The Real Reasons Your Iron Is Low
Iron deficiency is one of the most common nutrient deficiencies I see in clinic. Women are especially vulnerable. Between menstruation, pregnancy and other hormonal factors, women often need more iron than they absorb. The problem is – even when women eat iron-rich foods or take supplements, many still don’t see improvements in their iron levels.
So, what’s really going on? Why isn’t the iron being absorbed?
The most common causes I see in clinic are:
- Low Stomach Acid (Hypochlorhydria)
Stomach acid plays a crucial role in breaking down food and releasing minerals, especially iron. It helps convert iron into a form that’s easier to absorb in the small intestine.
Low stomach acid can be caused by:
- Chronic stress
- Long-term use of acid-blocking medications (like PPIs) – apparently to lower your acid levels! Go figure!
- Low zinc and protein.
- Too many refined carbs and sugar in the diet
- Poor eating habits (like eating in a rush or while stressed)
- Getting older
- Gut Health Problems – this is a big one
Your gut is where iron is absorbed. If the lining is inflamed or damaged, absorption will be compromised no matter how much iron you take.
Chronic inflammation in the gut interferes with nutrient absorption and reduces the effectiveness of iron supplements.
Leaky gut (intestinal permeability) and an imbalance of gut flora (dysbiosis) are very common. Pathogenic bacterial species feed on iron which affects our energy. Addressing your gut function is key in resolving your low iron issues.
- Diet High in Iron Inhibitors
Certain foods and drinks contain compounds that block iron absorption, especially non-heme iron from plant sources. Common inhibitors include:
- Tannins – in black tea, coffee and wine
- Calcium – in dairy products and supplements
- Phytates – in wholegrains, cereals, legumes and seeds
- Oxalates – in spinach, beets, nuts
- Copper & Heavy Metal Toxicity
Hair Tissue Mineral Analysis (HTMA) tests for nutrients imbalances and heavy metal toxicity. Copper excess is very common, as well as elevated levels of metals like mercury and lead. These block iron from being absorbed. You can be eating all the meat you like (and maybe even digesting it!) but if you have heavy metal and copper toxicity, these will block iron absorption.
- B vitamin deficiency
Vitamin B12 and folate (B9) deficiency can also worsen iron deficiency by hindering the body’s ability to use iron effectively.
Iron is like the bricks for building red blood cells, while B12 and folate are the blueprint and tools. Without all three, the body can’t build strong, oxygen-carrying cells, which is why low B12 or folate can make iron deficiency worse.
- Poor Dietary Intake or Restrictive Diets
Plant-based and restrictive diets can put women at risk for iron deficiency. Non-heme iron from plants is harder to absorb than heme iron from animal sources.
Other issues include:
- Not eating enough protein
- Frequent dieting or low-calorie eating
- Avoiding red meat due to dietary trends
What You Can Do
- Eat iron-rich foods like red meat, lentils, pumpkin seeds, spinach and eggs.
- To increase HCl, eat in a relaxed state, chew food thoroughly and avoid drinking water with your meals.
- Add a source of vitamin C to meals (like lemon juice, capsicum, or berries).
- Avoid consuming tea, coffee or calcium supplements with meals.
- Get assessed for low stomach acid or gut inflammation.
- Consider gut-healing or anti-inflammatory support before jumping to high-dose iron supplements.
Poor quality iron supplements
Poor quality iron supplements (the ones usually prescribed by your doctor unfortunately!) do not absorb well and cause constipation in many. Getting the right treatment is critical and many well absorbed iron supplements are available. Never supplement iron without having your levels checked.
Final Thoughts
Low iron is more than a simple dietary deficiency especially for women. If your iron levels aren’t improving despite your efforts, it may be time to dig deeper into the root causes. From gut health and hormones to lifestyle and genetics, many interconnected factors can affect iron absorption.
By addressing the why, you can finally support your body in rebuilding and maintaining healthy iron levels and start feeling more energised, focused and resilient.
Book a 1:1 with Sal and get to the why of your iron deficiency.