Iron deficiency and anemia are two significant risk factors for dementia. This is a major public health concern, as rates of both dementia, including Alzheimer's disease, continue to rise. Iron deficiency is the most common micronutrient deficiency worldwide, and it can have a serious impact on cognitive function. Because its primary role is to help shuttle oxygen to the brain, it should be of top concern for those at risk. Let's find out who should be most concerned with iron levels, how to improve iron status, and what proactive measures you can take to protect against cognitive decline.

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Iron deficiency is the most common nutrient deficiency in the world

More than 10 million people in the U.S. are iron deficient, with about half of those having iron deficient anemia—a condition that results in insufficient hemoglobin for red blood cells. Iron deficiency can have a serious impact on cognitive function, and severe iron deficiency can cause serious effects including heart problems, pregnancy complications, and developmental delays.

Iron is essential for the production of hemoglobin, which is a protein responsible for carrying oxygen to the brain. When iron levels are low, the brain doesn't get enough oxygen, and this can lead to cognitive impairment and even dementia. Anemia, a condition characterized by low levels of hemoglobin, is also linked with cognitive decline.

Studies have shown that iron deficiency is a risk factor for Alzheimer's and other types of vascular dementia (1). Low levels of iron can lead to inflammation in the brain, which has been linked with Alzheimer's disease.

Read more: New Clues About Alzheimer’s Risk

Lack of iron causes iron deficiency anemia

Anemia is a condition where there is a decrease in the number of oxygen-carrying red blood cells, or hemoglobin.

Anemia can occur as a result of certain infections, autoimmune disease, or some medications, but it can also be caused by a lack of iron in the diet. This is known as iron deficiency anemia. When there is not enough iron in the body, red blood cells cannot be produced properly. This can lead to fatigue, weakness, and other symptoms.

Anemia can also cause cognitive impairment, including memory loss, confusion, and trouble concentrating.

Neurological symptoms associated with anemia

In addition to cognitive impairment, anemia can also cause other neurological symptoms, like:

Headaches
Dizziness
Cold hands and feet
Pale skin
Irritability

These symptoms are caused by the lack of oxygen that is being delivered to the brain. If you are experiencing these symptoms, it is important to see a doctor to get checked for anemia.

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Anemia doubles the risk of dementia

In several large studies, people with anemia have been up to twice as likely to develop any type of dementia than those who did not have anemia (2). One study in particular found that people with anemia were 41 percent more likely to develop Alzheimer's disease, and 34 percent more likely to develop any type of dementia than those who did not have anemia (3).

Researchers are still working to fully understand the mechanisms that link anemia to dementia, but they do have several theories:

First, the chronic brain hypoxia associated with anemia (4).
Second, anemia due to chronic kidney disease.
Third, anemia due to deficiency of micronutrients such as iron and vitamin B12.
Finally, it is also possible that anemia is an overall indicator of poor health, as other studies have demonstrated that dementia is often associated with a range of age-related health issues.

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How does iron-deficiency anemia develop?

Normally, a well-balanced diet brings in plenty of iron to make hemoglobin and keep your iron stores full. Iron deficiency anemia occurs when there’s not enough iron in your diet, or your body exhausts your iron storage before they can be replenished. This doesn’t happen all at once, but progresses in three stages:

First stage: Lowered total-body iron stores. Early on, the supply of iron to produce hemoglobin and healthy red blood cells is reduced but you’re probably not yet feeling any physical symptoms.

Second stage: Iron storage is low, and so is red blood cell production. The supply of iron isn’t enough to make new red blood cells, but the body tries to compensate by using other methods which is sometimes called latent iron deficiency.

Third stage: Iron-deficiency anemia develops. Hemoglobin concentration drops below the normal range, and you’ll likely begin to notice iron deficiency anemia symptoms like fatigue, chest pain, headaches, or cold hands and feet.

Struggling with chronic fatigue? Learn more about functional treatment.

Anemia is sometimes caused by deficiencies of vitamin B12

In addition to iron, anemia can also be caused by deficiencies of vitamin B12 or folate. Vitamin B12 and folate are essential for the production of red blood cells. Incidentally, vitamin B12 deficiency has also been associated with the development of Alzheimer’s and vascular dementia (5).

Vitamin B12 deficiency is most common in older adults, as it can be more difficult to absorb this nutrient as we age. Vitamin B12 deficiency can also be caused by certain medications, such as metformin and long-term use of proton pump inhibitors or acid blocking drugs which treat GERD or reflux.

Folate deficiency is more common in pregnant women and people with chronic illness, and these groups have an increased need for this nutrient.

It’s important to note however that current studies do not prove that either low iron, excessive iron, or anemia directly cause Alzheimer’s or other forms of dementia—only that there is a link between them. More research is needed to fully understand the mechanisms that drive the development of cognitive decline, and whether hemoglobin levels could be used as a biomarker for various types of dementia.

Diagnosing iron deficiency anemia

There are several tests that can be used to diagnose iron deficiency anemia (6):

Complete blood count (CBC): A very common test for measuring the number and types of cells in your blood.

Hemoglobin level: This test measures the amount of hemoglobin in your blood, which is the protein in red blood cells that carries oxygen to organs and tissues, including the brain.

Serum iron level: A measurement of iron available in your body. Low iron level indicates iron deficiency anemia.

Ferritin: This test measures iron stores in your body. A low ferritin level usually indicates iron deficiency anemia.

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Increase iron intake to prevent iron deficiency & iron deficiency anemia

Anemia can be treated with iron supplements and by eating foods that are high in iron, such as:

Red meat, poultry, or pork
Grass-fed beef or chicken liver
Oysters, mussels, and clams
Dark leafy greens
Beans

When consuming plant-based sources of iron (non-heme iron), eating vitamin C-rich foods at the same time can help improve absorption. Some people with anemia may also need IV therapy to improve iron levels.

Who should be concerned about iron status?

Iron-deficiency anemia is most common in pregnant women, young children, and people with chronic illnesses. Women over the age of 65 may also be at increased risk for iron deficiency.

If you’re at increased risk for iron deficiency anemia, your doctor may recommend that you boost iron intake daily with iron supplements or consume foods that are high in iron.

What conditions make it hard for my body to absorb iron?

For some people, even though iron intake is sufficient, the body isn’t able to properly absorb it. There are several reasons for this, including:

A digestive condition like celiac disease, autoimmune gastritis, or inflammatory bowel disease like ulcerative colitis, or Crohn’s disease.
H. pylori infection.
Weight loss surgery such as gastric bypass.
Certain genetic conditions.

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Protect against dementia with integrative medicine

Research has shown that integrative medicine approaches, including diet and lifestyle changes, can help improve risk factors for cognitive decline and dementia. To reduce your risk:

Eat a well-balanced diet with plenty of quality proteins, fruits and vegetables, and healthy fats. Limit processed carbohydrates and sugar.
Talk to your doctor about testing iron levels, plus any other preventative screenings for cognitive function.
Stay active to increase blood flow to the brain and other tissues.

While there is still much to learn about the relationship between iron deficiency and cognitive decline, there are some things you can do to reduce your risk. One of these is ensuring that you have a healthy intake of iron and other essential nutrients. If you’re experiencing any symptoms of low iron, be sure to speak with your doctor—early diagnosis and treatment is key in preventing cognitive decline. By taking steps now to keep your brain healthy and well-nourished, you’ll be doing everything possible to protect yourself from these devastating diseases down the road.

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About
the author

CentreSpring MD, formerly known as Atlanta Center for Holistic and Integrative Medicine, provides the best medical care by using an integrative approach to find a patient’s centre—their core—empowering them to spring forth into health.

Blog Reviewed By:

Dr. Taz Bhatia, M.D.

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At CentreSpringMD, we do medicine differently. Our focus is on giving you hope and your life back.

Our team of dedicated board-certified providers relentlessly pursue your health until you have the answers that you deserve to change the trajectory of your health—and your life.

This Common Nutrient Deficiency Increases Dementia, Alzheimer’s Risk