"Your iron is fine" usually means your haemoglobin is fine.
Eight pages on low iron. The symptoms, the exact words to take to your GP, the ferritin number worth aiming for, and how to work out why your iron keeps dropping.
Where should we send it?
Eight pages, free.
- The exact words to take to your GP
- The ferritin number we aim for
- Works alongside your GP and any infusion
What is in the guide
Eight pages. Page three is the one most people photograph before their appointment.
Symptoms, and getting the test right
- Twelve symptoms to tick, including the ones rarely connected to iron: restless legs, craving ice, a short fuse, slow recovery from illness
- What to ask for by name, because a blood count alone misses low stores. Full iron studies means ferritin, serum iron, transferrin and transferrin saturation
- Why CRP belongs on the same form, since inflammation lifts ferritin and can hide low stores behind a normal-looking number
- How to read your ferritin, including the band between 30 and 50 that gets called normal while symptoms carry on
Food, supplements, and the why
- What to pair with plant iron, and the five things that block absorption, from the cup of tea with dinner to long-term reflux medication
- Why a lower dose every second day often gets more iron in than a big dose daily, and what hepcidin has to do with it
- The gentler form of iron, and the probiotic strain shown to lift iron absorption
- Six questions for working out why it keeps dropping, and the four questions worth asking before an infusion
They said it was a bit low, but nothing to worry about.
Iron carries oxygen around your body and helps make energy in every cell. Your body keeps a store of it, measured on a blood test as ferritin. Those stores run down long before haemoglobin, the oxygen-carrying protein in your red blood cells, starts to drop. So you can feel it for months or years while your blood count still reads normal.
Many labs only flag ferritin once it falls below 15 to 30. Between 30 and 50 it tends to be called normal, and that is exactly the range where fatigue, hair shedding and restless legs are still common.
In a randomised trial of 198 women with fatigue, normal haemoglobin and ferritin under 50, iron reduced fatigue by almost half, well beyond the placebo group. We look for ferritin above 50 in women, and ideally higher.
If you have had an infusion, or one has been suggested
Iron infusions have a real place. Very low iron with symptoms, supplements that cannot be absorbed or tolerated, ongoing heavy loss, late pregnancy, or preparation for surgery. They can make a large difference quickly.
There is one side effect worth understanding beforehand. Some infusion types lower phosphate, a mineral your muscles, bones and cells use to make energy, usually within the first fortnight. It feels like new or worse tiredness, muscle weakness, aches and bone or joint pain, which is easy to read as the infusion simply not working. For most people it settles on its own.
Page seven gives you four questions to ask before you book, including which product is being used and whether a lower-phosphate option suits you. Take them with you.
An infusion refills the tank. Finding the why stops the leak. Plenty of the women we see have had more than one, without anyone asking why their iron keeps falling.
Why we made it
Low iron is the single most common thing we pick up in women who have been told everything is normal, and it is also the one most often treated without anybody asking the next question.
Topping up the tank works until it empties again. Heavy periods are the most common reason in women, and low iron makes periods heavier, so the two feed each other. Coeliac disease, low stomach acid, long-term reflux medication, gut inflammation and H. pylori all reduce how much you absorb. Hard training raises hepcidin for hours afterwards. Ongoing inflammation locks iron away while the numbers look fine.
The guide walks through all six of those questions so you can work out which one is yours, and names the tests that help answer each.
Send me the guide
Free, eight pages.
General information only, and not individual advice. It does not replace assessment or treatment by your own doctor, and nothing here is a reason to change or stop a medication. Please test before taking iron, since too much causes its own problems. See your GP promptly for black or bloody stools, unexplained weight loss or ongoing abdominal pain. © The Family Naturopath, The KAN Clinic.