A 35-year-old woman came to the clinic. She had been suffering from low energy for some time and the symptoms were getting worse. Her doctor recommended an iron supplement that she bought at the pharmacy. She had been on this for a long time with little improvement and it made her very constipated, as many iron supplements do.
A complete blood count showed that her hemoglobin and hematocrit were low and her red cells were smaller than normal (microcytic anemia), but taking iron did not help. On an iron test, her ferritin was also low.
She had the classic symptoms of anemia – fatigue, shortness of breath, headaches and dizziness – and felt her memory and concentration were failing. His skin was dry, he had occasional palpitations and was very pale. She had cold hands and feet even in hot weather. With her menstrual cycles, her periods were heavier than normal – a common symptom of low iron that exacerbates the deficiency.
She suffered repeated low-grade respiratory viral infections, felt constantly ill, and was prescribed multiple courses of antibiotics to reduce the risk of secondary infections. Unfortunately, the antibiotics exacerbated his digestive symptoms.
Since iron supplements were ineffective and her GP was talking about iron infusions to raise her levels, she came to get another opinion as she was not happy with the idea. There is a risk of iron poisoning when taking supplements for a long time or in high doses.
While iron deficiency anemia is common in young menstruating women, it is often more complicated than that. Prescribing an iron supplement may not solve the problem, and when this happens, it is necessary to conduct further investigations and diagnose why the person is low in iron. There are various causes that need to be addressed before her blood levels rise.
Iron is mainly regulated at the level of absorption. If a person has digestive symptoms, they may not absorb iron effectively, even when supplemented.
Iron from food does not cause digestive problems, but constipation caused by iron supplementation does because only a small percentage of the iron added is absorbed. Residues remain in the gut – slowing bowel function, hardening stools by drawing water and disrupting the microbiome – increasing the growth of pathogenic E coli and inhibiting beneficial bacteria such as Lactobacillus and Bifidobacterium. Not only does this imbalance cause constipation, bloating and cramps in about 40 percent of people, excess iron can also lead to increased oxidative stress and inflammation.
Diet-wise, she rarely ate animal foods, and vegetarians (especially vegans) get enough iron in their diet. Up to 35 percent of heme iron is bioavailable from animal proteins because it is relatively easily absorbed. Although blue, purple, black and red vegetables contain non-heme iron, only two to 10 percent is absorbed. Vegetables also contain other compounds such as phytates that inhibit iron absorption. Getting adequate iron from vegetables may require taking vitamin C at the same time.
During the discussion, she was willing to eat seafood – the best choices are oysters, sardines, mackerel and redfish. Increasing her protein intake with fish and seafood while taking protein-digesting enzymes (also anti-inflammatory for the gut) was a good option.
Fixing the inflamed digestive system and subsequent leaky gut was important. For this, he was prescribed a formula containing cabbage, aloe, turmeric, licorice root and glutamine. Adding organic coconut-based kefir to her diet also provided much-needed probiotics, along with a prescribed probiotic (Saccharomyces boulardii/cerevisiae) that helped repair the gut after antibiotics.
He was a vegetarian, eating reasonable amounts of prebiotic foods and was advised to increase them to feed the beneficial gut bacteria.
For her headaches, she regularly took aspirin or ibuprofen – which promote inflammation of the lining of the intestine, thus making the symptoms more likely to worsen. Acetaminophen wasn’t necessarily an alternative because it could damage the liver if taken regularly. Correcting iron deficiency helps reduce headaches.
Because iron supplements were causing constipation, a different approach was needed, so he was recommended a lactoferrin supplement instead of iron. Lactoferrin regulates iron absorption and transport. It helps restore the intestines, improves immunity against various infections, including viral ones, and supports bone health.
He was also prescribed a tissue salt called Ferrum phos – homeopathic iron. It reduces inflammation, improves immunity, supports energy and improves iron absorption, utilization and metabolism. Ferrum phos can improve both hemoglobin and ferritin in people with anemia without the side effects of constipation or the risk of iron overload.
At first the results were remarkable. Her symptoms improved within two weeks, and her blood levels normalized several months later.
