Does dietary beetroot improve hemoglobin levels in healthy individuals and in patients with iron-deficiency anemia?

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Last updated: September 18, 2026 • View editorial policy

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Beetroot Does Not Improve Hemoglobin in Anemia and Is Not Recommended as Treatment

Beetroot is not an evidence-based treatment for iron-deficiency anemia in either healthy individuals or those with anemia, and should not be used as a substitute for proven iron supplementation strategies. The current AGA guidelines 1 make no mention of dietary beetroot as a therapeutic intervention for iron-deficiency anemia, focusing instead on oral iron salts (ferrous sulfate, ferrous fumarate, ferrous gluconate) and intravenous iron formulations.

Why Beetroot Is Not the Answer

The available evidence on beetroot and hemoglobin is limited to animal studies and mechanistic research that does not translate to clinical practice:

  • Animal studies only: One rat study 2 showed beetroot powder ameliorated phenylhydrazine-induced hemolytic anemia in rats, but this is an artificial model of hemolytic anemia, not iron-deficiency anemia in humans
  • Transient hemoglobin elevation: A small study 3 in 8 healthy volunteers showed beetroot juice caused a 3% increase in hemoglobin through spleen contraction—a temporary physiological response, not correction of iron deficiency
  • No clinical trials in humans with IDA: There are no randomized controlled trials demonstrating beetroot improves hemoglobin or iron stores in patients with iron-deficiency anemia

What Actually Works: Evidence-Based Iron Repletion

For Iron-Deficiency Anemia Treatment:

Oral iron supplementation is first-line therapy 1:

  • Ferrous sulfate (65 mg elemental iron per tablet)
  • Ferrous fumarate (106-150 mg elemental iron per tablet)
  • Ferrous gluconate (27-38 mg elemental iron per tablet)
  • Take once daily (not more frequently, as hepcidin elevation blocks absorption for 48 hours)
  • Expect hemoglobin to increase by 1 g/dL within 2 weeks if effective 1

Optimize absorption 1:

  • Take on empty stomach when possible
  • Consider 80-500 mg vitamin C with iron dose
  • Avoid tea and coffee within 1 hour of iron intake
  • Taking with meat protein improves absorption

Switch to intravenous iron if 1:

  • Oral iron not tolerated (constipation in 12%, diarrhea in 8%, nausea in 11%)
  • No hemoglobin increase after 2 weeks of adherent oral therapy
  • Ferritin fails to increase after 1 month
  • Malabsorption conditions present (inflammatory bowel disease, celiac disease, post-bariatric surgery)
  • Iron loss exceeds oral absorption capacity

Diagnostic Work-Up Is Essential:

Before treating with iron, identify the underlying cause 4, 1:

  • Men and postmenopausal women: Bidirectional endoscopy to evaluate for GI blood loss 4
  • Premenopausal women: Consider gynecologic evaluation; may trial iron first if asymptomatic 4
  • Test for H. pylori: Treatment improves hemoglobin by mean 2.2 g/dL when combined with iron replacement 4
  • Screen for celiac disease in appropriate patients 1

Critical Pitfall to Avoid

Do not delay proven iron supplementation in favor of dietary interventions like beetroot. Iron-deficiency anemia causes significant morbidity including fatigue, exercise intolerance, worsening heart failure, impaired cognition, and depression 5. The condition requires prompt, evidence-based treatment with pharmaceutical iron preparations, not food-based approaches that lack clinical validation.

While beetroot contains beneficial nitrates and antioxidants with cardiovascular effects 6, these properties do not address the fundamental problem in iron-deficiency anemia: depleted iron stores requiring repletion with bioavailable iron supplementation.

References

2
Research

Protective effect of Beta vulgaris roots supplementation on anemic phenylhydrazine-intoxicated rats.

Environmental science and pollution research international, 2021

3
Research

Spleen contraction and Hb elevation after dietary nitrate intake.

Journal of applied physiology (Bethesda, Md. : 1985), 2020

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