Iron deficiency – Iron deficiency despite tablets: what could be behind it?
In short: If your iron levels don't rise despite tablets, it's often down to how you take them, poor absorption in the gut or ongoing losses, for example from heavy periods. Finding the cause matters more than increasing the dose.
1. How you take it
- Coffee, black tea and dairy products reduce absorption. Leave a gap of about two hours.
- Vitamin C can improve absorption, for example a glass of orange juice or vegetables rich in vitamin C.
- Less can be more: studies show that iron taken every other day is often absorbed better than high daily doses.
- Stomach protectors (proton pump inhibitors) and certain other medications can reduce absorption. Talk to your doctor about this.
2. Absorption in the gut
Iron is mainly absorbed in the upper small intestine. If the lining there is irritated or inflamed, absorption is poorer. Possible reasons include coeliac disease, a Helicobacter infection, too little stomach acid or chronic inflammation in the gut. Parasites can also block iron absorption.
3. Ongoing losses
- heavy or long periods
- bleeding in the gastrointestinal tract that goes unnoticed
- frequent blood donation
- intensive endurance sport
4. Inflammation distorts the result
Ferritin, the iron storage marker, rises with inflammation. A “normal” ferritin level can therefore mask a deficiency. That's why it's worth looking at ferritin together with an inflammation marker (CRP) and other iron values.
How I approach it
I look at your blood results, your diet, your cycle and your digestion. This makes it clearer where the problem lies: intake, absorption or losses. We then adjust the form, timing and support of your iron supplementation.
When should I see a doctor first?
Very low levels, blood in the stool, black stools, very heavy periods, unintended weight loss, shortness of breath or a racing heart should be checked by a doctor first. Iron infusions are prescribed by your doctor – and they can certainly make sense. I'm here to support you in the long term.
Find out more: Naturopathy.
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