A 16-year-old with pallor and fatigue; CBC consistent with iron deficiency anemia. What should the PNP tell the teen?

A 16-year-old with pallor and fatigue; CBC consistent with iron deficiency anemia. What should the PNP tell the teen?

• A. Antacids increase iron absorption
• B. Dairy foods are good sources of dietary iron
• C. Juices fortified with vitamin C inhibit the absorption of nonheme iron
• D. Tannin-containing products, such as tea, inhibit the absorption of nonheme iron

Answer: (D)

Nonheme iron absorption is driven by the meal context: some substances boost it, others inhibit it. Tea contains tannins that readily bind nonheme iron in the gut, forming insoluble complexes and reducing how much iron gets absorbed. That’s why telling the teen to limit or avoid tea with meals improves iron uptake. Other options don’t fit this situation as well. Antacids raise gastric pH and can decrease iron solubility, so they don’t increase absorption. Dairy foods aren’t a strong iron source, and calcium in dairy can actually interfere with iron absorption when eaten with iron-rich foods. In contrast, vitamin C enhances nonheme iron absorption by helping convert iron to a more soluble form and forming a complex that is easier to absorb; juices fortified with vitamin C would aid absorption, not hinder it. So the best counseling point is to minimize tannin-containing beverages like tea during meals and pair iron-rich foods with vitamin C sources to maximize iron absorption.

Nonheme iron absorption is driven by the meal context: some substances boost it, others inhibit it. Tea contains tannins that readily bind nonheme iron in the gut, forming insoluble complexes and reducing how much iron gets absorbed. That’s why telling the teen to limit or avoid tea with meals improves iron uptake.

Other options don’t fit this situation as well. Antacids raise gastric pH and can decrease iron solubility, so they don’t increase absorption. Dairy foods aren’t a strong iron source, and calcium in dairy can actually interfere with iron absorption when eaten with iron-rich foods. In contrast, vitamin C enhances nonheme iron absorption by helping convert iron to a more soluble form and forming a complex that is easier to absorb; juices fortified with vitamin C would aid absorption, not hinder it.

So the best counseling point is to minimize tannin-containing beverages like tea during meals and pair iron-rich foods with vitamin C sources to maximize iron absorption.