Is iron deficiency an after effect of COVID infection? Experts answer, shed light on the signs, sources and supplementation

Iron deficiency is a condition that occurs when the body lacks sufficient iron levels in the body, limiting it to perform vital functions and posing several health risks.

The human body requires iron to make hemoglobin, a protein in the red blood cells that helps carry oxygen from the lungs to every part of the body, and myoglobin, a protein that provides oxygen to the muscles. This is why, if loss, insufficiency or poor absorption of iron is not sufficiently compensated with an iron-rich diet, one may fall into a state of iron deficiency.

However, as simple as it sounds, iron deficiency is as complicated a condition. While it most often occurs when our body does not get enough iron from the foods we eat or does not absorb the mineral efficiently, it can also transpire when the body has enough iron, but cannot effectively carry it into the cells. This is mostly the case with people suffering from chronic infections or underlying diseases such as cancer.

In light of the pandemic, researchers have looked into the ways COVID-19 has affected different parts and aspects of our body including iron metabolism – the set of chemical reactions that maintain human homeostasis of iron at the systemic and cellular level.

Is there a possible link between COVID and iron deficiency?

Dr. Ankita Baidya, Consultant – Infectious Diseases, HCMCT Manipal Hospitals, Dwarka says, “Different studies have found increased inflammatory markers in severe COVID-19 patients, which actually produce hepcidin – an important chemical released from the liver, which helps in regulating and absorbing iron in cells.”
According to her, this is a very commonly studied pathway when it comes to bacterial infection. But somehow, it has also been noted with COVID, wherein there is a decrease in the serum levels, leading to iron deficiency.
Furthermore, she explains that patients with severe COVID-19 infection also tend to have some high form of ferritin levels, which is a blood protein that contains iron. But rather than indicating iron sufficiency, she shares that it is indicative of acute phase reactants (APR), which are inflammatory markers that exhibit significant changes in serum concentration during inflammation.

Additionally, Ms. Edwina Raj, Senior Clinical Dietician, Aster CMI Hospital, Bengaluru discusses the cause of iron deficiency post COVID-19 infection. She says that it could be due to prolonged and severe inflammation in the body. Given that the body is still battling the infection, dealing with imbalance in nutrients, or experiencing any blood loss, especially in the case of women, deficiencies are likely to occur, she explains.
“This disruption in iron metabolism can impact overall well being and delay your recovery from illness,” she explains.
“Patients recovering from COVID-19 continue to report severe fatigue, breathlessness, poor appetite, chest pain, dizziness, cognitive dysfunction and hair loss,” she adds.
Signs of iron deficiency and foods to treat it
“Fatigue is the most common symptom of iron deficiency,” says Dr S.N. Aravinda, Consultant – Internal Medicine, Aster RV Hospital.
Other symptoms include weakness, pale skin, chest pain, fast heartbeat or shortness of breath, headache, dizziness or lightheadedness.
Meat, chicken, leafy greens like spinach, kale, beet, broccoli, legumes, tofu, nuts, dry fruits are the best sources of iron, the doctor recommends.
Clinical Dietician, Edwina Raj explains, “Iron is a complex nutrient, as its absorption and utilization in our body depends on various factors and natural sources are safe to boost your intake of iron , folic acid , protein and vitamin B12 which are supportive nutrients for iron synthesis in our body.
“Iron from animal sources is known as heme iron and is found in meat and fish. Iron from plants is known as nonheme iron, and is found in certain vegetables and in iron-fortified foods . Heme iron (animal source) is better absorbed by the body than nonheme iron (plant source) , as it requires vitamin C for enhancing its absorption in our body, she further elaborates.
Some of the animal sources include egg yolk , chicken, liver, tuna/fish, shrimp, lamb, spleen or turkey(leg), which should be taken as per your nutritionist’s advice.

Plant sources include sprouts, beans (soya,kidney, lima, navy), garden cress seeds, sesame seeds, nuts, lentils/dals, spinach/shepu/amaranth leaves & other leafy vegetables, brown rice/red rice flakes, niger seeds (uchellu), raisins, figs, dates in moderation .

Beware of toxicity

“It is not recommended to supplement yourself with iron without consulting your Doctor or Nutritionist , as there could be an overload of iron stores or serum ferritin which leads to toxicity and damages organs like liver, lungs and so on,” says Ms. Raj.

As a clinical dietician, she warns against overdose of zinc supplements, which can also hinder the absorption of iron. Therefore, one must check with their health care provider before resorting to supplements.

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