Iron levels during pregnancy: how do you know if you are deficient?

Iron is essential during pregnancy for the mother's health as well as for the growth and development of the foetus. 

During pregnancy, an adequate intake of iron is essential to meet the increased demand for oxygen consumption [2]. 

In cases of mild iron deficiency in the mother, iron is prioritised for the foetus. However, in cases of moderate or severe iron deficiency, the entire maternal-placental-foetal unit becomes iron-deficient, with significant short- and long-term consequences for the foetus. Iron deficiency is associated in particular with an increased risk of premature birth or low birth weight [3]. 

Although iron deficiency is more common, it is also possible to have an excess of iron. Iron excess is equally harmful during pregnancy, as it causes oxidative stress, induces cellular damage, and is associated with various health concerns, including cardiovascular risk, gestational diabetes, and foetal complications [4]. 

A full blood panel to assess iron requirements can help you decide whether to take a iron supplement for pregnant women or not, depending on her individual needs. 

There are several different blood tests that can determine the amount of iron in your body [5]: 
A serum iron test - measures iron in the blood.
Ferritin measurement - measures the amount of iron stored in the body.
A transferrin measurement - measures your body's capacity to transport iron in the blood.
The total iron-binding capacity (TIBC) test is another way of measuring how efficiently the body transports iron.
Transferrin saturation - a calculation used to determine the percentage of transferrin saturated with iron.
Haemoglobin measurement: measures the amount of haemoglobin (the protein that carries oxygen) in your blood [6].
Haematocrit: percentage of red blood cells in the blood
Ceruloplasmin measurement: an enzyme that enables iron to be transferred from tissues into the blood [7].

It is important to look beyond standard laboratory tests, which are not necessarily sufficient to assess the full picture regarding iron, and simply taking iron supplements is not always the solution. 

Copper: necessary for iron transport via caeruloplasmin.

Vitamin A: although vitamin A alone cannot correct anaemia, it plays a role in iron utilisation and it is important to assess it, as a vitamin A deficiency can worsen anaemia [8].

Vitamin D : a vitamin D deficiency can lead to a deterioration in iron status and increase the risk of anaemia [9]. Our vitamin D pregnancy will help to meet your needs. Our pregnancy food supplement also contains it.

Since iron depends on other nutrients that act in synergy with it for absorption and assimilation into cells, it is important to know whether these levels are low, as they could also affect your body's ability to absorb and use iron. If you only know that your iron levels are low, but are not aware of all the underlying causes, you may not be able to resolve the issue with an iron supplement alone, and it may be necessary to also take a fatigue supplement containing vitamin D, A or copper. 

Iron is an essential nutrient whose balance must be maintained both before conception and throughout pregnancy.

Iron deficiency is particularly common during pregnancy, as iron requirements increase considerably due to the expansion of blood volume. However, elevated iron levels are also possible, so it is important to assess your iron status before taking a iron supplement.

To get a full picture of what is happening with iron in your body, it may be beneficial to carry out a comprehensive iron panel, which includes iron, ferritin, transferrin saturation, TIBC, haemoglobin, haematocrit, copper, ceruloplasmin, vitamin A and vitamin D. Imbalances in these elements interfere with your body's ability to transport or use iron appropriately. 

Remember to take it separately from your pregnancy vitamin if it contains zinc or calcium, to avoid interactions.