is low. That’s why vegans or vegetarians, who know about this and are on the brink of anemia but stick to the ideology that they will only take iron from plant-based food, it’s almost impossible (due to their individuality, body setup). They often don’t understand the details and have problems. They count absolute iron values, not absorbability, transport, and assimilation.
[00:25:43] Renata
So you think vegans have almost no chance of getting enough iron from their diet?
[00:25:52] Jakub
It’s the most common issue for vegans, even those who care about nutrition, but have had long-term problems with it. But it can be solved, everything can be, but there are specialists who raise awareness about how they solved it. And it’s a common occurrence.
[00:26:03] Michal
They are specialists, though...
[00:26:05] Jakub
Yes, they are specialists, I won’t name names, but they’re usually the ones doing the awareness work. They talk about how they had problems with it and how long it took to solve. It’s a common occurrence. And maybe to balance this, it’s not about saying that plant-based food is bad and meat is good, because iron is a dangerous element, even though it’s biogenic. The moment you absorb it and increase its stores in the body, you age faster. You’ll eventually die from it, either from calcium or iron.
[00:26:43] Michal
I can die from something else, maybe an accident, right?
[00:26:46] Jakub
But it’s one of the principles of premature aging, because iron is a transition metal, it has the potential to create free radicals, and with its unpaired electron, it increases oxidative stress in the body. And the moment the storage forms of iron exceed the capacity – the main storage organ is the liver, hepatocytes. A healthy person has about 1000 mg of iron in the liver, which is still fine. But in alcoholics or older people, who have a disrupted regulation of iron metabolism and can accumulate or absorb more due to blocked hepcidin, iron poisoning can occur during life.
[00:27:42] Michal
Like those people with red faces, red noses...
[00:27:46] Jakub
Yes, it’s also visible, their blood count is pathological on the opposite end. They have high hemoglobin and high stores of hemosiderin, ferritin, the storage iron. The body doesn’t have a way to get rid of it, so it stores it in tissues, and that’s toxic, primarily to the liver, spleen, heart. There are also cognitive impairments. It’s typical for athletes who use anabolic steroids.
[00:28:21] Michal
Then we'll come back to it. We’ve said that some people have a lot of iron, others very little, heme/non-heme, so let’s discuss sources. We’ve already said that plant-based sources have low absorbability. Now, whether I have a lot or little iron, how can I regulate it through my diet?
Which animal sources are rich in iron?
For animal sources, it’s mainly meat, organ meats, liver is one of the richest sources of iron.
[00:28:56] Michal
Is there a difference between chicken breast and organs?
[00:29:02] Jakub
Yes, there are big differences. You can check food databases for values. As Renča said, liver is the main storage organ, and it’s of course the richest source of iron. It varies – sometimes it’s 15 mg, sometimes 10 mg per 100 g. The problem is that if you’re iron-deficient, it’s not best to rely solely on liver, because you may overload your body with other components, mainly vitamin A, retinol. There’s a limit for consuming organ meats – it’s recommended to have up to 150 grams of liver per week. You can go a bit higher occasionally, but this average is good. If you’re iron-deficient and low on stores, it’s practically impossible to fix it through diet alone – it would take too long.
[00:30:26] Michal
It would take too long, but you could damage some organs.
[00:30:29] Jakub
Exactly, or you’d cause damage due to overload.
[00:30:32] Michal
So organs are the richest source.
[00:30:34] Jakub
It’s great prevention and also a good strategy for people with iron issues. It’s beneficial if you include organ meat blends in your diet as a preventive measure, but it depends on the quality of what you’re consuming, though we won’t get into that. And then, of course, you also consider the person’s size, like when you have a 100 kg athlete, it might be a little harder for them. If they’re heavily stressed, as we mentioned, the losses in certain sports disciplines will be higher, which is a factor to keep in mind.
[00:31:14] Michal
You’re being unathletic today, always jumping to the sports part. I want to finish discussing animal sources – then we’ll move on to sports.
[00:31:23] Renata
Red meat is generally rich in iron.
[00:31:25] Michal
So, meat is a rich source, it’s one step below organ meats.
[00:31:29] Jakub
Definitely, there you might have 7–8 mg per 100 g, so when you have a 200-gram serving of meat, you’re getting your daily dose in a very well-absorbed form. You could even drink coffee with it, and the absorption is still good. If you do this with plant sources like leafy greens, whole grains, nuts, or seeds, the absorption is very low unless you know the strategies to deactivate inhibitors, like soaking, sprouting, and cooking. This can be worked with, deactivating phytates, but that’s a specialized topic, and no layperson will answer that.
[00:32:19] Michal
After red meat, what about white meat, like chicken? It’s also a rich source, but a bit lower, or is it similar to red meat?
[00:32:27] Jakub
No, no, no. It’s very, very different. Then we’re talking about much lower values because it can be very lean meat, and it’ll have only a tiny amount of iron. But it’s still very well absorbed, and you can still compare it to eating 100 grams of nuts, which you probably don’t eat every day. You’d have a problem with weight gain. So, 100 grams of meat isn’t a problem for a woman to eat.
[00:32:55] Renata
What about eggs?
[00:32:56] Jakub
Eggs are also a pretty good source, but again, I don’t remember the exact amount of iron off the top of my head, but let’s say it would be about 1 mg. Iron, by its nature as an essential biogenic element for nucleic acid growth and so on, is actually everywhere – in seeds, nuts, organ meats, and eggs.
[00:33:21] Michal
I have one more category – fish, would they be on the same level as chicken, approximately?
[00:33:27] Jakub
There could be fish that, for example, tuna has higher iron values, but from that meat, even poultry... yes, there are more possibilities.
[00:33:36] Michal
And other animal products – dairy?
[00:33:40] Jakub
Pretty bad for iron content.
[00:33:41] Michal
So it really comes down to meat.
[00:33:46] Jakub
Meat, fish, eggs. Also, seaweed is often mentioned among plant sources, but that’s debatable, because if you don’t process it correctly, you won’t get much iron from it. Chlorella could be an interesting source, but you need to understand how to incorporate it into your diet, in what form, and how the cell wall is technologically processed...
[00:34:19] Renata
I also encounter attempts to supplement iron with molasses or nettle tea, which is...
[00:34:33] Jakub
That’s nonsense – you look at food source tables, and then you realize that it actually has no practical effect, because you wouldn’t eat 100 g of these foods every day. And if you did, you'd be heading toward diabetes.
[00:34:48] Michal
So it’s about the bioavailability and how much I eat.
[00:34:53] Renata
Sure, as a supplement, it’s probably not bad, but it won’t solve anemia.
[00:34:56] Jakub
If someone is within reasonable limits and has a varied diet and cares about it, it’s fine. But if you have low iron stores or are anemic, you need a different strategy, which is what we’ve done at the customer’s request – isolated iron, which we can talk about.
[00:35:21] Michal
And now, the moment for you, the athletes.
[00:35:26] Jakub
Maybe not so much.
[00:35:27] Michal
So, the math of intake and conversion is the same, but there are losses due to sports. Should we break it down into endurance, strength, or both?
[00:35:43] Jakub
I’d say mostly endurance. I don’t know how deep we want to go into the details, that’s more for specialists, so maybe we should skip that. But it’s fascinating once you understand why it happens and what to do about it, the strategy isn’t about supplementation, but about preventing losses and maximizing iron utilization that gets into the enterocyte. That’s the key.
[00:36:11] Michal
I’ll introduce this a little – why we’ve spent quite a bit of time on the sports topic recently. We have a great story – a big shoutout to Oberhof, where the Czech cross-country skiing team started buying supplements from us because our vitamin D was working well for them, and so on. Then they contacted us asking if we could offer them a discount, and that’s how the collaboration started. Now we’re helping them – we’re advising them on how to improve their supplementation – and we’ve become a partner to the Czech national team.
Recently, or in endurance sports in general, there’s still a prevailing opinion among experts – and it’s worldwide across all sports disciplines – that athletes are prescribed really high doses of iron, like 100 mg and so on. And we’ve somehow overturned this thinking and are taking a slightly more complex approach.
There’s also the context that we’re not just looking at performance enhancement and mindlessly reading studies like “100 mg of iron achieved this and that,” but we’re also thinking about what actually happens in the body. How does the body have to work with that, where does it store the iron, and so on.
[00:37:27] Jakub
Yes, I’d like to frame this in context. The problem is real. That means, if they ignore it, their performance gets worse. A large portion of these athletes – especially in the women’s categories – eventually end up with anemia, specifically sideropenic anemia. That’s something both doctors and the entire coaching staff need to address – they must handle iron supplementation.
But the right path is what we’re talking about here. Of course, it’s much more complex – doctors don’t have the time for it, it’s not their specialty, the athlete doesn’t have time for it either. But it’s time to really try and address these things and optimize them fully. And that’s what we’re attempting to do now. I believe we’ll succeed.
And this is one of the extreme cases, but others who aren’t in professional sports can learn from it as well. We know that many people do performance sports – and they have similar problems.
[00:38:24] Michal
There are those who ride their bike or ski four times a week, three hours at a time, and they go all out. So, this category would be...
[00:38:35] Jakub
Then they work and they’re tired, their immunity worsens, because they start lacking iron.
[00:38:41] Michal
What’s actually happening in extreme endurance sports?
[00:38:46] Jakub
That’s exactly what I’m not sure we should break down here, but in essence, it’s about the loss of receptors for iron binding. Because the process is complicated, we’d have to start from the beginning – how iron is absorbed, what it needs on the luminal and basolateral sides...
[00:39:08] Michal
But basically, the body has much higher demands.
[00:39:12] Renata
Partly, yes, because...
[00:39:14] Jakub
Well, actually, it doesn’t have to, because – as we’ve said – iron is recycled. So, if you don’t lose it, you have enough. But athletes, especially, experience this because the inflammatory cytokines, mainly interleukin-6, increase, leading to the loss of key receptors for iron distribution. This then affects erythropoiesis.
[00:39:41] Renata
Yes, so just to make sure I understand correctly... I understand it as...
[00:39:45] Michal
Great, let’s simplify it.
[00:39:46] Renata
Athletes have a higher need because iron is a component of myoglobin, which is a protein in muscles. So, they need more oxygen delivered to the muscles – they work harder. That’s one thing. The other thing is that because athletes are under high physical load, there’s an increase in inflammation. This then partly affects the intestinal lining – the intestines become disrupted, and iron absorption can deteriorate, or this is the reason for their higher need.
[00:40:27] Jakub
It’s primarily about the second point, yes, that’s what I’m saying. If I absorb 100 mg of iron, I’ve absorbed it, and there’s nowhere for it to go, unless I rip my hair out, scrape my skin, or bleed from my rectum. So, it’s really about the increased losses due to the sloughing of intestinal cells, the erythrocytes, where I hold the iron for some time and store it in ferritin. I need to get it into circulation, but because other factors are disrupted, which we don’t have time or space to break down here, the athlete’s intestines become overloaded with iron. They can eat steaks, liver, supplement, but most of the iron gets lost due to the sloughing of epithelial cells.
One negative consequence is that this increases the pro-oxidative effect of iron, so it irritates the mucosa even more. It chelates other important elements because they use similar transport systems – typically zinc, which is very important for endurance sports, but also copper. The body regulates iron homeostasis very tightly, and it doesn’t work like just throwing iron “here at the top” and solving the problem.
It works a bit because when I overload you with iron, some of it will get in. But if you’re not specifically... if you’re not the unlucky one, then something’s wrong.
[00:41:55] Michal
So, that’s the reason they’d rather overload with 100 mg to be sure.
[00:42:01] Jakub
Exactly, the doctor has no other choice but to save the situation, basically putting out the fire.
[00:42:05] Michal
Because they can’t address digestion and those things – they don’t have time for it.
[00:42:08] Jakub
They can’t ignore it, because if they do, performance will definitely worsen over time. So, this has been the approach with most athletes so far. Of course, this isn’t something we invented, many experts around the world have been working like this. But we need to talk about it.
[00:42:28] Michal
And with most athletes, this will continue. And now – those who care individually about their health, who aren’t just trying to win a medal and then deal with issues at forty – they can start to care about it this way. The problem you’re describing is that everyone influences the intake, but no one addresses what happens afterwards.
[00:42:53] Jakub
The distinction between absolute intake and iron homeostasis – that’s the message we’re discussing here. And that applies to pregnant women as well.
Of course, when the demands on blood circulation double – correct me if I’m wrong – there’s such a “blurring” of blood production, that the cofactors necessary for fetal growth and blood production – in addition to iron, folic acid, B12, and others – are so enormous that it’s very difficult to cover that with diet under normal conditions, nearly impossible.
The woman’s taste preferences also change naturally, and it’s perfectly natural for her to slowly become depleted, gradually. And now – the solution isn’t just mindlessly supplementing iron. That’s what we’re dealing with, and we’ll cover it in the second part – don’t forget to remind me about it.
Why we don’t think it’s a good strategy to supplement iron for every woman just because she’s pregnant. It’s a common occurrence that women lack iron, but if we give iron to everyone, we’ll also find studies that point out that a certain portion of women – estimated at a quarter – have good iron homeostasis during pregnancy.
They have good dietary habits, and when they start taking a prenatal multivitamin, you’ll end up chronically over-supplementing iron unnecessarily.
[00:45:00] Michal
So, when I have low iron, my body can regulate it and take more.
[00:45:05] Jakub
That’s already observed in pregnant women. We see this with many minerals. It’s the same with calcium. The need is high in the third trimester, and there’s no need to necessarily supplement it – there are other cofactors needed. The fetus takes what it needs, and the mother is not at risk. That’s how nature set it up.
But it’s up to us specialists to explain this to those who are interested. If someone says: “I don’t have time, don’t deal with it,” then of course – give them calcium, give them iron. What else can you do?
[00:45:43] Renata
I might jump in here too. As you mentioned – with increased need during pregnancy, the absorption also increases, so this is physiological.
So, when a pregnant woman goes to the doctor, and based on her blood tests, it shows lower hemoglobin, is this already a reason for her doctor to start supplementing iron? Is that enough, just based on the hemoglobin?
[00:46:12] Jakub
If it’s, say, below 135, or even under 120...
[00:46:17] Renata
120, maybe even under 110.
[00:46:19] Jakub
Probably yes, because I think anything below 135 isn’t quite optimal. But that’s not an immediate reason to start supplementing – that should always be evaluated by a specialist. We’re not replacing medical advice here. You just have to be lucky to encounter the right doctor.
However, once changes start appearing in the blood count, along with low ferritin, that’s a red flag. And I believe it will be very hard to choose another strategy other than starting iron supplementation.
In the second part, we’ll talk about which form to choose, how to dose it, and other important aspects.
[00:46:57] Michal
So, whether I’m an athlete, a pregnant woman, I look at ferritin, I look at my dietary intake. I can’t solve it with diet alone – or it’s not smart to solve it by eating only steaks and liver. That’s what I take from this.
And one more category we mentioned at the beginning, we haven’t discussed much – seniors.
[00:47:21] Jakub
With seniors, there’s certainly no immediate recommendation to start supplementing iron. I’d focus more on supporting absorption as much as possible – and that’s mainly dietary habits, plate composition, and a varied diet.
Iron wouldn’t be an issue if certain principles are followed. And if the person isn’t anemic, even in older age, I think iron can work fine without the need to supplement it.
There are other elements or supplements I’d definitely supplement and wouldn’t rely solely on a varied diet – but for iron, I wouldn’t go that route, especially because of its pro-oxidative effect.
I’d try to personalize it. There will be seniors for whom, besides B12 and other factors, it will make sense to address iron, but I’d still go the route of choosing the right forms. We’ll talk more about that.
But definitely, it’s not a given that every senior is automatically anemic and needs to supplement iron.
[00:48:27] Michal
Ideally, we wouldn’t sell much of our iron. Just like calcium, which is coming to the market soon – we’ll try to promote it in a way that people don’t buy it unnecessarily. So that only those who have specific needs buy it.
With iron, I think the trend is always that people Google “top 10 most important supplements,” and then they read the list, seeing what benefits it brings. But nowhere is the risk mentioned. Or not necessarily – but I’d guess that if I open “top 10 supplements,” I’ll see 20 websites, and half of them will list iron and calcium, with only the benefits mentioned. And they’ll certainly be among the top-selling products. So...
[00:49:16] Renata
I’d like to remind one more category we missed – and that’s children. Because children also have a higher need for iron. I don’t know, Kubo, if you’ve encountered this in practice – are children anemic? Is it common?
[00:49:31] Michal
How does that happen if the child isn’t vegan? They can’t really decide on their own, can they?
[00:49:35] Jakub
It’s really about poor dietary habits, or that bad habit that’s becoming common here – and that’s autoimmune diseases. Often still in the hidden, latent phase, where absorption is impaired, changes in the characteristics of the gastrointestinal tract occur.
Now – we don’t know if this is due to dysbiosis, excess chemical additives, preservatives... things that the gut “doesn’t like.” And this affects iron bioavailability.
[00:50:08] Renata
Sometimes, kids don’t want to eat meat at all, I don’t know, it’s probably for them...
[00:50:12] Jakub
That’s right. The causes are more in the fact that the child just doesn’t understand it at a certain age. And they can already be at the brink of severe pathology, which still isn’t a reason for the doctor to prescribe medication or bolus doses of iron.
And now the mom doesn’t know – is this for supplementation or not? She doesn’t have the tools, the guidelines to get out of the situation. And this condition can steadily worsen... until it ends up as a patient.
[00:50:49] Michal
If the child eats everything, doesn’t have autoimmune diseases – is there a real risk that they’ll be iron deficient? Of course, there will be a few cases, but generally?
[00:51:04] Renata
There shouldn’t be a risk, I think.
[00:51:07] Jakub
No, this really depends on dietary exposure to iron. If there’s enough iron intake from food and there’s no issue with losses – like occult bleeding or chronic inflammation due to an autoimmune disease – then the problem won’t occur.
[00:51:27] Michal
I think that reassures most moms.
[00:51:31] Jakub
It does occur, and the mom should address it with the right expert – ideally in collaboration with a doctor and a nutrition specialist who focuses on this. Yes, it’s interdisciplinary collaboration. That would be the ideal solution; that’s how we’d all like it. But unfortunately, that’s not the common scenario.
[00:51:51] Michal
Yes, yes.
[00:51:52] Renata
Sure, but if kids don’t like meat and are very pale and tired, it might be a good idea to talk to a pediatrician about checking their iron levels.
[00:52:03] Jakub
Definitely.
[00:52:04] Michal
Will the diagnostics be the same? Is it measured the same way – ferritin and so on? Are there any differences? And are the values the same?
[00:52:15] Jakub
The values are adjusted for children – there are different reference ranges.
[00:52:20] Michal
Well, we’ll leave that to the pediatricians.
[00:52:23] Jakub
Of course, this shouldn’t be interpreted by a layperson. Ideally, it should be evaluated by a specialist doctor. And we don’t even need to discuss it in-depth here – we’re more focused on why we’re addressing iron. It’s an ongoing evergreen topic – it keeps coming back. The girls know best how often moms and athletes ask about it.
Also, patients with various gastrointestinal diseases or autoimmune conditions – those are increasing. A lot of intolerances, allergies, food hypersensitivities... and all of this ties in. So, we had to respond to this. And this episode should serve to give anyone who’s lost in this topic as much information as possible. But it will still require individual resolution.
We opened this topic so it gets discussed more. That’s the point.
[00:53:17] Michal
Yes, yes. Regarding anemia – we discussed symptoms like being pale, tired, and losing hair – that doesn’t sound ideal, but it can also lead to more serious issues. Of course, for pregnant women, that’s clear, it can lead to the least desirable scenarios. But for a normal person...
[00:53:39] Renata
Decreased immunity, more susceptibility to infections – you’ll be sick more often.
[00:53:45] Michal
So, the fact that my hair is falling out or I’m pale is actually a merciful sign that I should start addressing this?
[00:53:52] Jakub
You could say that. And mainly – you don’t know if it’s due to iron. It could also be protein malnutrition, which is quite linked to the transport of minerals. When protein is low, transport proteins don’t function either. We’ve discussed this before.
[00:54:09] Michal
And when I have excessive iron intake – I know that genetics play a role here as well. How do I know if I have a problem with this?
[00:54:25] Jakub
Well, you won’t know. It doesn’t hurt. So, it’s just about some prevention.
[00:54:29] Michal
Just like with calcium.
[00:54:31] Jakub
Exactly. You can overload on calcium your whole life and gradually your body will start calcifying and hardening. And iron is one of those extremely negative factors – if you overload like that.
[00:54:50] Michal
So, how do I know then?
[00:54:53] Renata
That’s why we talked about testing. Prevention means not just looking at one marker, but getting a full panel done. If your ferritin is elevated, that’s already a certain sign.
[00:55:06] Jakub
At the same time, the specialist will tell you if you have low saturation or low transferrin. So, it’s important for someone to properly interpret the whole picture.
[00:55:14] Michal
So, while with anemia – I have low ferritin = red flag, clear solution. Here, it’s more complicated. It’s about individual work. I need to read more markers together, it’s not so black and white.
[00:55:30] Renata
Exactly.
[00:55:30] Michal
This is what we’re trying to digitalize – we’re trying to understand it. The advantage of iron compared to other elements is that it can be measured well. For example, people ask about magnesium, but magnesium can’t actually be measured in blood. Just for example – could you please explain why it doesn’t make sense to track magnesium levels in blood?
[00:55:57] Jakub
Let’s take that one.
[00:55:58] Renata
Well, magnesium is actually an intracellular mineral, it’s found inside cells. It’s in bones, teeth, and when you go and have blood drawn in the lab, and measure the magnesium in your serum, it’s only about 1%. That really doesn’t tell me anything about how I’m doing with magnesium in my whole body.
[00:56:18] Jakub
It’s the same with iron, but we actually have those other control markers. With iron, you won’t find 60% of iron stores in the blood – now I don’t want to say the exact percentages, but just like with magnesium, we’re talking about around 1%. But we don’t have anything to measure it against. With iron, the expert can calculate a lot of other markers and have a complete view of, let’s say, the iron homeostasis in the body. With magnesium, that’s not the case; you’d have to stress the body.
[00:56:49] Michal
Listeners, just so you don’t try to figure this out from 3 YouTube videos, because that’s what happens, and you always encounter so-called experts who interpret blood tests for themselves or someone else, and then you see what they measure or interpret, or when the most famous American podcaster says he measures magnesium in his blood and knows exactly thanks to an app what his levels are. We just want to point this out. It’s not that simple, but at the same time, rest assured that you can read iron from numbers – you don’t need to do complicated nutritional analysis and such.
[00:57:26] Jakub
They’ll solve the problem this way, most people do. Simply. So, it’s like the omega index, it’s like vitamin D, I can be self-sufficient at the end of the day.
[00:57:38] Jakub
And we don’t exclude the fact that there will be more complicated cases, just like with vitamin D.
[00:57:43] Michal
So, what role does genetics play in iron overloading?
[00:57:50] Jakub
You might belong to those people who have a hormonal regulation disorder – specifically the hormone hepcidin, which primarily controls iron homeostasis, especially at the level of absorption in the intestines. If you belong to those people where this regulation is disrupted – it’s a small percentage of the population, but there are also ethnicities where this is more common – you could be a “super absorber” of iron. You’ll have to monitor your iron intake your whole life, because your stores will keep increasing.
[00:58:32] Renata
Do you have any information on how many people have this disorder?
[00:58:36] Jakub
It’s relatively new – not that it wasn’t known before, but it’s a more recent discovery. By the way, I think it was a Czech scientific team that made a significant contribution – I can’t recall the exact name... But it’s an interesting phenomenon. Since these samples haven’t been collected for 40 years, we don’t have completely accurate data, but it’s a small percentage of the population.
[00:59:01] Renata
So, it’s actually...
[00:59:02] Jakub
...it’s not completely common, but I’ve already seen it in practice. I’ve experienced two people where it was confirmed.
[00:59:10] Renata
Hemochromatosis. We haven’t mentioned that yet – there’s also a genetic disease where iron absorption increases.
[00:59:19] Michal
So what can I do about it?
[00:59:21] Jakub
You have to take care of it, because you absorb iron fully – the down-regulation is missing. That means, whatever you take in from food, it’s almost 100% absorbed. Under normal circumstances, hepcidin occupies the transport channel – the receptor – and “hides” it in the cell. Therefore, the iron doesn’t get absorbed and isn’t sent through transferrin into circulation. That’s how it works in a healthy person – iron leaves through stool, and the body doesn’t overload on it.
This happens during acute infections – iron is also important for bacteria, so the body temporarily limits its distribution to better cope with the infection. In these people, though, this mechanism doesn’t work – so if they have a high dietary intake of iron, it starts accumulating in the body.
[01:00:28] Michal
So the solution is diet – I limit intake?
[01:00:31] Jakub
Yes, limiting intake is the first step. The second – other strategies are used, such as venopuncture.
[01:00:37] Renata
Blood donation – that’s often recommended to these people.
[01:00:40] Jakub
Exactly. And they should regularly monitor it. They are usually informed about this – although I’m not sure how widespread the screening is, probably not very much. I’ve seen it in two athletes, and it’s dangerous – because the older the athlete gets, the higher the risk. Their iron stores can become much higher. And when the liver becomes overloaded with iron – which is extremely important for life – liver function starts to deteriorate. It can even affect the heart.
So, that person could have really serious health issues. Anyone who has the possibility should regularly have their full iron panel checked – that’s where the tendencies can be caught.
[01:01:31] Renata
Maybe you have some information about whether people with hemochromatosis are regularly monitored by doctors? Do they have tests every year, for example, or when they have a confirmed diagnosis, are they in care?
[01:01:47] Jakub
I think that if they get to a specialist – like a hematologist – they’re definitely well cared for. The problem is that before they reach such a specialist, many of these conditions are underdiagnosed. General practitioners often don’t deal with it because they simply don’t have the capacity.
[01:02:06] Michal
I see...
[01:02:06] Jakub
It’s again about the fact that today we have the options to actively take care of our health ourselves. I’m not saying everyone should play doctor – this is a more complicated issue – but with basic screening, you can learn a lot about yourself. And then you just hand the results to the right specialist who can advise you.
[01:02:30] Michal
So we don’t forget – what do I do now? Either I’m in one of those high-risk groups, or I have an iron deficiency... Let’s talk about what I can do about it. Also, what we’ve prepared.
I know there’s quite a demand for iron from us – whenever I go through searches on the website, iron is in the top 2. We haven’t offered it for a long time because we couldn’t get it in the quality we require. Jakub, you have experience with different forms of iron – how do people feel after taking them, and what problems do they encounter?
[01:03:16] Jakub
Iron supplementation isn’t without risk – it has a lot of side effects. And what’s commonly used in medicine are unfortunately some of the worst forms, like ferrous sulfate. Renata could also comment on this from her experience.
[01:03:35] Michal
Sulfate – that sounds pretty nice...
[01:03:37] Jakub
It sounds delicious, doesn’t it? And then you have the typical symptoms of oxidative stress – constipation, nausea, poor digestion... and of course, it disrupts the gut environment, especially if it's used in high doses. The absorbability is quite low, but the side effects are significant.
[01:04:02] Michal
Maybe that’s why they dose such high amounts, right? To make sure it has an effect?
[01:04:08] Jakub
Definitely. Even though they have better forms of iron now – some are available by prescription, and some are really good, advanced – we don’t like things like chemical additives or preservatives. For a regular consumer, this might not seem significant, but for us, it’s crucial. Otherwise, the forms of iron, like heme iron or iron bound to polymaltose, have been developed for decades specifically to reduce side effects and improve absorbability.
Today, bisglycinate forms of iron are considered the gold standard. Generally, these are organic bonds between the metal and the ligand – ideally in a 1:2 ratio or higher. We’ve even looked for higher ratios to make sure the iron atom is as protected as possible from dietary inhibitors, making it stable and minimizing side effects.
This was difficult for us for a long time. Making iron isn’t a problem; it’s a cheap raw material. But our portfolio is limited, and it’s based on absolute quality. If we can’t get it in the quality we need, we’d rather not offer it at all than offer it in compromised quality.
[01:05:48] Michal
I’d also add that with minerals like iron or magnesium, another factor that plays a role is heavy metals. And that’s one of the metrics we focus on – can you please elaborate on this issue? Because if you have something very bioavailable and you have slightly elevated levels, even within the limits...
[01:06:12] Jakub
The limits for heavy metals in the EU are quite lenient. They should be adhered to by everyone, but sometimes they’re not. We’re looking for partners or contracting manufacturers who adhere to the highest pharmaceutical manufacturing standards. And even when they meet the limits, we have internal limits that are even stricter – often a third of the EU standards.
And if you have a highly bioavailable form of that metal, such as iron, it’s also very bioavailable for undesirable metals like lead, mercury, cadmium, and arsenic. So even if you stay within the allowed limits, long-term supplementation could lead to exposure to these heavy metals.
If someone takes iron short-term, it’s not a huge issue. But with long-term use, it becomes important. That’s why our focus on quality and purity is so meticulous – with iron, it’s a benefit, but with other supplements that are taken long-term or for a lifetime, it’s absolutely crucial.
[01:07:40] Renata
I might add that we’re also dealing with this with magnesium, which people use long-term and regularly. And there, purity and quality play the same role.
[01:07:48] Michal
When you look at some manufacturers’ websites, they list the limits, specifications, etc., but that doesn’t really mean much. What’s important is testing each batch – that’s when the reality shows up. Internally, we say that any Chinese manufacturer can meet the limits.
[01:08:20] Michal
Depending on when this podcast airs, we’ll have iron available in two products. One is simple – a standalone iron supplement with a dose of 12.5 mg. Why did we choose this dosage instead of, say, 30 mg?
[01:08:44] Jakub
It comes from the fact that physiological iron losses are not as high as often assumed. If someone is in severe sideropenic anemia, they need high bolus doses, where even 20, 30, or 50 mg won’t be enough. They might use 100 to 200 mg, which falls into the medicinal realm, not dietary supplements.
We wanted our product to be usable for children as well, where doses need to be even lower. We don’t want to overdose them with the usual 25 mg. And we can’t have a complex portfolio with four different iron products. Customers get confused, and the more variants, the bigger the confusion. We stick to the design we’ve planned – if someone needs a higher dose, they can take two capsules.
And because it’s a highly bioavailable form of iron, where the iron atom is protected by ligands on both sides, the absorbability is high. Additionally, it’s divalent iron, so there’s no need for reduction or oxidation. Absorbability is good as long as the person has enough protein and other important cofactors like copper.
[01:10:17] Michal
Then there’s the second product – a multivitamin for pregnant women. I know we’ve been promising it for a while, but we’ve always found something that could be improved.
The multivitamin is unique in that the substances it contains are in the so-called whole food concept. It will be in two capsules – one powdered and the other liquid. In the liquid capsule, slightly colored with beta-carotene, there’s a small capsule containing iron. It’s for stability – iron is very reactive and susceptible to reactions with other substances.
The liquid capsule contains 18 mg of iron. This product is designed for pregnant and breastfeeding women. Jakub, would you like to add why we chose a gentler dose than others?
[01:11:39] Jakub
So, we’ve mentioned how the iron cycle looks in the body, and if the pregnant woman is healthy, we don’t fully support the trend of routinely supplementing her with 30 mg. The recommended doses for pregnant women are between 22 and 36 mg – the demand for iron really increases or the body’s needs increase – but that’s not a reason to supplement with the full dose.
Our opinion is that it’s completely natural for the woman to get into mild depletion during pregnancy. We think that over time, we’ll see how things go. It has never been the case that we make a pregnant woman into an invalid, whom we need to medicate or supplement.
So, we’re more inclined toward a moderate strategy. That means – we’re not ignoring the problem. We know it concerns a large, or significant, percentage of women whose iron runs low during pregnancy. That’s why we’ve used a moderate dose. I’d even be in favor of a lower dose, but for many women, that wouldn’t be enough.
So, we’re somewhere in the middle, creating a new trend, highlighting this issue, so women don’t ignore it and do some prevention, some screening when they’re in the fertile period and want to conceive. So that they think about it in advance, and don’t get to those problematic levels.
Then it’s enough to do it moderately – there’s no need to overdose, because it still has the negative effects.
[01:13:23] Michal
So, if I’m in anemia, hypothetically... Now we’ve discussed prevention. If I’m a pregnant woman, I look at it differently, where these lighter doses are enough for me. But if I have anemia, how should I approach the dosing?
Can I also do something like with vitamin D – briefly increase the dose to higher levels and then gradually go back to the preventive ones?
[01:13:47] Jakub
Definitely. If it’s a proven sideropenic anemia, then bolus doses are indeed used. And neither our multivitamin complex, nor if you add this supplemental iron, will be enough on its own.
Before you... before you add one or two grams of iron to your system, it simply takes time – in terms of how complicated the absorption process is.
So, this is a completely different situation. But for prevention, or when you're on the edge, this is enough. And I’m not saying it should be given to every woman without knowing how her body is supplied with or overdosed on iron.
So, I think it’s better to stick to the more moderate strategy.
[01:14:39] Michal
Renata, anything about the products? Any direction or questions customers might have, so we can address them right away?
[01:14:48] Renata
It comes to mind about the usage... Kuba has already mentioned it, but since the form of iron we use is bisglycinate, a chelated form, it's stable, and there’s no need to be afraid of taking it with food.
Although it’s recommended to take it with some distance from meals, the absorbability is still very good even if taken with food, and if we drink it with milk – it will still be well absorbed.
This form doesn’t cause the problems associated with other forms – there won’t be constipation, stomach discomfort, or nausea.
And maybe I have a question for Kuba, regarding the timing of use – I've also received questions – is it better to take it in the morning, as it’s said that iron’s absorption is highest then, or does it not matter?
[01:15:47] Jakub
I’m also cautious about this. I don’t have a very firm opinion on it. I’d stick to what’s generally known. And when you look at the mechanisms and why it should be that way, that’s when it gets interesting. So, I’d like to hear the arguments for it – and I wouldn’t say they are that strong.
But mostly, it’s about the habit, so you don’t skip it. A lot of things are recommended to be taken in the morning – so the person is at home and won’t forget. And the composition of the plate and other things aren’t really discussed much.
[01:16:25] Michal
Anything else in connection with supplementation that we haven’t covered? What would be important to say?
[01:16:32] Jakub
Maybe a bit more about the benefits of our product, because you mentioned it a little – iron, of course, is problematic due to the unpaired electron in the penultimate shell...
[01:16:44] Michal
Again, you’ve simplified it. I’m really curious, I’ll check how many people turn off the episode halfway through. I think most have already dropped off, but go ahead.
[01:16:56] Jakub
It’s possible. So – we’ve invested a lot of time into making sure that the multivitamin, where several substances coexist... Iron is problematic in terms of lowering the stability of other nutrients, vitamins. That’s why it’s protected in the separate capsule.
I think there’s a huge benefit there. The technology isn’t cheap, and the development wasn’t cheap either – and we expect that pregnant women won’t have to supplement with three or four separate doses, but rather have it all in one supplement, with guaranteed or top-notch bioavailability, without it interacting with other ingredients.
This is a big advantage.
[01:17:47] Michal
That’s maybe the thing – if you wanted to choose a cheaper option. Not from us – because here we add, the product is really expensive compared to others on the market, but it’s really focused on the best possible inputs.
And when you see synthetic DL-alpha-tocopherol versus what we have, we admit that the entry cost is three times higher.
That’s why the final price is what it is.
So if someone wanted to go for a cheaper manufacturer, they should pay attention – for example, if they have 20 ingredients in one capsule, they should ask: "Send me some stability analysis," and so on.
[01:18:22] Jakub
Yes, we’ll have to explain the product anyway. That’s our job, so there will be a separate episode for that.
But maybe now, as we were talking about iron, I’ll just say what was complicated – that you can’t just throw iron in somewhere.
[01:18:36] Michal
Iron is extremely unstable with other substances, so for example, iron and vitamin K2 – problem. Now imagine that in multicomplexes, there are maybe 15 or 20 ingredients. That’s when it becomes either the job of a very experienced technologist and depends on the forms. Very often, it works well with synthetic forms, not so much with nature, which causes a mess. It’s difficult.
So, just pay attention to the stability, so that all those elements are actually in there as listed on the label.
Yes, I think the problem with dietary supplements is that we’re in an industry that’s minimally regulated, so you actually have very few – as a customer – mechanisms to defend yourself, and so on.
So it’s a bit of a wild west, our industry.
[01:19:27] Jakub
Rightfully criticized.
[01:19:29] Michal
Exactly.
[01:19:34] Jakub
So, yes, I’d like to summarize it a bit.
If someone has an iron problem, they might have recognized some of the symptoms we mentioned.
It’s definitely relatively easy to do something about it. If you have a deficiency, we gave some basic steps on how to proceed gradually.
It’s a little more complicated for those who have too much iron.
We discussed the differences between heme and non-heme, so plant-based and animal-based sources.
Then we talked about what to do with supplementation.
Of course, because this is a topic where I believe that specialists, nutritionists, and so on are the main listeners, they’ve probably found themselves in this.
So, if you have additional questions, feel free to send them to us.
Maybe we could do a webinar or Q&A episode.
Ideally, we’d point you to professional nutritionists and practitioners who can help you individually, and in the future, we’d like to create a network for them.
Because honestly, on our customer service line, we can’t provide personalized advice.
[01:20:56] Renata
I think you summarized it beautifully.
[01:20:58] Jakub
I think we’ve forgotten a lot.
[01:21:01] Michal
Oh, here we go again...
[01:21:02] Jakub
Well, I’m saying it because when someone gets lost and has more complicated questions, or sometimes even picky, distrustful ones, we’ve tried to show that it’s really a vast topic, and you can’t solve it in a five-minute advisory line. And that’s probably the most important thing.
And then about the individual products and their benefits – we’ll definitely write something for the blog and probably even make a special video. We’ll go into more detail there.
This was more of an introductory episode about how we approach iron. We’ve had this consensus from the beginning – we didn’t include iron in the multivitamin. We’ve explained why.
Now we’ve managed to solve it technologically, and we hope that it won’t be needed by too many people.
Except for the product for pregnant women – that’s clear.
And even about that, we could have a long discussion. We’ve mentioned some reasons why we’re not in favor of very high dosing. And we believe that with this, we’ll solve the vast majority of problems.
[01:22:14] Michal
The vision, or maybe just to describe how we always look at it when developing a product, is about who it’s for. So, for someone who is really struggling, we would create the product differently. But we’re betting that our customers will try to do something, even with their diet – we don’t have to look at them like patients. That’s what we tried to convey with this episode – to solve it partially. Then maybe with the help of supplements, but definitely not just referring to supplements and looking at it like medicine. Forget about everything else.
[01:22:51] Jakub
These products will be described with dosing, and we’ll also probably focus on different dosing schemes in specialized videos. For whom yes, how much, when, for how long – and we’ll probably look at each product separately.
[01:23:11] Michal
Okay, thank you both very much. I believe this was helpful. For you, our listeners, feel free to leave criticism in the comments. If you liked anything, you can praise us and give a like. Keep following us, and if you have ideas for other topics, we’ll be happy to hear them. If you reach out and continue following us, take care, and see you next time.
[01:23:34] Jakub
Thank you, take care.
[01:23:35] Renata
Thank you, see you.
