Feeling tired?  Have you had your iron levels checked?  Iron is a critical component of many of the proteins and enzymes in the body and is a key component in many biological functions including to transport oxygen around the body, for energy production and DNA synthesis.  So it is easy to see why you feel tired when your iron levels are low and how vital it is for your health and wellbeing.

We excrete very little iron, the main excretion pathway is via bleeding.  So to ensure iron stores do not build up, the body tightly controls iron absorption.  When body stores are sufficient for requirements dietary iron absorption is blocked.   If iron stores are so tightly regulated, why is it that some people who have low iron struggle to increase their iron levels with supplements?


Let’s first look at digestion, including how we absorb iron and the limiting factors.  Iron is most effectively absorbed in the small intestine, however iron tends to bind to oxygen or other minerals and food components, often resulting in large insoluble clumps which are too large to be absorbed through our cells.  This means that when we eat enough iron only 15 – 35% of it is absorbed.  Heme iron from animal sources is in a form that prevents it from clumping during absorption.  This is why in western countries heme iron accounts for only 10% of iron eaten but 2/3 of iron absorbed.

Often iron deficiency occurs when iron reserves are depleted from not consuming enough or absorbing enough to meet our needs.  This may be due to restricted diets or when iron needs increase during pregnancy or childhood development.  This can be addressed through increasing consumption.

Iron deficiency can also occur when the body can’t transfer enough into the cells, this is often the case when supplementation is not resulting in increased iron levels.

This can occur with acute or chronic infections, heart or autoimmune conditions or with cancer.  In these cases, the underlying condition needs to be treated first.  But this is not the full story, there are other reasons for low iron absorption.


To get a better picture, lets look closer at how the body absorbs iron and ways in which iron absorption can be restricted.

  • low stomach acid – most iron comes into diet as non heme iron and is broken down by hydrochloric acid in the stomach – low stomach acid can impact the breakdown of iron.
  • low digestive enzymes or vitamin C which are required to transform the iron into a digestible form.
  • incorrect balance of minerals – Absorption of iron competes with other minerals such as zinc, magnesium, copper, calcium. Hence why it is important to get advice on correct dosage for supplements that you are taking.
  • inflammation – the body responds to inflammation with an immune response which decreases the absorption of iron. During infections a battle for iron occurs between the human host and invading pathogens.   Hepcidin ( a protein which regulates the entry of iron into circulation) increases cutting off the supply of iron to the pathogen  Anyone in a state of inflammation, produces more hepcidin and therefore iron absorption is impacted.  This is one of the reasons you may feel tired after a viral or bacterial infection.


As you can see, If you aren’t absorbing iron there are a number of areas that can be investigated and treated.  When looking at pathology results for clients, I consider all of the above when determining the best treatment plan for each individual client.   Have a history of low iron or feeling fatigued?  Book an appointment and I can investigate and create a treatment plan specifically for you.