Iron can shift quite a bit throughout pregnancy because of fluctuating hormone and blood levels. Iron levels are typically monitored via hemoglobin. Hemoglobin levels naturally decrease during pregnancy due to shifts in blood volume and hormones.

Hemoglobin production stays the same while blood volume rises. Blood volume is increasing significantly during the third trimester, but since hemoglobin production stays the same, overall hemoglobin levels look lower.

Estrogen continually rises and peaks in the third trimester, which can naturally cause lower hemoglobin because it increases our blood volume amongst many other important functions.

There is also a big transfer of nutrients from mom to baby in the third trimester. During the third trimester, mom is giving the baby a large number of nutrients, including iron and copper. This increases the need for iron and copper during this time as well as vitamin A (vitamin A helps us use copper).

Iron Deficiency In Pregnancy

While hemoglobin is meant to decrease toward the end of pregnancy, there can be reasons for it to go too low:

• Lack of iron rich foods in the diet
• Poor digestion and absorption of iron
  • Inflammation
  • History of gut issues
• Low copper levels
• Low vitamin A levels
  • 1/3 of women have a vitamin A deficiency when they enter pregnancy.

​Iron Labs

• Non-pregnant women’s Hgb: 12.5 – 13.5 mg/dL
• Pregnant women’s Hemoglobin in 1st Half of Pregnancy: 12.5 – 13.5 mg/dL
• Pregnant women’s Hemoglobin in 2nd Half of Pregnancy: I don’t like to see it below 9-9.5 mg/dL
  

Conventional medicine looks at hemoglobin of 8.1-10 as mild anemia. I think it’s so important to keep someone’s health history and current nutrition intake in mind. I would also look at copper, ceruloplasmin, and vitamin A. We have to keep the full picture of each person in mind and not treat a lab value, but understand their nutrition, lifestyle, and health history.

Considerations For Iron In Pregnancy

When it comes to supporting healthy iron levels in pregnancy, we want to first ensure we are getting adequate iron from our diet and that digestion is good.

Iron Rich Foods

• Chicken liver (3oz = 9.9mg iron)
• Oysters (3oz = 5.7mg iron)
• Beef liver (3oz = 5.6mg iron)
• Venison (3oz = 3.8mg iron)
• Beef (3oz = 3mg)
• Sardines (3oz = 2.4mg)

If you need digestive support during pregnancy, you could consider apple cider vinegar, calm tummy bitters from Urban Moonshine, or digestive enzymes.

From there, you would want to get copper and vitamin A from your diet, which you can easily get from beef liver. This could be in food form 1-2x per week or in capsule form from a supplement.

If iron levels are still low, then you can use other strategies:

• Cod liver oil can help support hemoglobin levels along with adequate copper from beef liver and liquid chlorophyll. I’ve had clients use those to bring up levels during the third trimester to avoid unnecessary interventions. I’ve also seen success with spirulina.
• Incorporate blood building herbs: nettles and dandelion.
  • These herbs are also great to incorporate postpartum since you will have had some blood loss during birth.
• Lactoferrin can help increase iron absorption in the intestines and is good for those that have very low levels.
  • Colostrum contains small amounts of lactoferrin as well as whey protein. Paleovalley is my favorite whey protein that has added colostrum. You can use code HORMONEHEALINGRD10 to get a discount.

Learn more about mineral shifts in pregnancy in this podcast episode!

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