There are two kinds of naturally occurring iron in foods that are absorbed and handled by our body differently.
In a diet for iron overload, it is important to understand which foods you should pay the most attention.
The way our body absorbs these two types of iron is very different:
Heme iron is more easily absorbed and is therefore a large source of dietary iron for people both with and without hemochromatosis.
Non-heme iron is usually less readily absorbed than heme iron. Especially in people without hemochromatosis, non-heme iron tends not to be a big source of dietary iron. This, of course, is going to be different in those with hemochromatosis, which I will explain more in a minute.
It is important to note that heme iron comprises only 40-45% of the iron in meat. The rest of the iron contained in meat is actually this non-heme form (55-60%). So when you see the milligrams of iron listed for a portion of meat, approximately half of that is heme and half is non-heme. This becomes important to understand when thinking about substances that help block iron absorption, as most work to only block non-heme iron.
Why does any of this matter?
Our bodies absorb the iron from animal-based protein (heme iron) better than the iron from plant-based protein (non-heme).
This is one reason why a vegetarian (without hemochromatosis) is more at risk to develop iron-deficiency anemia than people who eat meat; the exclusively non-heme iron found in plants just isn’t as available to our bodies as heme iron is. People who eat meat are getting both non-heme and heme iron while vegetarians only get non-heme, even if they include dairy and eggs.
The absorption of non-heme iron in people without hemochromatosis is approximately 5-12% of the iron listed on the nutritional label. This is because during digestion, the body has to alter non-heme iron in order to fully take it in.
Heme iron is a different story. In someone without hemochromatosis, 20-30% of the heme iron they consume is absorbed from a meal.
The Iron Disorders Institute provides a nice real world example of how this may work. Say you eat a 4 oz hamburger containing 1.2 mg of heme iron. Someone with normal iron absorption might absorb 0.3 mg of heme iron from that burger. But someone with hemochromatosis might absorb the full 1.2 mg. Take that a step further and imagine meal after meal, day after day, year after year. If every hamburger consumed leads to this amount of iron absorption, then it can really add up.
This variation between what a food label states and what our body actually absorbs makes questions like, “How many milligrams of iron should I eat?” such an impossible question to answer. As you’re maybe starting to realize, it’s just not that simple!
One study that looked at how the foods we eat with an iron-rich meal impact how our body absorbed the iron discovered that:
“Heme iron…is well absorbed and relatively little affected by other foods eaten in the same meal. On the other hand, the absorption of non-heme iron, the major dietary pool, is greatly influenced by meal composition.”
Non-heme iron, the iron found in both plant and animal foods, the iron typically viewed as less threatening and less important when it comes to hemochromatosis diet, this very same iron is the one we have the most ability to affect and change by diet.
But when I say affect, I don’t just mean in a good way. The absorption of non-heme iron can be dramatically increased by unknowingly combining it with foods that make its affects WORSE for our situation. For example, certain foods may increase the absorption of non-heme iron from seemingly benign foods such as rice and corn two or threefold- which is the last thing we want.
But on the other hand, that same knowledge can be used to help reduce the iron absorbed from our meals. Knowledge of how food combining impacts non-heme iron absorption is a very powerful tool to have!
In reality, a well-rounded and nutritious diet is likely going to contain both heme and non-heme iron. That’s just a fact, and it’s hard to avoid. Fortunately, many delicious foods and healthful nutrients can be combined to help reduce iron absorption from our meals.
We should be very conscientious to include the nutrients that impair non-heme iron (and one that also impairs heme iron!) absorption as part of our overall diet.
An Extensive Guide to Help You Find Answers and Restore Health
Learn how you can improve your wellness, support your body, and engage in life on your terms. In this book, you'll discover how hemochromatosis can be managed successfully through the key to optimal health ~ balance.
Cooking for Hemochromatosis
With over 100 delicious low-iron recipes, Cooking for Hemochromatosis: Recipes, Menus, and Culinary Strategies to Lower Iron in Your Diet is a comprehensive guidebook to help you plan, shop, and cook to reduce iron in your diet. Much more than just a cookbook, it will teach you how to decide what to eat, plan meals, and enjoy food again when facing iron overload.
These books describe ways to think about heme vs non-heme iron, which special nutrients and foods can protect you, what precautions to take, and which commonly made suggestions may not be the best advice.
Top 10 Dietary Sources of Heme Iron (Animal-based foods):
Top 10 Heme Iron Foods
Heme Iron Content (mg per 3 oz serving)
3. Chicken Liver
5. Beef Liver
8. Extra Lean Ground Beef
10. Lamb Chop
In a more general sense, the following is a highest-to-lowest list of foods that typically have a high amount of heme iron:
Top 10 Dietary Sources of Non-Heme Iron (Plant-based foods):
Top 10 Non-Heme Iron Foods
Non-Heme Iron Content (mg)
1. Soybeans (cooked)
2. Blackstrap Molasses
3. Lentils (cooked)
4. Spinach (cooked)
6. Bagel (enriched)
7. Chickpeas (cooked)
9. Lima Beans (cooked)
10. Black-eyed Peas (cooked)
We all have to eat, and many nutritious foods contain iron in them, therefore it is important to understand heme iron vs non-heme iron so we can make the best choices for our health.
USDA Food Composition Database –> https://ndb.nal.usda.gov/ndb/nutrients/index
American Journal of Clinical Nutrition, Prediction of dietary iron absorption –> http://ajcn.nutrition.org/content/71/5/1147.full
Iron Disorders Institute –> http://www.irondisorders.org/iron-we-consume/
HealthCastle.com, Top Iron Rich Foods: A Complete List –> http://www.healthcastle.com/iron.shtml
Sean R. Lynch and James D. Cook, “Interaction of vitamin C and iron,” Annals of the New York Academy of Sciences 355, no. 1 (1980):32-44. Online –> http://pdf.usaid.gov/pdf_docs/PNAAQ804.pdf
Hemochromatosis Help Diet Book
Evidence-based analysis of dietary, nutritional and herbal remedies for iron overload.
Hemochromatosis Help Cookbook
A complete guidebook to cooking for hemochromatosis with over 100 delicious and family-friendly recipes.
Hemochromatosis Help Supplements
Safe, effective, and unique supplements for individuals with hemochromatosis, handpicked by a Naturopathic Doctor.
Dr. Eric Lewis is a naturopathic physician who also has hereditary hemochromatosis. With his unique perspective of being both a practitioner and a patient, he brings new insight into holistic approaches to iron overload, providing new understanding about the best diet and supplementation strategies to help support health with hemochromatosis.
He is the author of Holistic Help for Hemochromatosis and he has developed a line of supplements specific to the needs of people with hemochromatosis, available at MyHemochromatosisHelp.com.
Dietary Strategies for Hemochromatosis
Nutritional Supplements for Hemochromatosis
Turmeric Benefit for Hemochromatosis
Milk Thistle Benefit for Hemochromatosis