Understanding Iron Deficiency: A Comprehensive Guide

Iron deficiency is one of the most common nutrient deficiencies, especially among menstruating women. Yet, many individuals struggle to correct it—even after months of supplements. If you’ve been taking high-dose iron tablets with little improvement, it's time to reassess your approach. Dealing with low iron levels is not as simple as more is best.

The Problem with High-Dose Iron: Hepcidin and Absorption

Your body has an inbuilt safety mechanism to regulate iron levels called hepcidin, a hormone that controls how much iron you absorb from food and supplements.

• When you take high doses of iron in the form of a supplement your hepcidin levels spike. This actually shuts down iron absorption for the next 24 hours or more.

• Instead of helping, large doses can mean less iron gets absorbed. You may also experience gut symptoms like constipation, nausea, or cramping.

• Splitting doses, using lower amounts, or considering alternate-day dosing is often more effective and gentler on the digestive system.

• Most importantly, dietary iron levels should also be considered! The best way to get iron is through the diet, not a synthetic supplement (whether that’s from the pharmacy or a natural health care practitioner).

  
  

Could It Be Your Gut?

Even if you eat plenty of iron-rich foods or take supplements, you might not absorb them well if your gut health isn’t optimal.

Low Stomach Acid

Low stomach acid is needed to convert iron into its absorbable form. Low acid levels—common in stress, aging, or antacid use—reduce iron uptake.

Gut Inflammation

Conditions like IBS, IBD, coeliac disease, or chronic dysbiosis can damage the gut lining, impairing absorption.

Microbiome Imbalances

Some gut bacteria feed on iron, further reducing your available supply. Supporting digestion with proper stomach acid production, reducing gut inflammation, and restoring microbiome balance can make a huge difference in your iron status.

Iron deficiency isn’t just about not getting enough iron, it’s about absorbing, regulating, and utilising it properly. Instead of rushing to high-dose supplements or infusions, it’s important to:

• Test thoroughly (ferritin, full iron studies, CRP, inflammation markers, haematology)

• Address gut health and stomach acid issues

• Use smart iron supplementation strategies tailored to your needs (this may mean using no iron supplements at all!)

• Modify the diet to ensure adequate iron intake

  
  

I work with women who have been fighting low iron levels for years. Oftentimes, I actually get them to stop supplementing. If you're concerned about your iron levels, please reach out and book a discovery call. There are alternatives to iron supplementation and sometimes this is exactly what's needed.