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The Rotterdam Study (1a) confirms several other reports showing that low iron levels help to prevent heart attacks, as long as you are not anemic (1b,2). Furthermore, donating blood lowers blood iron levels and also helps to prevent heart attacks (7).

Before the bad LDL cholesterol can form plaques in arteries, it must be converted to oxidized LDL cholesterol and iron causes this reaction. Lack of iron reduces your chances of forming plaques in arteries to cause heart attacks and strokes (6). Less than 50% of the iron in your body is in your red blood cells. Most is in your iron reserves in your liver, spleen and other tissues. Your body needs iron to make red blood cells and if your body does not contain enough iron, you will become anemic, but, you will not become anemic from iron deficiency until you have depleted all your iron reserves. You can be iron deficient but not anemic, when you have an adequate supply of red blood cells, but no iron reserves. Iron deficiency does not make you tired unless you are also anemic. but it can tire athletes exercising at their maximum (3,4,5).

Routine blood tests measure the size of your red blood cells. If they are small, your doctor will order a test called ferritin to measure iron reserves. If your ferritin is low, your doctor will look for a source of bleeding from menstruation or through the intestinal tract. If no serious source is found, you need no treatment unless you are a highly competitive athlete.

1a) K Klipsteigrobusch, DE Grobbee, JH Denbreeijen, H Boeing, A Hofman, JCM Witteman. Dietary iron and risk of myocardial infarction in the Rotterdam Study. American Journal of Epidemiology 149: 5 (MAR 1 1999): 421-428.

1b) S Kiechl, J Willeit, G Egger, W Poewe, F Oberhollenzer. Body iron stores and the risk of carotid atherosclerosis: Prospective results from the Bruneck study. Circulation 96: 10 (NOV 18 1997):3300-3307. Innsbruck, Austria.

2) DG Meyers. The iron hypothesis - Does iron cause atherosclerosis? Clinical Cardiology 19: 12 (DEC 1996):925-929. At least seven epidemiologic studies have found a positive association between CHD and various indicators of body iron. Conversely, 18 epidemiologic studies have found a negative or no association.

3) YI Zhu, JD Haas. Iron depletion without anemia and physical performance in young women. American Journal of Clinical Nutrition 66: 2(AUG 1997):334-341.

4) Risser Med Sci Spts and Ex. 1988(April);20(2):116-121.

5a) Matter: Clinical Science 1987;72:415-422.

5b) JM Fernandezreal, W Ricartengel, E Arroyo, R Balanca, R Casamitjanaabella, D Cabrero, M Fernandezcastaner, J Soler. Serum ferritin as a component of the insulin resistance syndrome. Diabetes Care 21: 1 (JAN 1998):62-68.

6) Dietary iron and coronary heart disease risk: A study from Greece. American Journal of Epidemiology 147: 2 (JAN 15 1998):161-166.

7) JT Salonen, TP Tuomainen, R Salonen, TA Lakka, K Nyyssonen. Donation of blood is associated with reduced risk of myocardial infarction - The Kuopio Ischaemic Heart Disease Risk Factor Study. American Journal of Epidemiology 148: 5 (SEP 1 1998):445-451.

Checked 6/21/13

May 29th, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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