A Shift in Perspective

By Ginette Biro, B.Kin

Anemia affects more women worldwide than we realize. It is something we still feel we have to keep under wraps, because in most cases it is connected to our menstrual cycle. To put it bluntly, if you bleed a lot you are most likely anemic. In the previous article, Do You Question the Period, we talked about why asking your clients about their menstrual cycles is important, and we covered the physiological limitations to clients and athletes with anemia. So for this article, let’s talk about the next steps. What do you need to know if you or your client gets a diagnosis of anemia? How can you help them? And most important, what is within your scope of practice?

As always, I like to review some of the science so we so we can set a great foundation for understanding. Iron is a trace mineral, that in most cases we need very little of. We do not need to supplement with iron if the body is working in harmony and we have a proper diet, besides perhaps the small amount found in our standard multivitamin. The important thing to note though is that iron cannot be made in the body. It is a singular element that does not change structure in the body, and therefore our only way to get iron is to ingest it via food, supplements, and in more severe cases, injection or infusion.

Let’s look at our food options first. The most easily absorbed forms of iron come from heme iron. This is the iron that comes from animals, however, some forms will have more than others. Red meat is the most common source and liver carries the highest volume. Even bone broths provide a source of heme iron that is beneficial to the body. This is a great option for omnivores, however, for those that are vegetarian or vegan, this is a no go. Plant based irons are a good alternative, but it’s important to note that they are not as readily absorbed as heme based iron. We need to take in more plant based iron than heme iron to attempt to absorb the same amount. This can get tricky, because then we come across the limitation of total food volume. Dark leafy greens, oatmeal, and raisins are a few good options for iron sources, and nowadays the food industry has created iron fortified foods to provide us with more options. So, for some people anemia can be treated and reversed through diet alone! Hurray! However, this is not the case for everyone.

Some people will have no problem taking an iron supplement. They will add it to their vitamin regime, their levels will go up over a few months, and then they can stop that supplement until a time comes, when and if, they might need it again. This is a beautiful scenario. This means this person has a strong enough digestive system to break it down and the body is working as an efficient machine to absorb it and little goes to waste. I’m saying this because for many others the journey of iron is not as seamless. Many iron supplements can cause stomach upset, cramping, and the most common issue is constipation. You can tell right away that your body is not absorbing iron properly if suddenly your poops become jet black and very firm. This is a heads up to try another brand or an over the counter version.

When taking an iron supplement it is important to take it with a lot of water, as water is your best way to avoid constipation. In addition, something as simple as taking it with orange juice can maximize your body’s potential to absorb it. This is something we can easily recommend to our clients if their doctors have recommended an iron supplement. The acid in citric juices helps to increase iron absorption in the body, therefore decreasing the amount that is eliminated. Another easy suggestion is to recommend that they do not take their iron supplement within a few hours of drinking coffee or having any dairy products. Caffeine and calcium have been shown to decrease iron absorption when ingested together. Even pairing your iron supplement with a calcium supplement will have the same effect. And finally, many iron supplements recommend they be taken on an empty stomach. This can work for some people, however, if this is the chosen method for your client and they seem to be having difficulty, you could suggest they try taking it at night before bed or with a small amount of food. These simple recommendations can help your clients figure out their best method so that supplementation does not create a whole list of secondary issues.

With all this knowledge, it is important we touch on scope of practice. Diagnosing anemia can only be done with a blood test. We can suspect it and recommend our clients see their doctor for a blood test, however, we can not simply suggest they add an iron supplement. Iron can be toxic and the tricky part is that in the case of Hemochromatosis (too much iron), people will present with similar symptoms as anemia. For those who are certified as a Healthy Eating and Weight Loss coach with canfitpro, you will enjoy the success accompanying the following principles from the “wheel of integrated nutrition” and the suggestions that will aid in everyone’s nutrition goals, especially those ailing from anemia and other challenges. Knowledge is power and the more you know the better you can guide your clients on their journeys to health and wellness.


With a Bachelors degree in Kinesiology, Ginette brings her experience to training clients with secondary stage injuries, world class level athletes, and everything in between. She presents at numerous conferences and events across western Canada. Ginette is passionate to share her knowledge and first hand experience. She is currently writing a book on mind-body-spirit wellness.