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The Types and Side Effects of Artificial Sweeteners

We’ve already done a deep dive into how sugar impacts your health, and the verdict on that one is pretty clear (spoiler alert: it’s bad). So those of us with a sweet tooth might naturally turn to artificial sweeteners, which give you that sugary flavor without any of the sugar or calories. But are the effects of artificial sweeteners on the body and your weight any better than those of sugar? In this guide, we’ll answer that question, exploring the types of artificial sweeteners, the side effects of artificial sweeteners, the link between artificial sweeteners and diabetes, and more.

You can listen to an audio version of this guide on The WellBe Podcast.

Types of Artificial Sweeteners

As the name suggests, artificial sweeteners are substances that add sweetness to food or drink with a whole bunch of chemicals, rather than sugar itself. They generally have zero calories and, of course, zero grams of sugar. Because many Americans want to cut down on sugar without actually changing their diets significantly, the artificial sweetener industry is huge, and there are lots of different kinds to choose from.

Here are the most common brands and types of artificial sweeteners you’ll see:

• Saccharin: This is the ingredient used in the brand Sweet’N Low. It is made from the chemicals o-toluene sulfonamide or phthalic anhydride in a lab and is 300-400 times as sweet as sucrose (sugar), and can have a metallic aftertaste.
• Aspartame: This is the ingredient used in the brand Equal. It consists of the amino acids aspartic acid and phenylalanine, and is 200 times sweeter than sucrose.
• Sucralose: This is the ingredient used in the brand Splenda. It is made of sucrose that has been chlorinated, and it is 320-1,000 times sweeter than sucrose. 
• Stevia: Stevia is a plant-based artificial sweetener that is used in various brands. It is derived from the plant Stevia rebaudiana and is 30-150 times sweeter than sucrose.

There are other types of artificial sweeteners that you’ll see on the market (you’ll know it’s an artificial sweetener because it’s marketed as being zero calories or containing zero sugar), but the four above are the most common.

Side Effects of Artificial Sweeteners

So you get a kick of sweetness without any extra calories or any of the negative effects of sugar — win-win, right? Not so fast. Unfortunately, the list of side effects from artificial sweeteners is long. This makes sense, given that artificial sweeteners are made of chemicals in a lab, which are not things that your body recognizes or knows what to do with. The specific side effects of artificial sweeteners vary from brand to brand, but here’s a rundown:

• Increased appetite: While many people turn to artificial sweeteners to lose weight, they can actually have the opposite effect, as studies have shown that artificially sweetened food and drink can leave people feeling hungrier and craving sugar. This may be because they confuse your brain with a sweet taste but lack of calories. Increased appetite is a health risk because it can lead to overeating, which can in turn lead excessive weight gain or obesity, both of which increase risk of diabetes among other health issues. 
• Cancer risk. There’s an ongoing debate on whether or not artificial sweeteners can increase your risk of developing cancer, with different studies coming to different conclusions: However, given that at least one study has associated saccharine with bladder cancer, we think that’s reason enough to steer clear. 
• Depression: Research suggests that the sweetener aspartame can cause depression in some people, especially those with pre-existing mood disorders.  
• Headaches: Several studies have shown that aspartame can cause headaches in some people, with those who suffer from migraines more susceptible. 

One of the other serious side effects of artificial sweeteners is their impact on your gut health, which in turn can increase diabetes risk. We’ll explore this one more closely. 

The Relationship Between Artificial Sweeteners, the Gut, and Diabetes Risk 

People with diabetes often turn to artificial sweeteners to get the taste of sweeteners without throwing their insulin levels out of whack. Doing this has its own health risks, which we outlined above, but the real issue here is for those who don’t have diabetes yet: ironically, for those without diabetes, using artificial sweeteners can actually increase the risk of developing the condition. 

To understand why this is the case, you first need to understand how artificial sweeteners impact gut health. “A study came out that was pretty profound and was a big splash in the media, showing that artificial sweeteners actually destroy and injure the microbiome,” says Dr. Gerard Mullin, associate professor of medicine at Johns Hopkins Hospital. In the study, researchers found that artificial sweeteners disrupted gut bacteria balance in healthy participants who weren’t used to consuming artificial sweeteners. This is a big deal, since the makeup of our gut bacteria is what informs our gut health, and our gut health impacts basically every system in our body. 

In the case of artificial sweeteners, the shift in gut bacteria seems to make it far likelier that a person will develop diabetes. In the study, those whose gut bacteria had changed showed poorer blood sugar control just five days after consuming the artificial sweetener. In another study out of Europe, researchers found that chronic consumption of artificial sweeteners increased their risk of type 2 diabetes, regardless of other risk factors. 

This is also true in non-humans, with one study showing that mice who consume artificial sweeteners are at higher risk for developing diabetes. “In animals, they can actually induce diabetes just by the shifts in the microbiome that are performed with artificial sweeteners,” says Dr. Mullin. 

For those who are already diabetic, Dr. Mullin concedes that sometimes an artificial sweetener is the right choice if a person is struggling to control their blood glucose levels through other lifestyle changes. “For the person who’s stuck and needs to find a way to make some swaps, I encourage stevia,” says Dr. Mullin. 

While stevia is certainly not side effect-free, Dr. Mullin explains that it doesn’t have the known deleterious effect on the gut microbiome, and it’s certainly a better choice for diabetics than synthetic sweeteners, like aspartame. “Aspartame has been clearly shown in animals to be diabetogenic, which is a catch-22 because they’re diabetic already and they’re taking things to improve their diabetes and lessen their sugar load, but they’re making their diabetes worse because their microbiome is taking a hit,” says Dr. Mullin.  

Of course, the best way for diabetics to reduce their sugar load and to manage diabetes is to choose natural, whole, low-sugar foods, and stay away from processed foods with added sugars. A more natural artificial sweetener like stevia can be a good temporary option to help someone get things under control, but the real answer path to health comes with implementing sustainable lifestyle changes. Unfortunately, many practitioners who treat diabetic patients are not communicating that message. 

Perpetuating the Artificial Sweetener Myth

While the research exists on the side effects of artificial sweeteners and their negative impact on gut health and diabetes risk, there is a disconnect between that research and doctors, and between doctors and patients. 

“Who’s going to really elucidate this type of information? Most of the doctors aren’t very aware of it and would say it’s all about calories in/calories out, it’s all about energy, drink diet soda by the gallon,” says Dr. Mullin. “Some people actually do, and it’s a shame because they ultimately gain more weight because of what they’re doing to themselves.”   

The answer here is for doctors to become more educated on the long-term effects of these fake sweeteners, and pass that education onto their patients. Unfortunately, in our quick-fix medical culture, this isn’t generally the approach. Artificial sweeteners offer an easy, affordable way for people to feel like they can be healthy without making any sacrifices — but the research indicates that that’s not really the case.

More research is needed on the topic, as well as more coverage of the research to bring awareness to the issue. However, Dr. Mullin points out that with any forthcoming studies, we should be wary of the source. “There’s more and more data coming out about the effect of artificial sweeteners,” he says. “But there’ll be some studies that contradict that, which will be well-funded, and then others aren’t, so it confuses the masses.” 

By well-funded, we believe Dr. Mullin is talking about studies paid for by the sugar or soda lobby, with skewed data. This is a common move from large food industries (like sugar, snack, alcohol, meat, or dairy) to confuse people after research is published showing the products they sell can be harmful to human health.  

Conclusion: The Sweet & Low-Down on Artificial Sweeteners

There are a lot of different types of artificial sweeteners, and a lot of contradictory information on how they impact your health. Here’s what you need to remember on the topic:

• Artificial sweeteners are a class of substances that create a sweet taste without any calories or sugar. Most are derived from chemicals in a lab, but some (like stevia) come from plants. 
• The most common types of artificial sweeteners in the United States are: saccharine (Sweet’N Low), aspartame (Equal), sucralose (Splenda), and stevia. 
• While artificial sweeteners lack many of the negative health effects of sugar, they have their own set of issues. The side effects of artificial sweeteners include: headache, depression, increased risk of cancer, and weight gain due to increased appetite, as well as the two issues below (impact on gut health and increased diabetes risk). 
• Research has shown that artificial sweeteners significantly alter the makeup of bacteria in the gut microbiome, which hurts your gut health.  
• One of the impacts of this altered microbiome is poorer blood sugar control, which in turn increases the risk of type 2 diabetes.
• Many doctors are not aware of the health risks of artificial sweeteners and so do not communicate that risk to patients. Additionally, studies funded by vested interests may emerge that allegedly “prove” the safeness of artificial sweeteners.
• Instead of sugar or an artificial sweetener, try a healthier sweetener like honey or real maple syrup . To find out if the sweetener you’re using is WellBe-approved (and get product and brand recommendations if it’s not) write to us through the WellBe Holistic Health Concierge!

At the end of the day, remember that if anything seems too good to be true, it is. The best way to reduce your sugar consumption is to wean yourself off of sweet things, pure and simple. If you are having sugar cravings, it is likely an imbalance in your gut of bad microbes that are doing the craving, not you! The only way to stop cravings is to not give into them, or to slowly reduce your consumption until the cravings are gone. If you are going to have some sugar, make it a healthier sugar like the options above, have just a tiny bit, savor it, and make it just a rare treat!

Have you experienced the side effects of artificial sweeteners firsthand? Share your story in the comments below.

Citations:

1. Suez, J. et al. Artificial Sweeteners Induce Glucose Intolerance by Altering the Gut Microbiota. Nature. 2014 Oct 9;514(7521):181-6.
2. Fagherazzi, G. et al. Chronic Consumption of Artificial Sweetener in Packets or Tablets and Type 2 Diabetes Risk: Evidence From the E3N-European Prospective Investigation Into Cancer and Nutrition Study. Ann Nutr Metab. 2017;70(1):51-58.
3. Hoffman, B. et al. The Influence of Sugar and Artificial Sweeteners on Vascular Health during the Onset and Progression of Diabetes. Experimental Biology, 2018. 

Headache, fatigue and depression after sugar withdrawal. What to do and should I be worried?

• James Brown
• Associate Professor of Biomedicine Aston University

August 21, 2021

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Image copyright Getty Images

High sugar consumption is believed to be detrimental to health. However, giving up sugar is also not easy – in no small part because such a refusal can cause a whole range of unpleasant symptoms. What happens in our brain when we eliminate sugar from our diet?

It may surprise you, but sugar consumption (at least in the UK and other developed countries) has steadily declined over the past decade, despite all the variety of food temptations.

This could be due to a variety of factors, including changes in tastes, lifestyle, and the rise of low-carbohydrate diets such as the keto diet. A growing understanding of the dangers of excess sugar to our health is also playing a role.

Reducing your sugar intake has clear benefits – for those who want to lose weight, for example, or who want to take care of their teeth.

But when people try to cut down on sugar, they often experience some rather unpleasant side effects, including headaches, fatigue, and frequent mood swings.

We currently have a poor understanding of the causes of this side effect. But perhaps such symptoms can be explained by understanding how our brain reacts to sugary foods, and what the biology of the so-called reward system tells us.

Carbohydrates are a rather extensive class of organic compounds, among which are such low molecular weight carbohydrates as sugars: fructose, for example, is found in fruits, lactose – in milk. Sucrose (food sugar) is found in cane sugar, sugar beets, and maple syrup. Glucose and fructose are in honey.

Mass food production has led to sucrose and other sugars being added to food to make it more palatable. But behind this mouth-watering improvement in taste lies a profound biological effect on the brain.

This effect is so serious that it has even led to a heated debate about whether sugar is addictive, like a drug. This question has not yet been resolved.

Image copyright, Getty Images

Image caption,

Dietary sugar (sucrose) is a disaccharide made up of a glucose molecule and a fructose molecule attached to each other

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Sucrose activates sweet receptors in the mouth, which leads to the release of the hormone dopamine in the brain. Dopamine is a neurotransmitter; this chemical compound transmits signals between nerve cells in the brain.

When we encounter a rewarding stimulus, the brain responds by releasing dopamine, rewarding us for eating a certain food, for example.

The “rewarding” effect of dopamine can be seen mainly in those areas of the brain that are responsible for the sensation of pleasure and reward.

Reward generally controls our behavior, pushes us to repeat again and again those actions that lead to the release of dopamine. It is dopamine that can prompt us to eat something unhealthy, junk food.

Animal and human experiments have shown how strongly sugar activates the neural pathways of the reward system in the brain. In this intense sweet taste surpasses even cocaine.

Moreover, sugar has such an effect on the brain, regardless of whether it enters the body together with what is eaten (through the mouth) or in the form of an injection (as experiments on mice have shown). This means that the effect of sugar is independent of whether taste buds are involved.

There is compelling evidence that in rats, for example, sucrose consumption can alter the structure of dopamine-excited brain regions. Emotional processing and behavior are also altered, both in animals and humans.

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It’s obvious that sugar has a very strong effect on us. Therefore, it is not surprising that we experience such a “breakdown” when we refuse to consume it, or at least reduce it.

Discomfort symptoms (both mental and physical) are typically reported by those in the early stages of sugar withdrawal. These symptoms include depression, increased anxiety, mental fog and irresistible cravings for sweets, accompanied by headaches, fatigue and dizziness.

So yes, cutting out sugar can be frustrating, making it hard for some of us to transition to a different diet.

Image copyright Getty Images

Image caption,

Although sugar is found in many foods, its consumption in the US and Europe has been steadily declining.

The basis for these symptoms is not yet well understood, but it is likely that they occur in the same neural reward pathways in the brain. Although the notion of “sugar addiction” is controversial, there is evidence in rat experiments that sugar, like other addictive substances, can induce binge drinking, cravings, and withdrawal anxiety.

Other animal studies have shown that the state of the body addicted to sugar is akin to that of a drug addict. However, most of the research in this area has been done on animals, so it’s hard to judge how true this is for humans.

Neural reward pathways in the human brain are not altered by evolution, and probably similar pathways in many other organisms. Therefore, it can be assumed that the biological consequences of the rejection of sugar, which scientists see in animals, to one degree or another will be characteristic of humans.

The symptoms that people complain about when they cut sugar from their diet are almost certainly changes in the chemical balance in the brain. Dopamine, in addition to being involved in the reward system, also regulates hormonal activity, nausea and vomiting reflexes, and anxiety.

When sugar is removed from the diet, the rapid decline in dopamine exposure in the brain likely interferes with the normal functioning of neural pathways – and this explains the occurrence of unpleasant symptoms.

One of the few human studies on this subject has shown that obese, overweight adults experienced “sugar withdrawal” and an irresistible craving for sweets when sugar was removed from their diets.

What to do in such cases?

As with any transition to a new diet, the key is to stick with it and stick with it.

If you want to quit sugar for a long time, getting through the first few weeks is critical.

However, it must be emphasized that for a healthy person, sugar in itself is not harmful – you just need to consume it in moderation, eat healthy food and exercise regularly.

This article was originally published on The Conversation and is reprinted here under a Creative Commons license.

James Brown is Associate Professor of Biology and Biomedicine at Aston University Birmingham (UK).

Iron deficiency anemia: causes, diagnosis and treatment

Anemia is a group of diseases in which, for a variety of reasons, there is a decrease in the level of red blood cells – erythrocytes and / or hemoglobin, which deliver oxygen to all cells of the body.

Anemia has been known for a long time. It is assumed that this diagnosis began to be established from the moment the microscope was used, approximately from the end of the 17th century, when it became possible to study blood cells. But, despite the long history of the disease, about a third of the world’s population continues to suffer from anemia. And in more than half of the cases, the cause of anemia is iron deficiency in the body .

What are red blood cells and hemoglobin for?

RBCs, like leukocytes and platelets, are blood cells that are produced in the red bone marrow. Most of the erythrocyte is filled with hemoglobin, it is he who gives the erythrocytes their red color, which is why they are called “red blood cells”. Hemoglobin is a protein molecule that contains a large amount of iron. Due to the ability of iron to oxidize, red blood cells perform a respiratory function in the body – they capture oxygen in the lungs and transport it through the blood vessels to all body tissues. Therefore, as soon as iron deficiency occurs in the body, the ability of red blood cells to bind with oxygen decreases and the cells begin to experience oxygen starvation.

What do you need to know about iron metabolism in the body?

Like most trace elements, iron enters our body with food, then absorbed in the duodenum and upper jejunum, and from there it enters the bloodstream. The daily requirement for iron is very small – about 1.0-1.5 mg per day. However, the body absorbs only a tenth of the total iron intake. Therefore, in order to maintain sufficient reserves of this trace element, we must receive at least 10-15 mg of iron daily.

Food is the main source of iron. But not all products of this trace element are well absorbed. This is due to the fact that iron in products of animal and vegetable origin is in two different forms. Iron is best absorbed from meat, liver or fish, since animal products contain a soluble 2-valent form of iron, it is also called “heme”. But plant products – cereals, herbs, fruits, vegetables, contain an insoluble form of iron (3-valent), it is called “non-heme”. Therefore, before being absorbed by the body, iron must first pass from the 3-valent to the 2-valent form, i.e. become soluble. As a result, only a small part of the iron has time to be absorbed in the intestine.

On the one hand, iron is an indispensable trace element in our body and its deficiency negatively affects our health. On the other hand, its excess amount does no less harm, having a toxic effect on the nervous system, damaging the joints, liver and pancreas cells. Therefore, iron is stored in our body in a special form – in the form of a protein “ferritin”, which makes it neutral. But, as soon as the need for this microelement appears in the body, iron is split off from the protein and regains its properties.

What is the difference between iron deficiency and iron deficiency anemia?

There is a misconception that if the level of hemoglobin and erythrocytes in the blood is normal, then there is no lack of iron in the body. However, not all so simple! The fact is that the development of anemia, that is, a decrease in hemoglobin and erythrocytes in the blood, is preceded by a “hidden iron deficiency” and only then does iron deficiency anemia develop. Therefore, it is not enough to evaluate only the level of hemoglobin and erythrocytes, an additional study of the level of ferritin is necessary. A decrease in this indicator, with normal values ​​of hemoglobin and erythrocytes, will indicate the presence of a “latent” (hidden) iron deficiency in a person, which, just like anemia, requires treatment. But you should not focus on the level of iron, since it is very dependent on a meat diet or taking iron supplements the day before, which can falsely increase the content of this trace element in the blood.

The diagnosis of iron deficiency anemia is established only if, in addition to a reduced level of ferritin, a decrease in the level of hemoglobin and / or erythrocytes is recorded.

Symptoms of iron deficiency anemia

Symptoms of iron deficiency anemia are very diverse, they can be conditionally divided into two groups. The first group includes symptoms that can appear not only with iron deficiency, but also with other types of anemia (for example, with B9 or B12 deficiency anemia). Why are they called 9?0119 “anemic” , these include:

• weakness, lethargy;
• performance degradation;
• pallor of skin and lips;
• memory impairment;
• headache or dizziness;
• palpitations;
• poor exercise tolerance.

The second group includes symptoms that are characteristic only for iron deficiency anemia, they are also called “sideropenic” :

• discoloration of the skin – the appearance of pigmentation of the color “coffee with milk”;
• the appearance of “zaed” in the corners of the mouth;
• change in nails – striation and concavity of the nail plates, they become soft and brittle;
• changes in hair, which also become brittle, dull, the ends may split, begin to fall out excessively;
• appearance of muscle weakness;
• change in taste – craving for chalk, clay;
• change in smell – there is an addiction to the smells of varnish, paint, acetone.

Causes of iron deficiency anemia

Many causes can lead to iron deficiency anemia. These can be known causes such as: eating foods low in iron, poor absorption of iron, increased need for iron, or bleeding. But, there are reasons that few people know about, for example, endocrine diseases such as diabetes or hypothyroidism.

Most often, iron deficiency anemia occurs in vegetarians and vegans, who limit or exclude animal products.

Another reason may be substances that are part of the products and interfere with the absorption of iron. For example, “phytates” found in nuts, some vegetables or grains. They form a compound with non-heme (3-valent) iron, which makes it even more insoluble. Or the “polyphenols” found in tea or coffee. Iron absorption is also inhibited by dietary fiber and soy products.

In addition, the absorption of iron in the body is directly related to the condition of the intestines, where this trace element is absorbed. Therefore, diseases such as Crohn’s disease or ulcerative colitis, as well as the syndrome of excessive growth of bacteria in the small intestine, helminthic invasions or surgical interventions (gut resection) will significantly reduce iron absorption, provoking the development of iron deficiency anemia.

In addition, there is also a protective reaction in the body that prevents excessive intake of iron: as soon as it begins to be absorbed from the intestines in large quantities, the liver produces hepcidin protein, which blocks the absorption of this microelement. Therefore, it is absolutely pointless to load your body with a large amount of iron – it simply will not be absorbed.

However, low iron content in foods or poor absorption is not the most common cause of iron deficiency anemia. Most often, this disease occurs due to the development of bleeding. In this case, the bleeding does not have to be massive, it can be a slight “corrosion” for a long time, for example, with erosive gastritis, hemorrhoids or bleeding gums. There are also physiological causes of bleeding – these are childbirth or monthly menstrual bleeding. Therefore, very often iron deficiency anemia occurs in women of childbearing age.

Endocrine causes of anemia

But these are all well-studied causes of iron deficiency anemia. Recently, more and more attention has been paid to endocrine diseases, primarily type 2 diabetes mellitus and hypothyroidism, since iron deficiency anemia is much more common in these diseases.

Over the past decades, type 2 diabetes has spread so rapidly that it has reached the limits of an epidemic. At the same time, it turned out that the number of patients with iron deficiency anemia also increased with it. And it was especially common among patients with diabetic kidney disease. The exact cause of anemia in diabetes has not yet been established. It is believed that this may be due to a decrease in the production of erythropoietin in the kidneys, a hormone that stimulates the formation of red blood cells in the bone marrow. Another cause of anemia can be an inflammatory process that often accompanies obese people. And, as you know, most patients with diabetes mellitus 2 just have problems with weight.

Iron deficiency anemia can lead not only to severe complications in the body, but also be the cause of a false diagnosis, namely diabetes mellitus. With a low level of hemoglobin in the blood, the level of “glycated hemoglobin” begins to falsely increase – an indicator that reflects the average blood glucose level over 2-3 months. Since this indicator is used to establish a diagnosis or evaluate the effectiveness of hypoglycemic therapy, you should first compensate for the lack of iron, and only then investigate this indicator.

Severe deficiency of thyroid hormones, called hypothyroidism, can also cause iron deficiency anemia. The fact is that thyroid hormones (T3, T4) control the metabolic processes in the body, which accelerate with an excess amount of hormones and, conversely, slow down with a lack of hormones. Therefore, as soon as the level of thyroid hormones decreases, the metabolic processes in the cells begin to slow down. Of course, this also affects the work of the gastrointestinal tract, in which the lack of nutrients leads to thinning of the walls of the stomach and intestines, which is why the absorption of iron is disturbed. Another factor in the development of iron deficiency anemia in women is menstrual bleeding, which, with hypothyroidism, becomes longer and more abundant.

Why is iron deficiency anemia dangerous?

Generally, most of the symptoms of iron deficiency anemia are reversible with prompt treatment. Especially when it comes to mild anemia (hemoglobin level from 90 g/l) or moderate severity (hemoglobin level from 70 to 90 g/l).

And serious complications most often develop with a long course of anemia and with its severe degree, when the hemoglobin level does not rise above 70 g / l. Complications primarily affect the heart, in which dystrophic changes appear, leading to the development of heart failure. In severe iron deficiency anemia, the immune system is also suppressed, leaving the body susceptible to various bacterial and viral infections.

However, if a person has concomitant diseases, then even a mild degree of anemia can aggravate the course of this disease. This also applies to patients with diabetes.

In addition, anemia is dangerous for pregnant women, since oxygen starvation can lead to impaired fetal development or premature birth.

How to treat iron deficiency anemia?

First of all, the treatment of iron deficiency anemia begins with the elimination of the factor that caused the development of anemia, if this, of course, is possible. For example, eliminating the source of bleeding, or compensating for diseases that disrupt iron absorption in the intestines, or including foods high in iron in the diet.

Features of nutrition in anemia

Of course, in iron deficiency anemia, the diet should be enriched with foods high in iron – red meat, liver, seafood or spinach, pumpkin seeds, broccoli. But this must be done very carefully so as not to provoke an exacerbation of concomitant diseases. Namely, if there are diseases of the cardiovascular system, then you do not need to “get carried away” with animal products – red meat or liver, as this can lead to an increase in the level of bad cholesterol. Also, eating a large amount of fatty foods can provoke problems with the gallbladder and pancreas. If a person has problems with the intestines, then the use of a large amount of plant foods can exacerbate inflammatory processes, further impairing the absorption of iron. Therefore, a combination of products containing both “heme” and “non-heme” iron would be ideal.

In addition, you should try not to combine with products that impair the absorption of iron in the intestines.

Factors that improve iron absorption

We have already mentioned substances that prevent the absorption of iron in the intestines. But there are products that, on the contrary, improve the absorption of this trace element. First of all, these are foods high in vitamin C: sweet peppers, currants, sea buckthorn, parsley, dill, potatoes, citrus fruits. Fermented milk products also improve the solubility of iron. Vitamin C can also be taken in the form of supplements.

All this helps to prevent a further decrease in the level of hemoglobin or erythrocytes. But to replenish iron stores in the body, as a rule, this is not enough, so additional medication is required.

What are iron preparations?

There is a wide variety of iron preparations – they can be divalent or trivalent. As shown by numerous studies, both forms are equally effective in increasing the level of iron in the body. However, ferric iron preparations have some advantages – they do not lead to darkening of the enamel, cause less side effects from the gastrointestinal tract, do not cause an overdose of the drug in children, and also interact less with other drugs. Iron supplements can also be in the form of plain tablets, chewable tablets, or solutions taken by mouth.