Why are we so Iron Deficient?

Three main roles of significant importance that iron is responsible for in our body are:

  • Transports oxygen to cells as a part of red blood cell structure assisting in circulation, oxygen delivery and respiratory gas exchange for survival.

  • Production of energy in the form of ATP by acting in the electron transport chain of the mitochondria, those energy powerhouses of our cells.

  • For DNA replication, priming and optimal cellular division and proliferation.

Beyond these 3 main roles, iron is needed for our mood hormones, thyroid hormones, immune function, healing abilities and more.

But iron deficiency is common and is a state which we do not consume or absorb enough iron to meet basic bodily functions. When levels drop below what is required, we begin getting symptoms of iron deficient anaemia.

The key symptoms to look out for are

  • Weakness

  • Tiredness

  • Reduced capacity to do physical activity

  • Heart palpitations

  • Shortness of breath

  • Headaches

  • Poor concentration

  • Cold hands and/or feet

  • Pale conjunctiva, gingiva and nail beds

  • Hair loss

So why it is so many of us have iron deficiency or are diagnosed with iron deficient anaemia?

It's not always just what we put into our bodies, yes nutrition plays a major role, but some of us just really struggle to get our levels into optimal ranges. Even worse, many patients share their blood tests with their Naturopaths after them being reviewed by their doctor only to discover that they were borderline anaemic due to iron deficiency, but this was overlooked because they were in the conventional "normal" range. Meaning their ferritin levels (better indicator of total iron stores) were sitting at 31 of a reference range of 30-200; it may sound ridiculous but it constantly happens!


There are two types of dietary iron, heme and non-heme. Heme iron comes mainly from meat, poultry, and fish. Although heme iron accounts for only 10%-15% of the iron found in the diet, it may provide up to one-third of total absorbed dietary iron is more readily absorbed than non- heme iron. Non-heme iron is found in plants, dairy products, meat, and iron salts added to food and supplements. The absorption of non-heme iron is strongly influenced by enhancers and inhibitors - sometimes present in the same meal.


Phytic acid: phytates in legumes, nuts and seeds - food preparation, including soaking, germination, fermentation, and cooking, can help remove or degrade phytic acid.


Black tea

Herbal tea Calcium Medications that lower stomach acid

Systemic inflammation and Hepcidin

A hormone released from the liver called hepcidin has been found to be released in response to inflammation within the body. Hepcidin’s role is to block iron uptake from the GIT. The theory of this adaptation is thought to be to protect the body during infective inflammation. Infectious agents like bacteria need iron for survival and replication so through making the host (us humans) deficient in iron, hepcidin is protecting us from ongoing infection. The problem is, these days inflammation is stemming from may other factors beyond infection, stress, obesity, diet, alcohol & smoking amongst other inflammatory diseases we are faced with in present time.

Gastrointestinal diseases

Some diseases like inflammatory bowel disease (Crohn’s and Ulcerative Colitis) are strongly linked with iron deficiency and iron deficient anaemia. This is due to the inflammatory nature of the condition which stimulates the effects of hepcidin, blocking iron absorption in the GIT as a protective mechanism. Additionally, it is common for gastrointestinal lesions to be a site of chronic blood loss further contributing to reduced iron stores through the bowels. IBD, as well as conditions like coeliac disease and food intolerances cause damage to gastrointestinal membranes, which are the sites of nutrient absorption meaning many nutritional deficiencies can occur due to lack of surface area and cells to transport essential nutrients like iron into the bloodstream.

Heavy menstrual bleeding

For every millilitre of blood lost, so too is 0.5mg of iron. Menstrual blood is the most common cause of iron deficient anaemia in pre-menopausal women. Heavy bleeding has been linked to iron deficiency and iron deficient anaemia in a range of studies.

Life stages

It's also important to be aware of your requirements as depending on your age and gender, requirements will fluctuate. As previously mentioned, during a females menstruating years her iron is commonly low due to menstrual bleeding. Her requirements increase significantly from pre-puberty into adolescent years and continue until menopause.

Female recommended daily intakes are:

8-13yo - 8mg/day

14-50yo - up to 18mg/day

51yo + - 8mg/day

There is an even more substantial requirement increase for iron during pregnancy of 27mg/day. This ensures optimal development of new blood and oxygen delivery to the foetus. Iron for healthy cell division is of tremendous importance as a rapidly growing baby is a constant division of new cells!

Then we have the natural decline of cellular function with ageing. With focus on our gastrointestinal lining we find our digestive capacity reduced as a part of growing old, we have less ability to digest foods and thus, lack absorption of important nutrients from food, such as iron. We have smaller appetites and at this stage in life are more prone to being on medications that can interfere with our digestion and metabolism of essential nutrients.

What can a Naturopath do?

Naturopaths use optimal ranges when it comes to measuring blood results like iron. Not ignoring results that indicate low to normal levels (we won't wait for you be under 30 before we decide to address that obvious deficiency) we address these issues before our patients become victim to the signs and symptoms of anaemia. Working through diet and supplementation with patients ensures education around food sources, absorption enhancers and appropriate dosage and expected time frames to begin feeling the benefits of adequate iron levels. Replenishing iron stores with supplementation can take 3-6months and patients commonly will feel increased energy, better mood, improved concentration and increased capacity for physical activity starting after 4-6 weeks. And more importantly, identifying your cause of low iron, working on gut health, inflammation, menstrual health alongside rebuilding iron stores is highly important to ensure you maintain optimal iron.