Updated: December 20, 2024

Iron deficiency is a significant health concern in India, affecting a substantial portion of the population. According to the National Family Health Survey (2019-21), 57% of women aged 15-49 years and 25% of men in the same age group are anemic. Also, 59.1% of adolescent girls and 31.1% of adolescent boys 15-19 years have moderate to severe anemia. This highlights the importance of appropriate iron dietary supplement intake and, at the same time, presents a great business opportunity in the nutrition supplement sector.

The Role of Iron in Health

Iron is a vital mineral primarily found in the hemoglobin of red blood cells and the myoglobin of muscle cells. It enables red blood cells to transport oxygen from the lungs to tissues throughout the body and plays essential roles in oxygen and carbon dioxide exchange. Foods like meat, fish, tofu, beans, spinach, and fortified cereals provide dietary iron. Iron is commonly used to prevent and treat anemia caused by low iron levels or other health conditions such as pregnancy, kidney problems, or heart failure.

Dietary Sources of Iron

Incorporate iron-rich foods into your diet, such as:

• Meats and seafood: Red meat, pork, poultry, and seafood.

• Plant-based sources: Dark green leafy vegetables (spinach, kale), peas, beans, and other pulses.

• Others: Dried fruits (raisins, apricots), seeds, nuts, and iron-fortified foods.

Enhancing Iron Absorption:

Consume vitamin C-rich foods like fruits and vegetables alongside iron-rich foods to improve absorption. Avoid consuming large amounts of tea, coffee, or calcium-rich foods (like dairy products), as they may inhibit iron absorption.

Iron Deficiency

Iron deficiency occurs when the body lacks sufficient iron, leading to reduced red blood cell production and anemia. Causes include poor dietary intake, restrictive diets, blood loss (e.g., heavy periods), inflammatory bowel disease, and increased requirements during pregnancy.

Symptoms

• Fatigue, weakness, and pale skin.

• Chest pain, rapid heartbeat, and shortness of breath.

• Dizziness, headaches, brittle nails, and cold extremities.

• Unusual cravings (e.g., ice, dirt, starch).

Treatment

• Incorporate iron-rich foods into your diet.

• Consider iron supplements to replenish stores.

Iron supplementation is effective for treating anemia due to chronic conditions, pregnancy, or deficiencies and may benefit conditions like restless leg syndrome or cognitive improvement in adolescents.

Uses and Effectiveness of Iron

Effective For:

• Anemia due to chronic conditions: Effective when combined with medications like epoetin alfa or when given intravenously.

• Iron-deficiency anemia: Treatable with oral or intravenous iron.

• Pregnancy-related anemia: Oral iron can reduce the risk of anemia during pregnancy.

Possibly Effective For:

• ACE inhibitor-induced cough: Oral iron might help reduce the side effects of coughing.

• Heart failure: Intravenous iron can improve symptoms and exercise capacity.

• Restless legs syndrome (RLS): Oral and intravenous iron may alleviate symptoms, especially in individuals with low iron levels.

• Cognitive improvement: Oral iron might benefit cognitive function and attention in children and adolescents with low iron levels.

Possibly Ineffective For:

• Iron supplementation during the second trimester doesn't seem to affect pregnancy duration or birth weight.

• ADHD, breath-holding attacks, cancer prevention, fatigue, HIV-related anemia, and physical performance.

Side Effects and Safety

Iron is generally safe when consumed within recommended limits. However, it may cause:

• Stomach upset, constipation, diarrhea, nausea, or vomiting.

• Reduced absorption when taken with certain foods (e.g., dairy, coffee, tea).

Precautions

• Pregnancy and breast-feeding: Avoid doses above 45 mg/day unless medically advised.

• Premature infants: Treat low vitamin E before administering iron.

• For conditions like ulcers or inflammatory bowel disease, use iron cautiously, as it may worsen irritation.

Poisoning

Excessive iron, especially in children, can cause severe poisoning and even death. Doses above 60 mg/kg are dangerous.

Interactions

Be cautious of interactions between iron and certain medications:

• Antibiotics: Quinolone and tetracycline antibiotics' effectiveness may decrease when taken with iron.

• Bisphosphonates, levodopa, and levothyroxine: Iron reduces their absorption.

• Methyldopa, mycophenolate mofetil, and penicillamine: Iron may decrease their effectiveness.

Dosing Recommendations

Adults:

• Iron-deficiency anemia: 50-100 mg of elemental iron three times daily for 3-6 months.

• Pregnancy: 20-225 mg daily (45 mg is recommended).

• RLS: 325 mg of ferrous sulfate twice daily for 12 weeks.

Children:

• Iron-deficiency anemia: 4-6 mg/kg daily in divided doses for 3-6 months.

• Infants 6-12 months: 11 mg/day from food or supplements.

• Toddlers (1-3 years): 7 mg/day from food sources.

Recommended Dietary Allowances (RDA):

• Infants (0-6 months): 0.27 mg/day.

• Older children and adults vary by age and gender (7 mg/day for toddlers; 18 mg/day for women aged 19-50; 27 mg/day during pregnancy).

Tolerable Upper Intake Levels (UL) for iron:

• Infants and children up to 13 years: 40 mg/day.

• Adults (14 years and older): 45 mg/day.

Ensure medical supervision if exceeding recommended limits or for specific conditions.

Business Opportunities in Iron Supplementation

The Indian population still remains largely vulnerable to such health issues as increasing levels of iron deficiency, though the overall concerns over personal health have been growing. This shift is evident in the Indian nutritional supplements industry market, which, based on value, is predicted to be USD 42.97 Billion in 2024 and is expected to reach USD 68.43 Billion in 2030 with a CAGR of 8.1%. Globally, the market for iron supplements has similar trends: USD 2.59 billion in 2023, and with a growth rate of 3.82%, the market will reach USD 3.76 billion by 2033.

To achieve this depth of market, businesses can form partnerships with healthcare providers. It not only strengthens the distribution channels but also gains the confidence of consumers, especially those who tend to consult doctors for their health. Moreover, aligning with government programs, such as anemia prevention initiatives, positions organizations as key players in solving a major social problem and, therefore, enhancing reach and impact.