How to Prevent Iron Deficiency Bruising

Out of all the reasons for bruising, iron deficiency is a common one. If you notice easy bruising and have low iron levels, improving iron stores may help prevent future skin bruising and other symptoms of iron deficiency.

Today’s article will walk you through what you need to understand about bruising and iron, including:

• What is a bruise
• Common causes of bruising (and when to talk with your doctor)
• What is iron deficiency
• Symptoms and underlying causes of iron deficiency
• Action items for improving iron levels
• Iron supplementation

 Let’s get started!

How Bruising Happens

Bruising occurs when small blood vessels, called capillaries, break near the skin’s surface in response to a physical injury, like bumping your elbow on a door frame. Blood leaks under the skin, and the immune system swoops in to repair the damage. The result is skin discoloration, often blue or brown, and skin that is painful to the touch. Typically, a bruise will resolve with a little time.

What Causes Bruising

In medicine, there isn’t much we can do for a bruise once it’s there other than give it time to heal. However, when we understand the underlying cause of bruising and address it, we prevent future bruises.

Here are some factors that may contribute to easy bruising:

• Medication use. Certain medications, including NSAIDs (aspirin, ibuprofen), blood thinners, corticosteroids, certain antidepressants, and specific antibiotics, may increase bruising risk. (Source 1)

• Vitamin C deficiency. Collagen production requires Vitamin C, and without enough, the body can’t produce and repair collagen in the skin, leading to a weaker skin structure that is more prone to bruising. (Source 2)

• Vitamin K deficiency. Vitamin K1 is critical for proper blood clotting, where platelets adhere to each other. Symptoms of vitamin K deficiency include bruising and bleeding. (Source 3)

• Advanced age. Bruising may be more common in older adults because of weak capillaries, collagen loss, nutrient deficiencies, and medication use.

• Iron-deficiency anemia. Without enough iron to build hemoglobin, red blood cells will be in low supply, decreasing the oxygenation of tissues and increasing the susceptibility to bruising.

Unexplained bruises could also signify a more serious problem with blood platelets, liver disease, or other medical issues. Please work with your healthcare provider to thoroughly evaluate the cause of your bruising, including a review of family history, and a referral to hematology if necessary.

Iron Deficiency and Bruising

Let’s take a closer look at iron deficiency, one of the underlying causes of bruising.

Hemoglobin production requires iron. Hemoglobin is the protein inside red blood cells that carries oxygen through the blood. We obtain iron through our diet. Iron deficiency results when we don’t have enough iron to meet our needs.

Iron deficiency anemia, also known as iron deficiency anemia, is the most common type of anemia worldwide. Anemia occurs when you don’t have enough healthy blood cells. Other causes of anemia are vitamin B12 deficiency, folate vitamin deficiency, autoimmunity, or other factors. (Source 4)

Anemia may affect up to 25% of people globally, with iron deficiency being the cause of half the cases. (Source 4)

Iron deficiency anemia is diagnosed by measuring iron levels via blood tests. The criteria for iron deficiency anemia is when hemoglobin is at or below 13 g/dL (130 g/L) for men and 12 g/dL (120 g/L) for women. (Source 5)

It’s important to note that you can have iron deficiency and related symptoms without an iron-deficient anemia diagnosis. Ferritin, the iron storage molecule, will deplete well before hemoglobin gets low and is the most sensitive test for iron deficiency. Ferritin levels above 45 μg/L are optimal. (Source 5, 6)

 (Get all the functional lab ranges for iron labs here.)

Iron Deficiency Symptoms

Along with bruising, symptoms of iron deficiency and iron deficiency anemia include:

• Fatigue
• Shortness of breath
• Hair loss
• Constipation
• Cold hands
• Pale skin
• Rapid heartbeat
• Weakness
• Brittle nails
• Cravings for ice or dirt

Iron Deficiency Causes

If iron deficiency is the cause of bruising, we need to peel back another layer to understand what is causing iron deficiency.

Possible causes of iron deficiency include:

• Low dietary intake of iron. If you don’t eat as much iron as your body needs, you’ll become deficient. You may be more susceptible to deficiency if you are following a vegetarian diet, vegan diet, or another dietary pattern that restricts high-iron foods. (Source 7)

• Blood loss. Heavy periods (menorrhagia), oral ulcers, and GI bleeding are some of the ways people lose blood and, therefore, lose iron.  (Source 4, 8)

• Increased iron requirements. Iron needs significantly increase during pregnancy, making it harder to get enough through food alone. (Source 4)

• Decreased iron absorption. Even if you are eating enough iron in your diet, you may not be absorbing it into your body because of gut issues such as celiac disease or parasitic infection. (Source 4)

How To Prevent Iron Deficiency Bruising

Addressing the underlying factors contributing to iron deficiency will help prevent iron deficiency symptoms and restore iron levels if symptoms are already present. Here’s how:

• Eat enough iron-rich foods. Heme iron, found in red meat, shellfish, and other animal products, is the most well-absorbed form of iron. These are good sources of iron to include occasionally in the diet. Plant foods such as cereals, green leafy vegetables, and legumes contain non-heme iron and are still actually very beneficial, especially when paired with foods high in vitamin C. In fact, too much heme-iron has been implicated in several inflammation-based chronic diseases such as cardiovascular disease, cancer and diabetes. Because we are at a time where we can’t deny the negative impact of excessive intake of red meat on our health or planet, taking supplemental iron to help address deficiency is really imperative.

• Address medical issues. Work with your doctor to uncover any hidden sources of blood loss or health conditions. Address the root causes of heavy menstrual bleeding.

• Improve gut health. A healthy gut microbiome and digestive function help ensure you are absorbing iron from your diet. Work with a functional medicine provider for personalized guidance. Here are some tips for healing leaky gut.

• Have a plan for pregnancy. Most prenatal vitamins contain iron, and your provider may recommend an additional iron supplement to meet your needs during pregnancy.

• Monitor iron levels. Ask for a full iron panel, including ferritin, for a complete assessment of your iron status. This is especially important if you are working to replete iron levels, are planning pregnancy, pregnant, have heavy periods, regularly donate blood, or have another reason for monitoring iron levels.

Iron Supplements

Iron is a goldilocks nutrient, meaning that you don’t want levels too low, but you also don’t want too much iron as iron can be inflammatory. However, if iron is low, supplementing is the best way to increase levels quickly and resolve associated symptoms.

The main side effects of iron supplements include nausea, GI changes (constipation or diarrhea), abdominal pain, and headaches. In addition, iron in supplemental form often has poor absorption leading to black, tarry stool. (Source 9)

These side effects make supplementation challenging, especially if you are pregnant or already have compromised digestion.

The solution for improved iron tolerance and poor absorption is to choose the liposomal form of dietary supplements and other over-the-counter treatments. In this preparation, liposomes are fatty membranes that mimic your body’s cell membranes, encapsulate nutrients.

CoreMed Science’s Liposomal Iron harnesses the innovative liposomal delivery method to improve absorption, tolerance, and bioavailability. In fact, liposomal iron is more effective than standard iron supplements. (Source 10)

Iron is essential for overall wellness because it helps deliver oxygen to every cell in the body. Without enough iron, you’ll feel tired, weak, and more prone to bruising. Implementing these strategies and including a quality iron supplement will help prevent iron-deficiency bruising and restore iron levels so you can feel better soon.

References

1. Mayo Clinic. Easy Bruising: Why Does It Happen? Accessed 1/20/23. Full text: https://www.mayoclinic.org/healthy-lifestyle/healthy-aging/in-depth/easy-bruising/art-20045762
2. Linus Pauling Institute Micronutrient Information Center. Vitamin C. Accessed 1/20/23. https://lpi.oregonstate.edu/mic/vitamins/vitamin-C
3. Linus Pauling Institute Micronutrient Information Center. Vitamin k. Accessed 1/20/23. https://lpi.oregonstate.edu/mic/vitamins/vitamin-K#deficiency
4. Warner, M. J., & Kamran, M. T. (2022). Iron Deficiency Anemia. In StatPearls. StatPearls Publishing.Full text: https://www.ncbi.nlm.nih.gov/books/NBK448065/#_NBK448065_pubdet_
5. Soppi E. T. (2018). Iron deficiency without anemia - a clinical challenge. Clinical case reports, 6(6), 1082–1086. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5986027/
6. Killip, S., Bennett, J. M., & Chambers, M. D. (2007). Iron deficiency anemia. American family physician, 75(5), 671–678. Full text: https://www.aafp.org/pubs/afp/issues/2007/0301/p671.html
7. Pawlak, R., Berger, J., & Hines, I. (2016). Iron Status of Vegetarian Adults: A Review of Literature. American journal of lifestyle medicine, 12(6), 486–498. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6367879/
8. K, S., B, S., Palaneeswari M, S., & Devi A J, M. (2014). Significance of ferritin in recurrent oral ulceration. Journal of clinical and diagnostic research : JCDR, 8(3), 14–15. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4003613/
9. Low, M. S., Speedy, J., Styles, C. E., De-Regil, L. M., & Pasricha, S. R. (2016). Daily iron supplementation for improving anaemia, iron status and health in menstruating women. The Cochrane database of systematic reviews, 4, CD009747. Abstract: https://pubmed.ncbi.nlm.nih.gov/27087396/
10. Baomiao, D., Xiangzhou, Y., Li, L., & Hualin, Y. (2017). Evaluation of iron transport from ferrous glycinate liposomes using Caco-2 cell model. African health sciences, 17(3), 933–941. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5656219/