Iron 101: What Every Practitioner (and Patient) Should Know

Iron is one of the most important minerals within the body, but unfortunately recurrent iron deficiency is one of the most common nutritional imbalances I see clinically, with many women unable to regulate their levels long term despite iron infusions and multiple supplements. If you’re feeling tired all the time, struggling with brain fog, or noticing hair loss, low iron might be a big piece of the puzzle. And before you go grabbing any old iron supplement, it’s important to understand why your iron levels might be low in the first place and what you can do about it.  

Iron and Menstruations  

Let’s talk about your period. If you’re changing your pad or tampon every couple of hours, leaking onto your bedsheets or bleeding for more than five days, you’re losing a lot of blood and with it, a lot of iron. 

Heavy periods put you at much higher risk of iron deficiency, so it’s important that we understand and treat the root cause of why your periods may be heavy in the first place. There are many reasons why your period might be heavy, but one I see commonly is oestrogen accumulation. If your liver and gut aren’t metabolising oestrogen effectively, this hormone will accumulate driving heavy, clotty and painful periods. This means that tackling the root cause - hormonal imbalances, sluggish detoxification, and gut health - is just as important as replenishing your iron levels. 

Iron and Gut Health: Are You Absorbing It? 

I see this all the time - someone has had multiple iron infusions or has been taking iron supplements for months, yet their levels still aren’t improving. When this happens, it’s not just about how much iron you’re getting in - it’s about how well your body is breaking it down and absorbing it. 

Your gut plays a significant role in iron absorption, so when I see a client with recurrent low iron, my first line of questioning revolves around how well their upper and lower digestive tract is functioning. Reflux, heartburn, nausea, bloating, constipation and diarrhoea are all signs of a dysfunctional gastrointestinal tract and, if you’re experiencing these symptoms alongside low iron levels, we need to consider the gut as a contributing factor.  

If you have low stomach acid or poor enzyme production, you’re likely not breaking down your meals effectively and therefore are unable to extract the iron from the food source that you’ve consumed. If you have gut dysbiosis (imbalanced microbiome levels) or inflammation, your gut lining might not be absorbing iron effectively. And if you’ve got parasites or bacterial overgrowth they could actually be stealing your iron, leaving you depleted no matter how much you’re consuming. 

This is why gut health is key to iron status. Supporting digestion, healing the gut lining, and using bioavailable iron sources like beef liver can make all the difference when it comes to actually absorbing and utilising the iron you’re consuming. 

Iron and Thyroid Function 

If you’re dealing with thyroid issues like hypothyroidism or Hashimoto’s, or even suspect your thyroid function may be a little sluggish, you need to consider how your iron levels may be contributing. Your thyroid relies on iron to produce hormones that regulate your metabolism, energy and mood. Without enough iron, your thyroid can’t function optimally which means you’re more likely to feel fatigued, experience brain fog and cold extremities as well as cycle irregularities. What I see clinically and what the research confirms is that women with iron deficiency are much more likely to experience hypothyroidism and thyroid autoimmunity, so optimising thyroid levels is a key treatment aim for these clients. 

How to Read Your Iron Blood Test