A Complex Case of Iron-Deficiency Anaemia
A 35-year-old woman visited a clinic with persistent low energy and worsening symptoms. She had been taking an iron supplement for some time, as recommended by her general practitioner (GP), but saw little improvement. The supplement caused significant constipation, a common side effect of many iron supplements.
Her full blood count revealed low haemoglobin and hematocrit levels, along with microcytic anaemia — a condition where red blood cells are smaller than normal. Despite the iron supplementation, her ferritin levels remained low. This indicated that her body was not effectively absorbing or utilising the iron she was taking.
She experienced classic signs of anaemia, including extreme fatigue, shortness of breath, recurring headaches, and dizziness. Her memory and concentration were also affected. Other symptoms included dry skin, occasional rapid heartbeats, and pale skin. She often had cold hands and feet, even in warm weather. Additionally, her menstrual cycles were heavier than usual, which can exacerbate iron deficiency.
She had been suffering from frequent low-grade respiratory viral infections, leading to repeated antibiotic prescriptions. Unfortunately, these antibiotics worsened her digestive symptoms, making the situation more complicated.
As the iron supplements were ineffective and her GP suggested considering iron infusions, she sought another opinion. She was concerned about the potential risks of long-term or high-dose iron supplementation, such as iron toxicity.
Iron-deficiency anaemia is common in young menstruating women, but it can be more complex than it appears. Simply prescribing iron supplements may not resolve the issue. It is crucial to investigate further and determine why the person has low iron. There are various underlying causes that need to be addressed before blood levels improve.
Understanding Iron Absorption and Digestive Health
Iron is primarily regulated at the absorption level. If a person has digestive issues, they may not be absorbing iron effectively, even when supplemented. Iron from food does not typically cause digestive problems, but iron supplements can lead to constipation because only a small percentage is absorbed. The remaining iron stays in the gut, slowing digestion, hardening stools by drawing out water, and disrupting the gut microbiome. This imbalance can lead to constipation, bloating, and cramping in about 40% of people. It can also increase oxidative stress and inflammation.
In terms of diet, she rarely consumed animal products, which is common among vegetarians and vegans. Heme iron from animal proteins is more bioavailable, with up to 35% being absorbed. In contrast, non-heme iron from vegetables has a much lower absorption rate — between 2% and 10%. Vegetables also contain compounds like phytates that inhibit iron absorption. To improve absorption, vitamin C should be consumed alongside these foods.
Dietary Adjustments and Gut Healing
After discussing her dietary habits, she was open to incorporating seafood into her meals. Oysters, sardines, mackerel, and red-coloured fish are excellent sources of iron. Increasing her protein intake with fish and seafood, along with a protein-digesting enzyme, was a good strategy to support gut health and reduce inflammation.
Healing her inflamed digestive system and addressing leaky gut was essential. She was prescribed a formula containing slippery elm, aloe vera, turmeric, liquorice root, and glutamine. Adding organic coconut-based kefir to her diet provided probiotics, while a prescribed probiotic (Saccharomyces boulardii/cerevisiae) helped repair the gut after antibiotic use.
Being vegetarian, she already consumed reasonable amounts of prebiotic foods. She was advised to increase these to support beneficial gut bacteria.
Managing Headaches and Alternative Treatments
She was regularly taking aspirin or ibuprofen for headaches, which could contribute to inflammation of the gut lining and worsen her symptoms. Acetaminophen was not always a safe alternative, as it can harm the liver if taken frequently. Correcting her iron deficiency would help reduce the frequency of headaches.
Since iron supplements were causing constipation, an alternative approach was needed. Lactoferrin supplementation was recommended instead. Lactoferrin helps regulate iron absorption and transport, supports gut healing, boosts immunity against infections, and promotes bone health.
She was also advised to take a tissue salt called Ferrum phos, a homeopathic form of iron. It reduces inflammation, improves immunity, supports energy, and enhances iron absorption and metabolism. Ferrum phos can improve both haemoglobin and ferritin levels without the side effects of constipation or the risk of excess iron.
Positive Outcomes and Recovery
The results of these interventions were dramatic. Within a few weeks, her symptoms improved significantly. Several months later, her blood levels had returned to normal. This case highlights the importance of a comprehensive approach to managing iron-deficiency anaemia, focusing on diet, gut health, and alternative treatments when conventional methods fail.
