Iron Building Protocols in Pregnancy
Timing & Integration
Begin gentle daily iron support in the first trimester if tolerated, increasing in the second trimester as blood volume expands. Use herbs, herbal infusions and food first, supplements second. Avoid taking iron within 1-2 hours of calcium-rich foods or calcium supplements. Pair iron with vitamin C for improved absorption.
Building Iron through Diet - Foundational Food & Herbal Practices
I recommend a combination of dietary sources to build your blood and iron stores. You are building not just yours but baby’s blood, too, and iron is necessary for oxygenation. Iron is most easily assimilated when consumed alongside vitamin C and away from calcium, as calcium binds to the iron, resulting in neither nutrient being absorbed into the bloodstream. I also recommend consuming cooked, easily digested foods to reduce the burden on the digestive system to process the nutrients in the food. So avoid gut-irritating foods (think spicy, acidic, RAW). Also, please avoid dairy, unless you are consuming it at least 2 hours away from any of your iron-building foods.
Here are my top suggestions if you are beginning with diet:
● Dark leafy greens (e.g., kale, collards, spinach): eat 6 cups of cooked per day (yes, 6 cups per day!).
● Sauté in ghee or coconut oil so the greens reduce to about 1 cup to actually consume. Add salt, pepper, turmeric, lemon juice as enhancement if desired.
● Blackstrap molasses: add 1 tsp to cooked oatmeal or buckwheat cereal or add to your tea. Rich in iron, calcium, and magnesium; the oatmeal and buckwheat are also sources of iron.
● Chlorophyll: add drops to water every other day to support hemoglobin synthesis.
● Herbal infusions: stinging nettles, red raspberry leaf, alfalfa, oatstraw, hibiscus, rose hips, jujube dates; pour 32 ounces of boiled water over 1 ounce of the bulk herb or any combination of them and allow to steep for 4+ hours or overnight. Add honey or lemon to taste. These herbs have SO much iron in them, and are the exception to the calcium rule, as they contain both, but the body seems to accept them in this form. I recommend herbal infusions as one of the main hydration sources during the day.
● Bone broth: add a squeeze of lemon or lime to enhance absorption!
● Nuts and seeds for snacking: cashews, pumpkin seeds, sesame seeds, apricots, raisins.
● Other good iron-rich food sources: tofu, whole grains (brown rice, quinoa, oatmeal), Legumes (beans, lentils, peas), brussels sprouts, beets, grass-fed red meat (beef, pork, lamb), poultry, chicken, turkey, fish (e.g. mackerel, tuna, salmon), eggs. Cow liver can also be an excellent source of iron, but be intentional with sourcing, as the liver is a detoxifying center, choose a butcher or farm where you know the animals are fed and live well.
● Blood-building syrup (prunes, goji berries, dang quai, astragalus, molasses - see recipe below): 1 tbsp twice daily.
● Kitchari (see recipe in nutritional guidelines): consume as often as daily to soothe the GI system and aid in nutrient absorption. Add a dollop of extra ghee with each serving.
● Cast iron cookware to naturally enrich meals with bioavailable iron.
Ayurvedic and TCM Herbal Supports:
○ Amalaki (Indian gooseberry): Supports iron absorption and immunity. Use 1 tsp powder with honey. Consume 2x/day
○ Shatavari: Nourishes blood, reproductive tissues, and boosts postpartum recovery. Use 1 tsp powder with honey. Consume 2x/day
○ Bhringaraj: Strengthens liver and enriches blood. Take in tea or capsule form. Use 1/2 tsp powder with honey. Consume 2x/day
○ Huang Qi (Astragalus): Builds Qi and supports digestion to improve iron assimilation. **consume along with other ingredients or simmer in your bone broths (yum!) rather than as a stand alone herb
Supplements for Severe Iron Deficiency Anemia
If consuming the diet and herbs above is not realistic for your life or tastebuds, or if you have tried this for at least four weeks and your iron levels remain low, or you just need your iron up FAST, I recommend turning to the following supplements to aid the body in building iron-rich blood.
Chlorophyll - in water (daily, as directed on bottle)
B6 P5P – helpful for processing iron uptake. Take 2x/day
Iron Repair Plus – double dose, two times a day
Betaine Hydrochloride – take 1 tablet with meals. Standard Process makes a reliable one.
Increase vitamin C intake to 2000 mg per day (split between meals to support absorption); Vitamin C can come from diet or from supplement sources.
Ancestral Supplements Grass-Fed Liver – Natural source of heme iron, B vitamins, and retinol. Take 4-6 capsules daily with food.
Jarrow Methyl B12 + Folate – Supports red blood cell formation and prevents megaloblastic anemia. 1 tablet daily .
Postpartum Blood Building Syrup Recipe:
This is my postpartum blood building recipe, but I think it also works just as well during pregnancy:
1. Combine 1/2 cup prunes, 1/2 cup goji berries, 1 oz Dang Gui, and 1 oz Huang Qi (astragalus root).
2. Add 8 cups of water and simmer until the mixture has a syrup consistency and the fruit is soft.
3. Let cool, then blend. After blending, strain the liquid through a strainer.
4. In a separate pot, melt 2 tbsp ghee and add 1 tsp cinnamon, 1 tsp cardamom, and a pinch of sea salt.
5. Combine ghee spice mix, fruit and herb mix, and 1 cup molasses
6. Cook on low and stir for 10–15 min.
7. Take 1–2 tbsp two times a day . Store in a cool, dry place.