Resume: Recent research highlights the role of iron, an often overlooked nutrient, in maintaining mental health. Researchers suggest that iron deficiency may exacerbate mental health conditions such as depression and anxiety.
A test result with a low ferritin level, indicating an iron deficiency, calls for an increase in iron levels in the diet and possibly supplements, under professional guidance. This revelation urges caregivers and patients to consider nutritional aspects in mental health care.
- Iron, an essential nutrient for bodily function, is also essential for mental health; deficiencies can exacerbate symptoms of mental illness.
- Ferritin tests, which assess the body’s iron stores, are recommended for individuals with mental illnesses, and provide a more accurate insight than standard iron or hemoglobin tests.
- Iron supplementation has shown improvements in mood and fatigue even in people without iron deficiency anemia, suggesting it may be possible as part of an integrated mental health treatment plan.
Source: University of Michigan
Most people today understand that mental health problems stem from physical differences in our brains, genes and bodies, and differences in our life experiences.
But what you eat and how your body uses the nutrients in your food also matters for mental health.
A growing body of research suggests that one key nutrient – iron – plays an important role, and that too little of it can affect psychological symptoms.
But many people with mental illnesses like depression or anxiety and the health care providers who treat them may not know about this link, says Stephanie Weinberg Levin, MD, a psychiatrist at Michigan Medicine and the VA Ann Arbor Healthcare System.
She delved deep into the subject while doing a fellowship in integrative psychiatry. Recently, she and former resident psychiatrist Theresa Gattari, MD, summarized the current state of knowledge in a review article for their fellow psychiatrists. The article was published inCurrent Psychiatry.
The bottom line: Eating iron-rich foods is important for everyone, and many people don’t get enough iron. But people with mental illness may want to specifically ask their doctor or other healthcare provider to order a blood test that measures their iron levels in some way.
If the result of that test — called a ferritin test — is low, it’s important to get more iron in the diet and take iron supplements if a healthcare provider recommends it.
“Iron is the most common nutrient deficiency and can have a major impact,” Levin said. “You can be iron deficient without being anemic, but many mental health professionals are unaware that iron deficiency per se is linked to worse symptoms, or that supplementation is linked to improved symptoms. But there is evidence for that.”
Primary care providers also shouldn’t order tests of iron levels unless someone has symptoms of anemia, or a health condition or medical treatment known to affect the body’s iron levels, she notes.
“We don’t always look for nutrient deficiencies, but they can really take a big toll on well-being,” says Levin, who also stresses that the role of nutrients in mental health complements the growing knowledge about the importance of stress, sleeping habits and physical activity.
That’s why she encourages people diagnosed with a mental illness to talk to their healthcare team about getting tested and possibly taking supplements.
In addition to its well-known role in helping red blood cells perform the critical function of carrying oxygen around the body, iron helps your body make the molecules needed to make important brain chemicals.
In particular, iron plays an important role in how your body produces the neurotransmitters serotonin, dopamine, and norepinephrine, all of which are important for mental health.
Research suggests a link between low iron levels and symptoms of depression, anxiety and schizophrenia, write Levin and Gattari.
This includes surveys of large numbers of people that showed a higher percentage of people with depression also reported a history of iron-deficiency anemia, and a large study that showed higher rates of anxiety disorders, depression, sleep disorders, and psychotic disorders in patients with iron-deficiency anemia.
Smaller studies in people experiencing their first episode of psychosis also suggest a link between how severe their symptoms were and lower iron levels.
Low iron levels are also known to be associated with fatigue, which is one of the symptoms that can combine with others to qualify someone for a diagnosis of depression.
In addition to studies that have looked at the relationship between iron levels and symptoms, other studies have evaluated what happens when people with mental illness are given iron supplements.
A 2013 review of the evidence showed that iron supplementation was associated with improvement in mental symptoms in three studies published before that year, and others showed improvements in thinking ability.
Multiple studies in people with and without a mental health diagnosis have shown improvements in mood and fatigue after iron supplementation, even if they did not meet criteria for iron deficiency anemia.
One study showed improvement in half of those whose ferritin levels were below 100 nanograms/milliliter, which is above the 30 ng/ml level commonly used to define iron deficiency.
Ferritin levels are important to measure because they are an indicator of the body’s overall iron stores — the ferritin molecule keeps iron stored in a protein shell so it’s accessible when the body needs it.
Blood tests for iron only measure the level of iron in the blood, and blood tests for hemoglobin only measure the amount of iron-containing protein molecules in the blood that carry oxygen to the body.
Levin especially recommends ferritin testing for people who have both mental illness and another factor that makes them highly susceptible to low iron levels. That includes pregnant women, young children, women with heavy menstrual bleeding, frequent blood donors, cancer patients, individuals who have had gastrointestinal surgery or have digestive disorders, and people with heart failure.
For anyone with mental health symptoms whose ferritin levels have been tested low, there is still no consensus on the optimal level to aim for through dietary changes and supplementation, nor how often to test after making changes.
There is also no evidence yet about the effects of low iron or iron supplementation on people with mental illnesses other than those listed above.
In general, Levin says, it may be better to aim for a ferritin level of 100 ng/ml and get tested every 4 to 6 weeks.
It is also important that your GP knows about any supplement you are taking, even if it has been recommended by a health care professional or if you have started taking it yourself.
There’s a risk of overdoing it with iron supplements, warns Levin, so it’s important to read the label on the supplement and choose a brand that has been tested by an independent organization.
If you have toddlers or young children in the home or visiting, it is also important to keep iron supplements out of reach, as they can cause serious and even fatal poisoning if taken by a very young child.
But overall, she said, “Iron supplements are cheap and can really have a big impact on someone’s mental health if they’re deficient.”
About this news about mental health research
Author: Stephanie Weinberg Levin
Source: University of Michigan
Contact: Stephanie Weinberg Levin – University of Michigan
Image: The image is credited to Neuroscience News
Original research: Open access.
“Iron deficiency in psychiatric patients” by Stephanie Weinberg Levin et al. Current Psychiatry
Iron deficiency in psychiatric patients
Nutritional deficiencies are one of many causes of or contributors to symptoms in patients with psychiatric disorders. In this article, we discuss the prevalence of iron deficiency and its association with poor mental health, and how proper treatment can improve psychiatric symptoms. We also offer suggestions for how and when to test and treat iron deficiency in psychiatric patients.
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