Dr Bernadette Carr answers your questions on plantar fasciitis and iron deficiency anaemia

I have recently started walking in an attempt to shed some baby weight. But, over the last month, I have begun experiencing a lot of pain in the soles of my feet. Why is this?

This sounds like plantar fasciitis — a common condition which results from repetitive trauma to the underside of the foot. It occurs when the fascia (a thick band of fibres which support the underside of the foot) becomes inflamed. This may occur as a result of overuse or excessive exercise. It may commonly appear at the heel in conjunction with “calcaneal spurs” which are deposits of calcium, also a result of damage to the foot.

Pain commonly will appear after periods of inactivity — often first thing in the morning or after sitting for long periods.

Many athletes suffer from this condition as well as people who are new to exercise or suddenly begin a new regime after a period of inactivity. Overweight individuals may be more at risk as well as people with flat feet. Changes to the body after pregnancy may make you more likely to develop the condition.

Treatment includes rest and stretching exercises for the feet (especially the calves and Achilles tendons) as well as orthotic inserts for shoes. Anti-inflammatory painkillers such as ibuprofen may be helpful temporarily as well as ensuring footwear is appropriately cushioned with adequate arch support for any physical activity.

It is important to avoid walking barefoot or in flat shoes/ flip flops as these can all aggravate the condition. It’s also important to stretch before and after exercise and to give the body adequate rest periods when engaging in any new exercise regime. If symptoms are not relieved with these measures, physiotherapy sessions may be helpful to advise on stretching exercises for the feet, as well as steroid injections into the fascia for pain relief.

With time and rest most cases of plantar fasciitis improve completely within one year.

I had recent blood tests which revealed that my iron levels were low. Are there any particular foods that will provide more iron than others? Or should I look at taking iron supplements.

Iron is an important nutrient in the body needed to transport oxygen around the body and in the building of healthy blood cells. Iron deficiency anaemia can occur commonly in women and teenage girls who may lose haemoglobin through monthly menstruation. Vegetarians or vegans or people who do not get enough dietary sources of iron may also be at risk of the condition.

The recommended daily allowance of iron for men is currently 8.7 mg / day and for women it is 14.8 mg/ day. Lack of iron is called anaemia. It may lead to tiredness, fatigue, breathlessness, pale skin, and palpitations.

Red meat is a good source of protein and iron, however, there are many other ways you may incorporate this into your diet. Many vegetables, pulses and other foods are rich in iron such as spinach, chickpeas, tofu, quinoa and egg yolks. Many cereals are fortified with iron and choosing milk with added iron can also boost your daily intake.

Vitamin C is important in helping iron to be absorbed into your body and so it is a good idea to incorporate sources of this into your diet as well. This can include citrus fruits, oranges, kiwi, raspberries, pineapple to name but a few. It is also important to moderate your consumption of teas and coffees as these may inhibit the absorption of iron.

Taking sources of calcium along with iron-rich foods can also inhibit its absorption, so it can be a good idea to avoid consuming these foods together.

Your doctor may recommend iron supplements to further boost your iron levels. Often after a course of three months your doctor may advise re-checking your iron levels to make sure they have returned to normal. Iron stores may accumulate in the body also so it is important never to exceed the recommended daily dose of the supplement. Side effects may occur when using these, including stomach upset and constipation.


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