If you go to your doctor complaining of lack of energy, weakness, lowered immunity or dizziness, he or she will likely run lab work to check your iron levels.

If your total blood count comes back low or low-normal, you’ll be advised to increase your consumption of iron-rich foods and perhaps given a supplement.

However, if your total blood count is within “normal range”, you’ll likely be told “you’re fine”, to “try and get more sleep” and “let’s monitor it”.

Yet your body still tells you something is not right…and the body doesn’t lie.

The problem with “standard” lab tests is the total blood count doesn’t give you and your doctor the whole picture when it comes to your iron levels.

And the whole picture is crucial in determining whether you have low-iron, excessive iron, low or excessive ferritin (stored iron) and why there’s an imbalance.

Our medical director Dr. Jeff Gladd, MD, has seen hundreds of patients in private practice with “normal” total blood counts who have serious iron issues. So if you suspected something was off with your lab work, chances are, you’re right.

In today’s article (the second in our “Understanding Your Lab work” series), you’ll learn exactly what you need to know about your iron levels and lab tests including:

  • Symptoms of low iron or iron issues
  • Why you should get your levels checked
  • The key components of blood work missing from most lab tests (and doctors)
  • The optimal/functional ranges of iron
  • The root causes of deficiency (hint: it’s not just diet)
  • How to optimize your iron levels
  • And how to keep track of your levels long-term

Symptoms of Low Iron or Iron Issues Include:

  • Chronically low energy that doesn’t get better with more sleep or rest
  • Feeling lightheaded or dizzy often
  • Cognitive decline
  • Fatigue
  • Lowered immunity
  • Feeling unwell
  • Headaches
  • Fainting
  • Irregular heart beat
  • Autoimmune conditions
  • Inflammation
  • Cold hands and feet
  • Muscle cramps, pain or spasms
  • Restless leg syndrome
  • Tinnitus/ringing in ears

Why Get Your Iron Levels Checked?

Iron is an essential mineral—“essential” meaning we must ingest it from food or supplements—that plays a key role in healthy bodily functions, including1:

  • Metabolism and energy
  • Muscle health
  • Brain function
  • DNA synthesis
  • Oxygen transportation

What Most Iron Lab Tests Are Missing

If your doctor suspects iron issues, she or he will typically order labs to check your total blood count. This is the medical standard for checking iron levels and diagnosing anemia.

The problem with this approach is, even if your total blood count is within the “normal range”, you can still have significant issues with iron…and you probably kNew that deep down.

At kNew Health, we use advanced lab panels (free with your membership) to check both the percent saturation of iron which measures your available blood level, and your stored iron known as ferritin. 

The reason we check both levels is because we want to know how much iron you have available in your blood for immediate use, plus the status of your stored iron which can indicate a trend toward anemia (before it becomes full-blown), inflammation and other health concerns.

What’s Your Optimal/Functional Range of Iron?

Remember, we’re testing two components of your iron levels: your percent saturation (the amount you have available in your blood) and your stored iron (aka: ferritin).

  • Optimal ranges of percent saturation are: 20-50%
  • The optimal/functional ranges of stored iron (aka: ferritin) are: 50 ng(ml)-150ng(ml)

A level below 20% saturation often indicates low iron, which can be caused by a variety of factors.

A range below 50 ng(ml) ferritin can also indicate a trend toward iron deficiency, and a range above 150ng(ml) can indicate an excess of iron, which is also cause for concern.

The Root Causes of Low Iron or Iron Deficiency

If your iron levels are sub-optimal, that means we need to uncover the root cause so we can get your levels back to safe and optimal ranges.

Keep in mind, iron imbalances are far more common than most people realize and can usually be resolved quickly and painlessly.

Common Root Causes of Low Iron:

  • Digestive system imbalances―a poorly functioning digestive system cannot break down and absorb nutrients, like iron, effectively. This can be due to a compromised gut, low levels of stomach acid and digestive enzymes or digestive ailments like Leaky Gut Syndrome or Irritable Bowel Syndrome (IBS).
  • Food sensitivities―certain trigger-foods can cause digestive imbalances which lead to poor absorption of iron and other key nutrients.
  • Diet―a diet lacking in iron, and its co-factors like vitamin C, is a common root cause of iron deficiency.
    • Vegetarians and vegans often suffer iron deficiency because they lack the more absorbable “heme” iron that comes only from animal sources. Non-heme iron, from plants, is nutritious but not as absorbable…especially without enough vitamin C or if digestive issues are at-play.
    • In addition, the phytates in certain grains, like wheat, can inhibit the absorption of iron if consumed in excess2.
  • Blood loss―this is a big causal factor of iron deficiency in women with heavy periods. Blood loss can also be caused by an accident, trauma, birth or more serious issue like a pathogenic infection or colon cancer.

The Root Causes of Low or High Ferritin Levels

Your ferritin levels give us precious insights into not only your iron levels and risk of anemia, but also your body’s level of inflammation which may indicate the presence of certain diseases and infections.

  • Autoimmune disease―causes chronic inflammation and can interfere with your body’s ability to process and/or properly absorb iron, causing elevated levels of ferritin.
  • Infections―such as Epstein Barr, can be indicated by high levels of ferritin.
  • Hereditary Hemochromatoses―is a genetic condition in which iron levels builds up in your system. While rare, it’s important to identify as this requires regular blood donation to control.

How to Address The Root Causes and Optimize Your Iron Levels Safely

Now that you understand the root causes behind iron deficiency, let’s look at how to get your iron levels where they ought to be.

If it’s a digestive health or food sensitivity issue, your Health Coach or practitioner may recommend any of the following:

  • An elimination diet―is an affordable and accurate way to rule out trigger foods that may be harming your digestive tract. “Trigger foods” to eliminate for a period of time may include gluten or other grains, dairy, sugar, soy and eggs.
  • Probiotic support―this may mean taking a multi-strain probiotic supplement and/or increasing your intake of probiotic-rich foods like kombucha, kim chi, cultured vegetables, real pickles, yogurt and kefir.
  • Digestive enzyme support―plant-based digestive enzymes or hydrochloric acid supplements offer an effective way to support digestion while you work on healing your GI tract. Food-based sources of enzymes such as papaya, pineapple cultured or raw vegetables, may also be recommended.

If absorption and/or diet are at the root cause, your Health Coach or practitioner may recommend the following:

  • Iron supplementation―is a fast way to quickly increase your iron levels. However, be sure to work with your Health Coach or practitioner as too much supplemental iron can cause constipation. Plus, an excess of iron can cause a slew of separate health issues, so be sure to have your levels monitored regularly.
  • Increasing your intake of vitamin C―which is crucial to optimal iron absorption. Vitamin C-rich foods include:
    • Cherries
    • Citrus fruits
    • Papaya
    • Broccoli
    • Kiwi
    • Brussels sprouts
    • Mango
    • Kohlrabi
    • Pineapple
    • Or supplementation may be indicated.
  • Increasing your intake of iron-rich foods such as:
    • Grassfed beef, bison and lamb
    • Organ meats, such as beef liver
    • Bone broths (these also aid in healing the digestive tract)
    • Dark leafy greens such as kale, collard greens, spinach, bok choy, chard, etc.

If you have a normal iron level and high ferritin, this suggests an inflammatory issue. Therefore, your Health Coach will help you focus on strategies to identify the root cause of that inflammation so it can be lowered, and on tracking your levels.

For high ferritin levels in addition to a high blood iron level, your Health Coach may refer you to a functional medical doctor for additional tests to rule out more serious conditions like Hereditary Hemochromatoses.

How Often to Track Your Iron Levels via Lab Work

This should be determined on an individual basis with your Health Coach or Functional Medicine practitioner.

That said, if your iron levels are off it’s a good idea to monitor your labs every few months to check progress and adjust your protocol accordingly.

And now that you understand how all your iron levels affect your health, how to read your lab results and optimize your levels know we are here to help.

All kNew Health members receive a percent saturation iron and stored iron lab workup as part of their initial assessment, along with a dedicated Health Coach to help you optimize your levels for the long-term.

To learn more about kNew Health’s approach to health and membership benefits click here.

-The knew Health Team

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3999603/
  2. https://www.ncbi.nlm.nih.gov/pubmed/2820048
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