Low Iron Can Cause Chronic Pain

Thursday, October 22, 2009
By: Byron J. Richards,
Board Certified Clinical Nutritionist

A new discovery about the need for iron in your brain stem1 (where pain registers) opens the door for an additional approach to chronic pain that may be of immense benefit to many people who are currently suffering.

It has been proposed for a number of years that one cause of restless legs syndrome is low iron.  Indeed, researchers have demonstrated in an animal experiment how an iron-deficient diet creates changes in the brain stem that result in restless legs.

The newest study is groundbreaking because it shows that low iron causes pain by altering the structure and function of the brain stem – setting up adverse nerve circuitry that facilitates chronic pain.  This finding is of immense importance to any person struggling with ongoing pain.

Patients with chronic fibromyalgia pain3 are known to be lower in iron.  Such patients also have “wind up” in their brain stems resulting in excess substance P and lots of pain.  In addition to nerve-related pain, low iron also causes muscles to fatigue easier due to a lack of sustained oxygenation of muscle (the myoglobulin protein that holds oxygen in muscle is iron dependent), in turn causing muscle pain4.  Iron-rich hemoglobin carries oxygen to body tissues that need to repair.  A lack of iron would certainly leave inflamed tissues in place longer – resulting in pain.  While there are various ways in which low iron may contribute to pain, the above nerve finding is central to the chronic pain issue.

One study with TMJ patients experiencing chronic pain5 showed that 70% of them had low serum ferritin (iron stored in the bank account).

Lab tests for iron level may not show iron need.  Frank anemia may also not be present.  Pain may reflect a functional loss of iron which might be predicted by hemoglobin on the lower side of the normal range, the number of red blood cells are the lower side of the normal range, or the size of red blood cells on the lower side of the normal range (MCH and MCV).  Also, serum ferritin could be on the lower side of the normal range.  Not having optimal iron, especially if you do have ongoing pain, could be a significant contributing factor.

The standard nutritional approach to assisting pain is to provide nutrients that help reduce inflammation, nutrients that help heal nerves, and nutrients that help heal body tissue.  We must now add high quality iron to the list of possible nutrients that can help reduce pain – especially pain that is of a chronic nature.


Referenced Studies:
  1. ^ Iron Deficiency as a Cause of Chronic Pain  Journal of Nutrition  Pascal Dowling, Florian Klinker, Franco Amaya, Walter Paulus and David Liebetanz.
  2. ^ Low Iron Linked to Restless Legs  Zhao H, Zhu W, Pan T, Xie W, Zhang A, Ondo WG, Le W.   J Neurosci Res.
  3. ^ Fibromyalgia Associated with Higher Rate of Iron Deficient Anemia  Clin Rheumatol.  Pamuk GE, Pamuk ON, Set T, Harmandar O, Yeşil N.
  4. ^ Low Iron Common in Muscle Pain   Acupunct Med.  Gerwin RD.
  5. ^ Most Common Nutrient Lacking in Chronic TMJ Pain is Iron  Proc (Bayl Univ Med Cent).   Mehra P, Wolford LM.

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