Understanding Anemia, How to Boost Your Iron Levels, and How Health Professionals Can Help
Alrighty, friends! This post is inspired by a dear friend of mine. We were chatting over coffee just the other day when she mentioned to me that she was struggling with anemia…again!
This is something she has struggled with her whole life, but her blood work in the fall had been normal, so it was a surprise to find out she is now all of a sudden she’s anemic again. Her doctor restarted her on iron supplements three times a day, but it is just a challenge to get them all in and her iron levels are still low. To add to the mix, since she’s going through peri-menopause, the doctor also suggested hormone replacement therapy (HRT). But she wasn’t quite ready to make that leap—especially since she wasn’t sure if her periods were the issue
Now, as a newbie to blogging and looking for inspiration, I thought to myself, “Hey! I bet there are lots of people struggling with this, so maybe I can help.” I decided to put together an informative post on iron deficiency and some practical ways to overcome it.
Here’s the interesting part, while doing some research, my pharmacist brain started wondering, “I wonder if she started any new medications recently?” I shot her a quick text, and sure enough—she’d recently started a proton pump inhibitor (PPI), a medication commonly used to help with symptoms of acid reflux or GERD, in December. Viola! The medication she was prescribed can directly inhibit iron absorption. Of course, no one had told her that!
This is a classic example of how our healthcare system doesn’t always connect the dots. Her GI doc might not know she’s at risk for anemia, her pharmacist dispensing the PPI, might not know she’s taking over-the-counter iron, and the doctor prescribing the iron might not know she’s now on a PPI…. and how on earth would she know to ask these questions? But that quick two-minute conversation uncovered a potential cause of her low iron, and instead of adding more treatments, she has the option to revisit her stomach acid issue.
So, all of this to say—if you’re reading this and something stands out to you, I hope it inspires you to ask questions or start a conversation with your doctor, pharmacist, or nutritionist. Don't just mask the symptoms—let’s dig deeper into the root cause of the issue.
Iron Basics
Iron is a key mineral that helps produce hemoglobin, the protein in red blood cells that carries oxygen throughout your body. When you don’t have enough iron, it can lead to a variety of health problems. So, let’s break down what causes iron deficiency, how to treat it, and when to see a doctor.
What Causes Iron Deficiency?
Inadequate Dietary Intake
If your diet lacks iron-rich foods like red meat, poultry, seafood, beans, lentils, and leafy greens, you might be at risk of iron deficiency. Vegetarians and vegans, in particular, can struggle because plant-based iron is harder for the body to absorb.
2. Increased Iron Needs
Certain groups of people need more iron, for example:
Pregnant women to support the growing placenta and baby
Infants, children, and adolescents to support rapid growth
Athletes, especially endurance athletes who lose more iron through sweat
3. Blood Loss
Chronic blood loss can lead to iron deficiency, This could be due to:
Heavy menstrual periods
Internal bleeding from conditions like ulcers, hemorrhoids, or gastrointestinal bleeding
Donating blood frequently
4. Poor Absorption
Even if you’re eating iron-rich foods, some conditions can affect how your body absorbs it, such as:
Celiac disease and inflammatory bowel disease (IBD), which affect the intestines' ability to absorb nutrients.
Leaky gut syndrome, which may also be referred to as intestinal permeability, leaky gut can prevent the body from absorbing iron efficiently. In leaky gut, the lining of the intestines becomes damaged, allowing toxins and undigested food particles to enter the bloodstream.
Certain medications like PPIs, antacids, certain antibiotics, or blood pressure medications just to name a few.
5. Other Medical Conditions
Chronic diseases like rheumatoid arthritis or heart failure, and conditions like cancer, can also contribute to low iron levels.
What Can Help?
The good news is that iron deficiency is treatable with a few changes. Here are some ways you can help improve your iron levels:
Dietary Changes
Start by eating more iron-rich foods. There are two types of dietary iron:Heme iron is found in animal products (e.g., meat, poultry, fish), and it’s more easily absorbed by the body.
Non-heme iron is found in plant-based foods (e.g., nuts, seeds, beans, spinach, and fortified cereals). Pairing these with vitamin C-rich foods (like oranges, bell peppers, or tomatoes) can help improve absorption.
2. Iron Supplements
If dietary changes aren’t enough, your doctor may recommend iron supplements. There are different forms of iron supplements, and the right one for you will depend on your age, diet, and how your body reacts to them. This is where a pharmacist can be super helpful. We can recommend the best form for your specific needs. Always, take supplements as directed to avoid side effects such as nausea, stomach irritation or constipation.
Spinach has non-heme iron. Eating non-heme iron with Vitamin C helps your body take in the iron.
Addressing Leaky Gut
If gut health issues like leaky gut are preventing you from absorbing iron, addressing that underlying problem is crucial. This may involve eliminating foods that irritate your gut (processed foods, gluten, or dairy), adding gut-healing foods (bone broth, fermented foods, and prebiotic-rich vegetables such as garlic, onions, and asparagus) into your diet, and working on reducing inflammation. A nutritionist can help you with these changes, creating a personalized plan to support gut health and improve nutrient absorption.Intravenous (IV) Iron Therapy
In more severe cases of iron deficiency or if you’re struggling to absorb iron from supplements, IV iron therapy could be an option. This allows iron to bypass the digestive system and be delivered directly into your bloodstream.
When to See a Doctor
While mild iron deficiency can often be managed with dietary adjustments, there are times when you should seek medical help:
Symptoms Persist or Worsen
If your symptoms don’t improve with diet or supplements, it’s time to consult a doctor.Severe Symptoms
If you experience dizziness, fainting, shortness of breath, chest pain, or confusion, these are signs that immediate medical attention is needed.Heavy Menstrual Bleeding or Blood Loss
If you have heavy periods or suspect internal bleeding, see your doctor for further evaluation.Frequent Illness or Fatigue
Chronic fatigue or frequent infections can sometimes point to iron deficiency. Don’t wait for these symptoms to take over your life.Gut Health Issues
If you have digestive problems like bloating or IBS and are struggling with iron deficiency, you may have leaky gut, and correcting these issues could be crucial. A nutritionist or functional medicine practitioner can help you find the root cause and create a treatment plan.
Conclusion
Iron deficiency is common, but it’s very treatable. By making mindful dietary changes and seeking the right support from health and nutrition professionals, you can boost your iron levels and improve your overall health.
If you’re experiencing more serious symptoms or suspect you have iron deficiency, don’t hesitate to talk to your healthcare provider. And if you’re struggling with iron absorption or digestion, working with a pharmacist or nutritionist can be a game-changer. They can help you implement strategies to improve your iron levels and your overall nutrition for long-term health benefits.
Ellie Dixon is a clinical pharmacist and certified holistic nutritionist helping people live their best lives through optimizing medications, nutrition, and caring for their bodies as God intended.
References:
National Institutes of Health, Office of Dietary Supplements. (n.d.). Iron: Fact sheet for health professionals. U.S. Department of Health and Human Services. Retrieved January 29, 2025, from https://ods.od.nih.gov/factsheets/Iron-HealthProfessional/
Mayo Clinic. (2023, December 7). Iron deficiency anemia - Symptoms and causes. Mayo Clinic. Retrieved January 29, 2025, from https://www.mayoclinic.org/diseases-conditions/iron-deficiency-anemia/symptoms-causes/syc-20355034
Bischoff SC, Barbara G, Buurman W, Ockhuizen T, Schulzke JD, Serino M, Tilg H, Watson A, Wells JM. Intestinal permeability--a new target for disease prevention and therapy. BMC Gastroenterol. 2014 Nov 18;14:189. doi: 10.1186/s12876-014-0189-7. PMID: 25407511; PMCID: PMC4253991.
Harvard T.H. Chan School of Public Health. (2021). Iron: An Essential Nutrient. Retrieved from https://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/iron/
