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Feeling tired all the time can come from too little or too much iron. Believe it or not, drinking red wine while enjoying a steak can lead to too much iron in your body, which is far more common than iron deficiency anemia is today. Iron metabolism can be affected by nutrient deficiencies, disturbed digestion, and hidden infections. Optimizing your iron levels can fix your fatigue.
When you go to your health care provider for fatigue, they start by looking for iron deficiency anemia. This is most common in women who have blood loss through monthly menstruation and in people with chronic disease. But it’s not always a lack of iron in the diet that causes this; antacids and low stomach acid impair absorption even when there’s plenty of iron in the diet. It’s also caused by a deficiency of necessary cofactors including bioavailable copper, magnesium, Vitamin C and/or boron. Pathogenic viruses, bacteria, parasites and fungi require iron for growth and can also deplete our iron stores and leave us feeling fatigued for multiple reasons.
Iron is one of the most important minerals in the body for energy, but also one of the most toxic. Hemochromatosis is a genetic disease that causes high iron in the blood, but only a small percentage of people with iron overload have this genetic issue. Iron overload is most common in adult men and postmenopausal women. Anytime iron accumulates in our tissues it causes damage, much like heavy metals do. And exposing that iron to oxidation causes us to “rust” on the inside, leading to a variety of health issues. Excess iron has been implicated in cardiovascular disease, Alzheimers, diabetes, arthritis, cancer, cataracts, osteoporosis and more.
It’s difficult to distinguish too much from too little since the symptoms of fatigue, heart palpitations, hair loss and frequent infections are the same for both extremes. And the blood tests can be misleading because low iron in the blood does not mean iron is low in the tissues. Actually, lack of functional (bioavailable) iron causes the body to store iron in the tissues, so on blood tests you look anemic but in reality you are storing iron in the brain and other deep tissues, which causes disease. Iron in the blood is not functional when we have deficiencies of magnesium, copper, and/or boron. These deficiencies keep iron from going where it is needed and instead cause it to be stored.
The most common tests done for iron levels include Hemoglobin and Hematocrit, done either alone or as part of a Complete Blood Count (CBC). Another common test is Ferritin, which is an indicator of iron stores in the body. There are other less common iron studies, which include serum iron, Total Iron Binding Capacity (TIBC) and Lactoferrin. To keep it simple, let’s just look at heme, the protein being measured in hemoglobin. Heme holds 2 molecules of oxygen-bound iron. This is how oxygen is delivered to your tissues. When your hemoglobin is low, this shows the oxygen carrying capacity of your blood is low. If you don’t have functional iron available, heme isn’t made properly and you don’t get oxygen to your tissues. This is a major reason for fatigue.
Thorough iron studies should include the CBC, ferritin, serum iron, TIBC and levels of magnesium, zinc, ceruloplasmin and copper. Read and interpreted by a knowledgeable health care provider, these should give you a good picture of your iron levels and where the issues are.
Regulate iron through diet. We only absorb 5% of iron from vegan sources, and most of this is due to the Vitamin C in the plant foods. We absorb up to 50% of the iron in red meats. Absorption of iron in foods is increased by drinking alcohol. If you have iron overload, decrease your consumption of alcohol and red meats while increasing fruits and veggies. Also, avoid cooking in cast iron or stainless steel as these increase the iron content of foods cooked in them, especially acidic foods. If you are iron deficient, increase Vitamin C rich plant foods while increasing red meats. Vitamin C helps increase iron absorption but does not contribute to iron overload.
Normalize stomach acid levels. Whether iron levels are high or low, this is important. Your body needs enough stomach acid to absorb iron, calcium, protein, Vitamin B12, zinc as well as other nutrients. Antacids inhibit iron absorption. Low stomach acid, which is the most common cause of acid reflux or GERD, keeps you from absorbing crucial nutrients and leads to anemia and osteoporosis. Supplementing with betaine HCl is a good way to normalize stomach acid levels and increase iron absorption. Remember, low iron causes us to store iron in deep tissues where it leads to other diseases.
Support your liver. The liver is where the iron transporters like ferritin and lactoferrin do their work. Actually, with everything the liver does for iron metabolism it is the key regulator of your iron stores and your blood iron levels. Keeping this organ healthy is vital to optimizing iron levels. In addition to a diet high in sulfur-rich foods, consider wheatgrass juice and a good liver supplement.
Consider a Cleanse. Pathogens like parasites, bacteria, viruses, and fungi greatly affect our iron levels because they need iron for growth. Intestinal parasites, Candida, Lyme and co-infections, chronic latent viral infections, even toxic mold exposure – all of these can dramatically increase and decrease iron levels, leading to overload or deficiency. A colon cleanse along with cutting out sugar and processed foods is a good first step to controlling or eliminating these bad bugs and getting iron levels back to normal.
Supplement with Magnesium, Boron and Vitamin C. It’s estimated 80% of Americans are magnesium deficient, and most of that is due to stress and sugar consumption which deplete magnesium at alarming rates. Both magnesium and Vitamin C can be supplemented to bowel tolerance, which is the highest dose that doesn’t cause diarrhea. Boron is best supplemented at 3mg daily. Copper is much more bioavailable through food and is not recommended in supplement form. Ann Louise Gittleman’s book Why Am I Always So Tired? is a great resource for understanding copper metabolism and the related fatigue.
If you have iron overload, donate blood. Though bloodletting is considered barbaric by our modern medical standards, it’s a practice that can still be put to good use when it comes to iron overload. If you have mild iron excess with ferritin levels 200 or less, you can donate blood 3-4 times per year to bring levels back to normal. If you have ferritin levels higher than 200, more frequent prescribed donation through a hospital-based center may be needed.
Consider IP-6 to reduce iron stores. Inositol hexaphosphate (IP-6), also known as phytic acid, is a powerful mineral chelator that effectively removes iron from the tissues. In foods, it is found in high levels in grains, legumes (beans) and some seeds. But since these foods are problematic for many people because of their lectins, a supplement form based on rice bran extract is available. It is not recommended for long-term use unless iron overload is severe, because it also removes zinc from the body and causes deficiency.