everything you didn’t know about iron deficiency

Earlier this week, I posted about synthetic vitamins, and how they aren’t a viable long term solution for resolving deficiencies.  I received a lot of feedback on those two posts, mostly related to iron deficiency and vitamin D deficiency.  A lot of my readers found the information difficult to digest and potentially dangerous.  I thought it would be helpful to delve into each topic in depth and give tips on how you can avoid health issues related to deficiencies, and increase your levels for these two naturally rather than relying on synthetic sources.  I will be posting about vitamin D later in the week.What is Iron Deficiency

The most prominent deficiency in the world in iron deficiency, which affects over 30% of the population.  Iron deficiency is unique in that it affects people with limited access to proper nutrition, as would be expected, but also people in developed countries that don’t have issues with food access.  Iron is also the most abundant element in the world; we are exposed to it every day of our lives.  Yet, deficiency affects many people, especially women and children.

When it comes to iron, you can be either deficient, or have deficiency anaemia.  Iron deficiency means that your iron is low, but isn’t causing any symptoms.  Iron deficiency anaemia means that in addition to low iron, you are having serious symptoms like fatigue, shortness or breath, cold hands or feet, weakness, chest pains, restless leg syndrome, or in extreme cases, arrhythmia.

In general, iron deficiency is not a cause for concern if you have no other symptoms.  If you have iron deficiency anaemia with serious symptoms, then it is important to supplement in order to come out of the danger zone.  Serious symptoms will normally require prescription-strength supplements or in-hospital procedures.

Measuring Iron Deficiency

The problem with diagnosing iron deficiency (anaemia) is that doctors often look at an incomplete picture.  The most common test is going to be a complete blood count (CBC).  This looks at your red blood cells, white blood cells, and platelets, in addition to your haemoglobin and hematocrit levels.  Let’s understand these a bit better:

  • Red Blood Cells (RBC): responsible for carrying oxygen from the lungs to the rest of the body, and give blood their distinctive colour.  The CBC gives an indication of the number of red blood cells in your body, colour, and their size. A deficiency of B9 or B12 can lead to abnormal results.
  • White Blood Cells (WBC): immune system cells which are responsible for fighting infection.  A high WBC could indicate infection or inflammation.  It can also point to liver disease, alcoholism, or an autoimmune condition.
  • Platelets: blood cells that help your body form clots to stop bleeding.  Low platelets could be an indication of a vitamin deficiency, liver disease, autoimmune condition, alcoholism, or other factors.  High platelets are normally associated with a large bleed, inflammation, infection or surgery.
  • Haemoglobin (Hb or Hgb): protein in red blood cells that measure its ability to carry oxygen.  Low haemoglobin means that the red blood cells are not working efficiently.  This can lead to anaemia.
  • Hematocrit: a measure of the volume percentage of red blood cells in the blood.  Too little red blood cells by volume are a cause for concern.

The exact range of “healthy” depends on the sex and age of the person being tested, but the CBC shouldn’t be looked at in isolation.  This is because two of the tests, haemoglobin and hematocrit, almost always mirror the RBC levels.  The values above tell us some of the story, but there are other factors:

  • Serum Iron measures the actual level of iron in your blood.
  • Serum Ferritin is a protein that helps to store iron in your body.  High ferritin levels can indicate liver disease, inflammation, infection or autoimmune conditions.
  • Transferrin is the protein responsible for carrying iron in your blood.
  • Serum Total Iron Binding Capacity (TIBC) measures how much transferrin in your blood isn’t carrying iron.

Factors Affecting Iron Levels

Reading above, you can see that iron levels can be affected by other factors besides not actually having enough iron.  These include:

  • Underlying medical conditions: liver dysfunction, inflammation, infection, autoimmune conditions, thyroid function and alcoholism can all lower iron levels.
  • Vitamin and mineral deficiencies like B12, folate (B9), copper or magnesium.
  • Being a vegan or a vegetarian also affects iron levels because you aren’t getting heme iron (animal protein).  In the case of vegans, you are also missing vitamin B12, which is only present in animal proteins and products (like meat, cheese and eggs).  Heme iron is bio-available, meaning it is absorbed intact, so you will get more iron from heme sources than from non-heme (plant-based, eggs and cheese) sources.  While 100 grams of spinach has more iron than 100 grams of steak (2.7mg vs 2.4mg), you will absorb up to 35% of the iron from the steak and only 10% of the iron from the spinach.
  • Pregnancy can also affect iron levels due to the extra demands on the body. This does not mean you need to take supplements! Iron levels in pregnancy can be supported easily with the tips below.
  • Breast fed babies have low iron levels starting at around six months.  Although the blanket advice is to supplement with iron, most breast fed babies do not have iron deficiency anaemia when exclusively breast fed for at least seven months.  Before any supplementation takes place, babies should have a full iron panel done to ensure there is actually a problem.  This is extremely important, as they have immature gut health, and introducing iron into their diet can disrupt gut flora and create other problems like increased risk of infection and slowed growth.
  • Parasites, bacteria and intestinal worms feed on two things: sugar and iron.  If you have a candida overgrowth or parasite or worm infestation, then these creatures are eating away at your iron stores and depleting your body’s levels.  Worms and parasites are actually the leading cause of iron deficiency in developing countries.  Excess iron is also a breeding ground for bacteria and puts you at greater risk of infection, because it disrupts your gut flora balance, the same as with an infant.  Adding more iron would only continue to feed them and create a bigger issue.

I generally do not believe in supplementing iron.

As I stated above, iron deficiency is almost always associated with an underlying condition, and in the absence of serious side effects, people should focus on getting down to the root cause of the low iron.  Supplementing with iron without understanding the root cause of the issue is like putting on a hat and saying you are dressed.  It completely ignores other factors and can cause more damage in the long term.

How to Heal and Restore Iron Levels Naturally

The most important factor when deciding whether or not to supplement is this: how serious is the problem?  Are you having complications involving your heart health?  Are you anaemic to the point where you are fainting?  Most likely, the answers to these questions will be no, but if they are affecting your health to this extreme, then supplementation will be temporarily necessary.  Doctors are not generally trained to get to the root of the problem, so it’s important to listen to your body’s symptoms rather than accept synthetic supplementation.  They’re the first ones to put a hat on you, send you on your way otherwise naked, and tell you you’re dressed.

In the absence of supplementation, here are a few things you can do:

  • Increase heme iron foods, especially red meat and organ meats like liver.  This will give you both heme iron and B12.
  • Increase your intake of foods with folate, like dark leafy greens, citrus fruits (which also contain vitamin C and increase iron absorption), beetroot, almonds and avocados (of course).
  • If you are a vegetarian, understanding that you need to eat 3.5 times the non-heme foods in order to get the same nutritional content as someone that eats animal protein is important in order to raise and maintain iron levels.
  • For vegans, the complication of lack of B12 presents an added problem.  Fortified nutritional yeast is the only B12 source for vegans.  This goes back to my previous post on synthetic supplements with regard to efficacy and absorption.
  • If you aren’t pregnant or breast feeding, detox your liver with and .  If you are pregnant or breast feeding, then just use the magnesium malate.  Take magnesium at a dosage of roughly 10x your weight in kg or 5x your weight in lbs.  For example, if you weigh 60kg (132lbs), you should be supplementing with 600 to 660mg of magnesium daily.
  • Cut out alcohol for a few weeks.  This will give your liver a break if the cause of iron deficiency is a taxed liver.
  • Avoid caffeine, as it inhibits your iron absorption.
  • Avoid processed or sugary foods, and limit grains and legumes.  These foods encourage candida and parasitic overgrowth.  Removing these foods from your diet can encourage die off if parasites and candida are part of the problem.
  • Avoid disposable pads and tampons.  Many women have iron deficiency anaemia associated with heavy menstrual bleeding.  The chemicals in disposable pads and tampons can cause some women to have longer, heavier periods.  Consider switching to or a instead.
  • Reevaluate your birth control method.  The copper IUD can lead to copper toxicity.  Too much copper can lead to iron deficiency anaemia.  Many oral contraceptives contain iron, which causes iron toxicity, and can present the same as many of the symptoms of iron deficiency.  If you are having symptoms like fatigue, brain fog and joint pain, too much iron might be to blame.  Oral contraceptives also deplete folate, which in turn can cause iron deficiency like symptoms.
  • Write down all your symptoms.  Unfortunately, autoimmune conditions can present similar symptoms to iron deficiency, and it can be difficult to know the difference between the two.  If you find yourself chronically fatigued, in pain, ill, suffering from memory loss or brain fog, or have other symptoms that don’t seem to go away, speak to your doctor about doing an antibody panel to ensure that the underlying cause isn’t autoimmune.

Measuring Success

Iron levels can take a few months to completely resolve, even with synthetic supplementation.  If you have low iron levels, your doctor will hopefully want a repeat blood test in four to six weeks.  If the doctor doesn’t order one, ask for it.  You want to be able to see if you are making progress or not, regardless of the route you take to build up your levels.  Incremental progress can show you that you are on the right track, and help you tweak your approach.  On the other hand, if you’re not making progress despite lifestyle and diet changes (or synthetic supplementation in extreme cases), further investigation is vital to prevent more serious complications.  The last thing you want is a situation where you end up with a blood transfusion or intravenous iron drip.

I know in a world where we depend on vitamins and supplements, the idea of not supplementing sounds completely crazy.  I promise you that it is 100% better to get to the root of the issue.  You will have more effective, long lasting benefits and in a lot of cases you can remedy the problem completely.

7 thoughts on “everything you didn’t know about iron deficiency

  1. Hi I have very heavy periods and have been anemic is the past. I do take iron supplements when I have my period. Are iron supplememts bad for me? What would you recommend I do? Thanks

    1. There are a few things I would suggest. First is your collection method. Pads and tampons have chemicals that can cause your periods to be longer and heavier. Switching to a reusable method like reusable pads or a menstrual cup can help. Second, if you are on birth control and are able to come off, consider doing so. All birth control except for natural family planning will interfere with your cycle. Third, try cutting out grains for a few weeks and focusing on iron rich foods. You can try this leading up to getting your period and see if that makes a difference. Grains will tax your liver and make iron absorption and transfer less efficient.

  2. I have iron deficiency because I dont have functioning thyroid or parathyroid glands.
    I have to take calcium every day and it binds to whatever iron I could have absorbed.
    There is not much I can do about this. What do you suggest? I tried taking liver but cant tolerate more then 500mg a day without my stomach hurting.

    1. It might be a good idea to experiment with your diet and see if that helps. I had a lot of vitamin and mineral deficiencies until I cut out grains. Grains have anti nutrients which leech nutrients from our food and bodies and inhibits absorption from food. It might be a good idea to cut them out completely for a few weeks and see if that makes a difference. Have a blood panel done before and after so you can see if it’s having an impact.

  3. In all my research and from and a Dr specializing in Iron Deficiency Anemia and the Iron Clinic in the UK, I was told it’s not caffeine which blocks Iron absorption, it’s the tannins. Also, almonds have phytates and beetroot has oaxlic acids which block/inhibit the absorption of iron as was the recommendation above to take to increase your iron intake.

    1. The amount of phytic acid in almonds is negligible compared to grains, and so the benefit of eating them is greater than the risk of side effects from phytic acid, as they would not significantly reduce iron absorption.

      With regard to your point on tannins, this is correct. But, as there is no way to easily reduce tannins, the best advice would be to avoid caffeine in order to increase iron levels.

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