Beating Iron Deficiency

When it comes to managing iron deficiency, particularly iron deficiency anemia, where your levels are affecting your ability to make red blood cells, a novel approach needs to be considered for women who have tried everything else.

If you have endured infusions, supplementation, and eating organ meat for months or perhaps years with no real headway, let’s review what’s not working and what we might consider changing.

Iron deficiency affects almost every aspect of a person’s life. From feeling teary, depressed, overwhelmed and short of breath to cold, exhausted, inflamed and having low immunity. Let’s be real about the numbers, if your ferritin levels are lower than 50ng/mL then I would expect you to be feeling less than your best and we need to address what’s going on.

If you’ve been on this jounrey for a while you are hopefully becoming well versed in your Iron, Transferrin, and Ferritin stats (if your Doctor isn’t testing all of these then it’s time we spoke), but it might be time to have a conversation about Hepcidin, a little known BIG player in your ability to absorb Iron.

Hepcidin is a hormone produced by the liver that plays a central role in regulating iron absorption and distribution in the body. Because as a species we don’t always want to absorb large amounts of iron, we have a control mechanism. Large amounts of iron will increase inflammation, put pressure on the liver and antioxidant pathways and can feed pathogens such as a virus, fungi or bacterial infection. It’s actually a smart evolutionary control to have Hepcidin protecting us from excess Iron. However, sometimes that control isn’t helping us.

The body elevates levels of hepcidin in a clever mechanism to inhibit iron absorption. It does this by blocking the release of iron from intestinal cells and sequestering iron within macrophages (white blood cells), leading to decreased iron availability for red blood cell production. Smart if that’s what you need, but a total nightmare if you’re living with chronically low iron.

But there’s a trick we can employ to override Hepcidin. Dosing (approx 48mg) every 48 hours helps to avoid interference from hepcidin.

Iron dosing every 48 hours is based on the principle of exploiting the low levels of hepcidin between iron doses. Studies have shown that administering iron supplements at regular intervals, approximately every 48 hours, can bypass the inhibitory effects of hepcidin and optimise iron absorption.

From a functional medicine perspective, this approach offers several advantages over traditional interventions such as infusions of Ferric carboxymaltose or prescription Ferrous sulphate which is really tough on the gut. While infusions can provide rapid short-term relief of anemia symptoms they do not address the underlying cause of the anemia and often the results are very short lived after a week or two of feeling uncomfortable due the the heavy load on the liver and antioxidant reuirements. When we consider Iron infusions we must also consider the risks such as iron overload, increased inflammation, and increasing underlying infections. This is especially important when I’m working with your gut health and have reason to be concerned about infection and inflammation.

In contrast, iron dosing every 48 hours optimises iron absorption and utilisation, avoiding hepcidin and thereby promoting sustainable improvements in red blood cell production and overall health without overwhelming the body.

Iron dosing every 48 hours represents a promising approach to anemia management in my clinic. It offers targeted support for optimising iron absorption and utilisation however it does not mean we’ve addressed the root cause of your low iron. While this approach is worth trialing at home and may make a world of difference, I still want to dig deeper to understand what is causing the loss of iron or poor absorption in the first place. Ruling out infections, gastrointestinal bleeding, celiac disease and heavy periods all need to be taken seriously to improve your outcomes and promote long-term health and vitality.