FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

IRON IN RED MEAT SHOULD NOT WORRY READER

Question: Last month I had a very bad nosebleed and had to go to the emergency room to get it stopped. One of the reasons the nosebleed was so bad is that I'm on Coumadin because of my irregular heartbeat. Now my doctor tells me that I'm slightly anemic, but he thinks it'll be OK in a few weeks after I've recovered from the nosebleed. Here's my question: My son says that I should try to eat red meat a few times a week to help build up my iron, but I'm afraid to do that because I've read that getting too much iron can increase your chances of a heart attack, especially if you're a woman. Do post-menopausal women (I'm 82) really have to worry about their iron levels?

Answer: Anemia can be defined as a reduction in the amount of hemoglobin. Hemoglobin, which contains iron, is the substance in the blood that carries oxygen to cells throughout your body.

For women of reproductive age, the "normal" level of hemoglobin in the blood is usually 12.0 to 16.0 g/dL (grams per deciliter), a value that is a bit lower than is the normal range for men. It is common for both men and women of advanced age to have "normal" values for hemoglobin that are actually a little lower. Consequently, I don't know if your "slight anemia" is truly due to blood loss, or if it is due to using an inaccurate age-based reference standard for normal.

Anemia may occur for quite a few reasons. Bleeding, of course, is one of these. Bleeding causes the blood count to drop quickly, but it also returns to normal as the body makes new hemoglobin and red blood cells. It is likely that you have this form of anemia. This does not imply that you have an iron deficiency.

Iron is an essential component of hemoglobin. Consequently, when the body's supply runs low, the amount of hemoglobin that can be made drops lower than it otherwise would be. Possible causes of iron loss that can lead to iron deficiency, are chronic heavy menstrual bleeding, stomach ulcers, or other conditions that produce bleeding. Cancer in the digestive tract is a common cause for those in your age group. Iron deficiency anemia can also be due to inadequate dietary intake or absorption of iron.

As your son suggested, small quantities of iron are found in red meats. Therefore, consuming them on a regular basis can slowly restore iron levels toward normal. This may be adequate treatment for someone with "slight anemia" As long as you maintain an overall low-fat diet, eating lean red meat once or twice a week to obtain more iron will not cause the heart-related health problems you referred to.

Individuals with more significant iron deficiency anemia are usually treated with supplements in the form of ferrous sulfate, a non-prescription type of iron. Though this drug is beneficial, it is also possible to overload the body with this type of iron by taking it in large amounts over a long period of time. It is probably the danger related to these iron supplements that you read about.

There are a number of risk factors for heart disease such as family history of heart disease, hypertension, diabetes, high cholesterol and use of tobacco. You would be wiser to modify any of these risk factors that are within your control, because their impact has been clearly proven, rather than worrying about the iron in a little meat. Love your son and appreciate his concern for your health, but talk to your doctor about your risk factors for heart disease, your diet and your need for iron.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.