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Iron – Nutrient Deficiencies found in Children with Symptoms of ADHD (Part 3)

Iron - Nutrient Deficiencies found in Children with Symptoms of ADHD (Part 3)

Multiple studies have demonstrated that children with symptoms of ADHD and other learning disabilities have low iron stores, and that increasing their iron stores with supplementation and/or diet improves symptoms such as verbal learning and memory.1 2 3 4

One of the studies showed that children do not even need to be anemic in order to benefit from iron supplementation 5. This highlights the need to attain functionally optimal levels of iron in order to support brain function in our children. However, it is also important to be mindful not to supplement without monitoring iron levels, as iron overload can also be problematic.

This overview of iron deficiency in children with ADHD will help you understand the role of iron in the body, what happens when iron levels are not optimal, how to detect suboptimal levels, and what to do when you discover iron deficiency.

in a nutshell
  • Iron is a mineral found in every cell in the body. It plays a major role in carrying oxygen throughout the body and delivering it to the brain.
  • Iron deficiency anemia is the most common type of anemia.
  • A child may be functionally anemic even when they are not considered to be anemic by standard blood tests. Achieving functionally optimal iron levels is key.
  • Blood tests will help determine your child’s iron levels so that you can attain optimal functional iron levels.
  • Simple steps can be taken to correct iron deficiency anemia by increasing iron intake and decreasing intake of foods, supplements, and medications that decrease iron absorption.

What nutrients are often found to be deficient in children with ADHD

Through this seven-part series, we discuss the science behind nutrient deficiencies linked to ADHD, and what steps you can take to correct them. Key nutrients that have been found to be deficient in children with ADHD symptoms include vitamin D, essential fatty acids (EFAs), and minerals including selenium, magnesium, iron, and zinc.

Understanding the function of these nutrients in the body and why the deficiency may have developed in the first place, along with how to identify and address the deficiency are crucial steps to helping your child.  

Keep in mind an entire book could be written about each of these nutrients. Here we will stick to the highlights to give you the best overview.

The importance and role of iron in the body?

Iron is a mineral found in every cell of the body. Hemoglobin, an essential protein that carries oxygen throughout our bodies, contains between 60 to 70% of the body’s total iron store. If your child has insufficient iron supply and/or stores, they will produce less hemoglobin, which in turn reduces the oxygen supply to the tissues in the body.

As you can imagine, good oxygen supply is essential to optimal brain function. Low brain endurance and poor focus and concentration are hallmarks of poor blood flow and/or oxygen delivery to the brain.

If your child is functionally anemic, which means they may not be “textbook” anemic but their body is functioning as though it doesn’t have enough iron, then other nutritional supports and interventions will be wasted. Because without an adequate supply of oxygen, basic functions of the body cannot operate appropriately, if at all.

While there is more than one type of anemia (it can also be caused by low B12, blood loss, or other chronic diseases—all of which can be determined by blood tests), the most common form is iron deficiency anemia 6.

How do you know if your child is iron-deficient?

There are many signs and symptoms of iron deficiency:

  • Low hemoglobin
  • Low iron
  • Low ferritin
  • Low total iron binding capacity (TIBC)
  • Pale, grey or “ashy” skin tone
  • Poor appetite
  • Lack of consistent energy, lethargy, tires easily
  • Behavioural problems, including irritability
  • Poor growth and development
  • Increased sweating
  • Breathlessness
  • Repeat or frequent infections
  • Strange food cravings for dirt (a.k.a. pica), ice, paint, or starches

Ask your practitioner to perform blood tests on your child to determine the functional ranges of optimal iron levels. A skilled practitioner will know how to assess the different iron markers. These tests should include a CBC with differential, serum iron, ferritin, and TIBC.

Reasons why so many children have an iron deficiency

There are many reasons why some children are at higher risk for an iron deficiency. Here are a few main reasons:

  • Eating a diet deficient in heme iron (iron from animal sources). Vegetarianism and veganism can result in iron deficiency anemia.
  • Poor digestion. Your child may be eating a diet that includes heme iron or other forms of iron, but if they have insufficient stomach acid (HCl) they will not absorb the iron they ingest. Read about how you can assess your child’s digestion here.
  • Eating foods or taking supplements or medications that impair absorption of iron when consumed along with iron-containing foods or iron supplements. These foods include dairy products or other foods high in calcium, whole grains (high in phytates), leafy green vegetables (high in oxalates), processed meats (high in nitrates), and soft drinks (high in phosphates). Supplements or medications include but are not limited to: antacids and calcium.
  • Lead poisoning. Lead poisoning can lead to iron deficiency. If your child is assessed as having low iron, be sure to rule out lead exposure as a root cause

And while you are going to the trouble of drawing blood (it’s not fun for either you or your child), ask your practitioner to order tests for other nutritional deficiencies and key immune and metabolic markers they think are important. Most blood work is not expensive and can be an extremely helpful tool to monitor the health of your child, help you target the most important solutions first, and monitor your progress.

Simple steps you can take now to correct iron deficiency

  1. Perform the required bloodwork to determine your child’s iron status.
  2. Encourage your child to eat a diet high in heme iron from pasture-raised meats (beef and lamb) and poultry, liver, and seafood (clams and oysters), all of which are good sources of heme iron, the most absorbable form of iron.
  3. Consider supplementing with heme iron. However, be sure to have your child’s blood work performed by your practitioner and monitored regularly when supplementing with iron. As mentioned earlier, an optimal amount of iron needs to be achieved—too much or too little can be harmful to your child’s health.
  4. Support digestion. Adequate stomach acid production (HCl) is required for easy absorption of iron.
  5. Pair supplementation and ingestion of iron-containing foods with vitamin C for maximum absorption.
  6. Avoid the following that reduce the absorption of iron when eating iron-containing foods or taking iron supplements: antacids, calcium (dairy, in particular), leafy green vegetables, processed meats, soy protein, and whole grains.


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Articles Related to Iron – Nutrient deficiencies found in children with symptoms of ADHD (Part 3)

Vitamin D – Nutrient deficiencies in children with symptoms of ADHD (Part 1)

Essential Fatty Acids — Nutrient deficiencies in children with symptoms of ADHD (Part 2)

Magnesium – Nutrient deficiencies found in children with symptoms of ADHD (Part 4)  

Zinc – Nutrient deficiencies found in children with symptoms of ADHD (Part 5)


  1. Long-term developmental outcome of infants with iron deficiency 
  2.  Iron deficiency in children with attention-deficit/hyperactivity disorder
  3.  Randomised study of cognitive effects of iron supplementation in non-anaemic iron-deficient adolescent girls.
  4.  Effects of iron supplementation on attention deficit hyperactivity disorder in children
  5. Randomised study of cognitive effects of iron supplementation in non-anaemic iron-deficient adolescent girls.
  6. Microcytic anemia. American Family Physician