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Why Iron levels remain Low
By Tony Pearce RN.
Specialist Trichologist, National Trichology Services
A Low Iron level is arguably the most prevalent nutritional deficiency in women of menstruating age. Iron is lost predominantly through menstruation each month, & if a woman’s periods are excessively heavy or frequent she may drop her iron storage (termed ferritin) quite rapidly. Iron deficiency may also occur during pregnancy as a result of increased demands on the mother’s nutrient reserves by the developing infant.
Iron is central to healthy functioning of the human body because it is the main constituent of hemoglobin – the oxygen-carrying protein inside red blood cells. Iron is also essential for many bio-chemical processes including the formation of Cytochromes & certain respiratory enzymes.
A small but constant daily intake of iron is essential to maintain the quality & numbers in red blood cell production. Females 14-50 years of age require 15-18mg of iron per day, decreasing to about 8mg/day after menopause.
When iron levels are reduced, fatigue & intolerance to cold are often early indicators. Both symptoms are related to inadequate oxygen supply (due to decreased hemoglobin) vital for ATP & thermogenesis (heat) production. The revealing pallor of iron deficient women is again due to low hemoglobin content in the blood.
Raising iron levels in a woman with iron deficiency anaemia can sometimes be a lengthy & exasperating process, for there are many factors to frustrate this undertaking. The main issues are:
- Blood Loss from bleeding ulcers, hemorrhoids, ulcerative colitis or other problems within the gastrointestinal or genitourinary tracts. When iron levels fail to rise with iron supplementation, the patient should be referred (by their GP/MD) to a Gastroenterologist for further investigation – and exclude any malignancy.
- Helicobacter pylori infection is – with the exception of blood loss – the most common cause of iron deficiency worldwide. H. pylori bacterium decreases the gut’s ability to absorb iron by inhibiting gastric acid secretion, damaging the stomach’s mucous layer, & underlying gastric cells. Helicobacter serology and/or a fasting C14 breath test should always be performed in chronic iron deficiency.
- Coeliac Disease/Gluten Intolerance occurs in the small intestines of pre-disposed people as a result of an inflammatory reaction to Gluten – the main protein of wheat, rye & barley. Over time the intestinal lining is obliterated, diminishing its capacity to absorb dietary nutrients – particularly iron. Coeliac serology should be mandatory when investigating the cause/s of iron deficiency.
- Intestinal Parasites & Disordered Gut Function: Blastocystis hominis is a ‘natural’ inhabitant of the human gastrointestinal tract. However when over-colonisation of this parasite occurs, it can cause chronic diarrhea, fever, nausea and abdominal cramping. B. hominis utilises iron from the host’s body to mature and replicate, thus depleting the person of iron for their body’s needs. Many chronic anaemia patients are found to be infested with this parasite.
Severe fermentative dysbiosis is an overgrowth of normal gut bacteria due to inadequate gastric acid and/or pancreatic enzyme production. Sufferers often exhibit multiple nutrient deficiencies including iron, B group vitamins, B12, zinc & magnesium.
- Competing Nutrients: When supplementing vitamins & minerals it’s important to know which nutrients aid or antagonise another’s absorption. Taking an iron supplement at the same time as the minerals zinc, or copper, or calcium or chromium will inhibit the absorption of all. Excessive or prolonged supplementing of Vitamin B12, D or E can inhibit the absorption of iron.
- Copper Deficiency may result in a refractory anaemia unrelieved by iron supplementation. A deficiency of copper hinders the deployment of iron by the red blood cells, resulting in the iron being accumulated (and unavailable) within the organs of the body. Because this stored iron cannot be utilised whilst the copper deficiency persists, symptoms of iron deficiency may present despite an actual iron sufficiency.
- Underactive Thyroid function (Hypothyroidism) is an indirect cause of low iron as the active thyroid hormone T3 (Triiodothyronine) is essential for good gut function.
- Heavy Metal Toxicity of lead, mercury or cadmium will inhibit iron absorption and utilisation. Heavy metal poisoning now receives greater investigative focus due to its severe impact on people’s health.
- Strenuous Exercise with a resultant heavy perspiring utilises iron, Vitamins B12, folate and protein at an accelerated rate. A demanding exercise regime may also lead to decreased nutrient absorption as blood supply to the gastrointestinal tract is diverted to the muscles. Excessive exercise/perspiration depletes zinc, magnesium, and often potassium. A good level of zinc is required for the stomach to produce hydrochloric acid (HCL) – HCL is essential for the absorption of iron, magnesium and ‘trace elements’ (Zinc, Selenium, Molybdenum, Manganese, Copper, Cobalt, Vanadium). Athletes who are iron or other nutrient deficient should rest or undertake very light workouts only, and replenish with quality supplements.
- Iron Combinations: its unclear why but some people better absorb and utilise certain forms of iron and not others. Supplementing with different types of iron or an iron ‘combination’ may yield better results. Iron Picolinate, Ferrous Fumarate, Ferrous Sulphate, or Iron Amino Acid Chelate are iron variations to be considered. Oral iron supplementation should be at least 80mg per day. Vitamin C & amino acid complex enhance the absorption of iron.
- Compliance, diligence, patience and time are essential pre-requisites to re-building depleted iron stores. Patients will often take an iron supplement for 3-4 months only to find their iron levels are unchanged or even lower. This is due to low bone marrow iron that has compensated by taking iron from the muscles (myoglobin). When iron is being replenished through supplementation, the bone marrow “debt” to the muscles must first be repaid – hence iron storage (ferritin) remains static or even falls. This is a temporary setback, and the person’s iron levels will eventually lift as they continue supplementing. At this time it’s important for the Practitioner to reassure the patient, allay anxieties and encourage continued compliance.
About the Author: Tony Pearce RN is a Specialist Trichologist and a Registered Nurse. He is a founding member of the Society for Progressive Trichology & the official lecturer for Analytical Reference Laboratory (ARL) for hair loss & hormone imbalance. He is the Clinical Director for Trichology Hair Solutions of Virginia/DC in the United States. In Australia he can be contacted on 02 9542 2700, or through his website at www.hairlossclinic.com.au.
Special thanks to Dr. Philip Van Zanden for his valuable contribution. References for this article available on request.
© Copyright Anthony Pearce 2007.
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