So you’ve been told you have an iron deficiency or iron deficiency anaemia. This might feel like a straightforward issue of having enough iron or not, but really there is a deeper story to be told. Beyond the mere numbers your doctor is looking at lies the intricate dance of iron metabolism where balance is key.
Accurately assessing your iron status requires careful preparation and comprehensive analysis, yet the medical community often overlooks this essential information. As a result, women grapple with inaccurately prescribed iron supplements that may cause unforeseen problems.
First of all, what is iron?
Most women know that iron is an essential mineral responsible for carrying oxygen around the body. Without enough iron and the ability to use it, you can feel weak, tired, pale, and mentally drained. Excessive iron damages tissues and organs and can worsen symptoms of inflammatory diseases (like endometriosis or Inflammatory Bowel Disease). The key is to have just enough iron and to ensure your body can use it.
How to get your iron levels checked accurately
Accurate iron status is crucial for understanding your overall health. The test requires preparation to ensure precise results, and unfortunately, most doctors do not communicate this preparation to their patients.
To get accurate results, follow these steps:
- Fast from all food and beverages (except water) for 5-12 hours. Anything taken before or after this period can lead to misleadingly high iron levels.
- Avoid alcohol, iron-fortified foods, iron supplements, and cooking with cast iron cookware 24 hours before testing.
- Avoid strenuous exercise 24 hours prior to testing. Also, avoid moderate exercise just before the test.
What you need to know about current iron testing methods
Using a standard iron panel on blood tests overlooks your overall iron metabolism and fails to consider other factors influencing your results. If your GP solely relies on ferritin as the best marker for iron deficiency anaemia (which happens frequently), they might give you inaccurate results.
For effective assessment, ask your GP to test the entire iron panel, including:
- Transferrin: This protein binds to iron and transports it in the blood, indicating how hungry your body is for more iron.
- Saturation: This indicates how much iron is attached to the transferrin and whether it is reaching where it is required.
- Serum iron: This provides insight into how much iron is in circulation at the time of the blood test.
- Ferritin: The primary iron storage protein found in the liver and bone marrow. It shows the amount of iron waiting to be used by transferrin. By the time ferritin appears in the blood, iron has been released and can be breaking down organ cells. Inflammation can also increase ferritin, making it an excellent marker for overall inflammation.
For a more accurate assessment, your doctor should measure your haemoglobin alongside your iron panel, as haemoglobin stores 70% of your iron and provides a better idea of your actual iron levels.
Once your iron panel has been checked, consider other influences for accurate results interpretation.
What could make your iron status look normal or falsely high?
- Inflammation from disease states, strenuous exercise, obesity, and regular alcohol consumption. Your doctor can measure your inflammation by ordering a sensitive CRP with the blood test.
- Liver disease, assessed by a Liver Function blood test.
What could make you look iron deficient when you’re not?
- Moderate exercise before testing.
- Copper deficiency, which hinders iron absorption and usage, manifesting symptoms resembling iron deficiency despite normal iron levels.
- Vitamin A deficiency, affecting the regulation of iron metabolism genes and the production of proteins like ferritin involved in iron storage and transport.
- Magnesium deficiency, as magnesium supports the absorption, transportation, and use of iron. It is required to incorporate iron into haemoglobin, where 70% of your iron is stored.
- Active bacterial infections and overloads, which use iron to support their growth and survival.
- A genetic mutation called C282Y HFE, leading to increased iron absorption and accumulation in tissues. This can present as iron deficiency despite excess iron stored in tissues, showing as low ferritin and transferrin on blood tests.
Other things to consider when evaluating an iron panel
When evaluating a woman’s overall iron status, consider the high oestrogen states connected to pregnancy, Hormone Replacement Therapy (HRT), and the Oral Contraceptive Pill (OCP). Oestrogen signals the body to increase iron uptake as iron is crucial for the healthy development of the foetus during pregnancy. If you take HRT or the OCP, your higher oestrogen state could signal the body for a higher iron intake, which you don’t need.
In conclusion…
It is crucial to find the right balance of iron as both iron deficiency and excess can profoundly impact your health. To find that balance, you must know where you are starting from, and that begins with accurate assessment. A woman’s iron status must be measured in the context of her entire nutritional biochemistry and overall health. This is the minimum standard you should expect from any health practitioner. Finding a health professional who understands testing nuances and nutritional interconnections is essential for a comprehensive understanding of your overall iron status and metabolism.
Empowering yourself with knowledge about how iron tests are performed allows you to make informed decisions, avoiding unnecessary supplementation and receiving the appropriate treatment when needed. Embracing this holistic approach can help you attain the balance of iron your body needs. When you find that balance, you will start to feel well again.
Does your doctor look at your blood work and tell you everything is ‘normal’ despite clear symptoms? If this sounds like you, book a consultation with me today where I can translate your results in the context of your symptoms and biological individuality. For more information, please contact me via my booking page.
