Iron is an important mineral. It is a necessary mineral, but also a dangerous one, because iron is a metal with medium reactivity, which in its free form, causes oxidative stress and damages cells.
There is no specific system for iron secretion. Iron mainly exits the body with old intestinal and skin cells and with blood loss. In case of an exhausting physical activity or illness, iron may to some extent, exit the body with sweat and urine .
During normal menstruation, women lose approximately 25-45 ml of blood and the upper limit for blood loss is around 80 ml. Blood loss more than 80 ml is considered heavy menstruation and this can cause women to suffer from iron deficiency anemia. Every third woman suffers from heavy menstruation during a certain period of life. Among fertile women, 9-14% suffer regularly from heavy menstruation .
1 ml of blood consists of 0,5 mg of iron. Already a couple of ml of blood loss daily can cause negative iron balance in our bodies . When 80 ml of blood is lost during menstruation, our bodies loose around 40 mg of iron.
Iron deficiency anemia develops step by step: first body´s iron stores are depleted from the liver, spleen and bone marrow, which causes low ferritin levels. Checking body´s ferritin level is considered the best analysis for diagnosing iron deficiency. Ferritin is an acute phase protein and its value is higher in case of infections, liver pathology, tumors, and other infectional diseases. Thus, a higher ferritin value can hide iron deficiency. It is optimal to check also transferrin soluble receptors, whose value is not affected by illnesses. During iron deficiency, transferrin (a protein transporting iron in our bodies) and transferrin soluble receptors (STfR) are higher. A higher than normal value of STfR also indicates iron deficiency.
To find out, how much blood is lost during menstruation, use menstrual cup! If you need to change menstrual pads or tampons every couple of hours, change them during night time, have more than 2,5 cm of blood clots in size and your menstruation period is more than 8 days, you have the signs of heavy menstruation .
In case you suspect heavy menstruation and have measured your blood loss during menstruation period, you can consult with a gynecologist. A gynecologist may suggest different tests and examinations, but often a gynecological examination, blood sample and vaginal ultrasound are enough. There are many reasons for heavy menstruation:
- reasons linked to uterus that make up almost half of the cases: benign changes, thickening of uterus´ mucosa, adenomyosis, copper spiral, infection or malign tumors
- systemical reasons: e.g. hypothyroidism, overweight, unadjusted diabetes, von Willebrand´s disease
- certain drugs: e.g. aspirin, warfarin, omega- 3 supplementation, valproate
- different other reasons 
The more blood is lost during menstruation, the higher the risk of suffering from iron deficiency anemia. When you know the reason for heavy menstruation and cannot eliminate it, you should consult with a gynecologist or physician. Perhaps it is reasonable to use iron food supplements during menstruation days.
Nôgel´s iron food supplements include three different products: 30 mg iron, 60 mg superiron and 20 mg iron syrup for children (can be used by all family members). All iron food supplements consist of divalent iron bisglycinate, which has the highest bioavailability among divalent iron salts. Iron bisglycinate is also considered stomach-friendly, due to its molecular structure and high bioavailability, it is less common to cause different side effects, especially with smaller daily dosages such as 20-30 mg of elemental iron. Iron bisglycinate is less reactive among divalent iron salts causing less oxidative stress. Read more about iron bisglycinate from here.
To compensate blood loss during menstruation, you should consider using whether the iron syrup 20 mg or 30 mg iron pill during heavy menstruation days. This helps to maintain your body´s ferritin level. Before using iron food supplements, consult with a doctor.
Our iron food supplements are produced without magnesium stearate, artificial additives, preservatives, dyes and sweeteners. Nôgel´s iron food supplements are free from lactose, casein, yeast, soy, GMO, corn, gelatin and animal ingredients. All iron food supplements are naturally gluten free and suitable also for vegans. For every 30 mg iron supplement we plant a tree in co-operation with Estonian State Forest Management Center. For all other products, we donate 5 cents to Tartu University Hospital´s Children Foundation.
Iron food supplements are not a source of vitamin K (nettle contains vitamin K1). Iron food supplements contain vitamin K only 0.9-2.7% of RDA in Estonia (75 mcg).
 Tiiu Vihalemm. Raud – väga vajalik ja samas ohtlik mineraalaine. Toitumisteraapia nr 4, 2012/2019
 Gynecologist Ivi Saar – Valvekliinik
 M.Sinisalo, P.Collin. Suomen Lääkärilehti 37/2016 vsk 71