The Top 7 Hidden Causes of Iron Deficiency

01 Aug 2018

The Top 7 Hidden Causes of Iron Deficiency

By Naturopath & Nutritionist Georgie Collinson

Iron is the most common nutrient deficiency amongst females and it may be keeping you feeling exhausted on a daily basis, especially if you know you’re deficient or have been in the past.

If you’re eating plenty of sources of iron, you have at least two portions of red meat per week and you diligently steam your greens to break down the phytates and oxalates that may bind to iron and prevent its absorption and you even add lemon juice to your spinach and rocket salad but still you feel tired and frustrated when you get your blood test results back and once again you have low ferritin (iron stores).

There can be more to iron deficiency than simply not getting enough in your diet. Here, we explore the most likely causes of iron deficiency that is not responding to an increased intake or supplementation

  1. Undiagnosed coeliac disease

Coeliac disease is an immune attack on the gut in response to gluten, which damages the gut lining and compromises the delicate brush border where our nutrients are absorbed. Coeliac disease is often undiagnosed, as it can occur without any symptoms or symptoms that appear to be disconnected from the gut, such as headaches and fatigue. There may be no digestive discomfort at all after eating gluten-containing foods, however the damage to the gut lining still occurs silently over time. Iron absorption is reduced, alongside many other nutrients.

  1. Overdoing the zinc

If you’ve been taking a zinc supplement for months on end, you can throw your other minerals out of balance, as they compete for absorption and utilisation in the body. Iron is one of these susceptible minerals. Copper is also prone to this effect and can go hand-in-hand with an iron deficiency. It is a good idea to take a break of at least two weeks from zinc supplementation every few weeks, especially if you are no longer correcting a deficiency but simply maintaining your zinc status.

  1. Parasitic infection

A parasite reduces iron absorption by disrupting the gut lining and causing tiny amounts of blood loss through the gastrointestinal tract that may appear in your stool. The blood loss adds up over time, causing a significant depletion of iron stores. This is more likely if there are also vague, chronic digestive symptoms such as diarrhoea, gas, bloating and blood or mucous in the stool.

  1. Insufficient gastric acid

Stress, ageing and certain medications can reduce the stomach’s output of gastric acid, which assists in iron absorption by separating iron from globin. Over time, a low gastric acid secretion can impact iron absorption and result in a deficiency.

  1. Chronic inflammation

When the body is in a state of inflammation, it can hide iron away in a certain type of white blood cell called macrophages. Iron absorption is also reduced by inflammation. Key considerations might be autoimmune diseases such as rheumatoid arthritis and chronic infections such as Helicobacter pylori or Epstein-Barr virus.

  1. Heavy menstrual periods

Women are far more prone to iron deficiency as they lose iron-rich blood from their bodies every month. Excessive menstrual bleeding in particular depletes iron stores. Causes of heavy menstrual periods can vary from uterine fibroids and hormonal imbalances to contraception choices.

  1. Inadequate protein intake

A lack of protein in the diet impairs your absorption of iron. While this is unlikely to be the sole cause of iron deficiency, it can certainly contribute. Ensure you’re getting enough protein by choosing a palm-sized portion at each main meal, as well as two extra handfuls throughout the day.


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