Why Your Iron Deficiency Isn’t Just An Iron Issue

Like most things with the human body, an iron deficiency is more complicated than meets the eye. If your iron is low, we have to look deeper than just iron levels. Minerals work synergistically in the body, meaning they all impact each other–some more than others. I have a mineral series on my blog that you can read here and here. Low levels of one mineral like copper can lead to low levels of other minerals like iron. We also use vitamins to help us properly convert and move minerals throughout the body. An essential one is vitamin A. If your only solution to an iron deficiency issue is to take iron, that’s ignoring a huge part of the iron deficiency picture. 

The Iron Recycling System

We all have an Iron Recycling System (RES) that helps our bodies produce 24mg of iron every 24 hours. Our bone marrow uses this iron to help make more red blood cells. Our red blood cells live for about 120 days and are then promptly broken down, and this process is repeated. There is an RDA for iron (8mg for men and 18mg for women), but our bodies make 24mg of iron every day. It takes 25mg of iron to support red blood cells’ production, which means we only need 1mg from our diet. Pretty crazy, right?

What else impacts this iron recycling system? Copper levels. Iron is meant to be in constant circulation with the recycling system.  Ceruloplasmin, made from copper and vitamin A, and ferroportin help make this happen. When copper or vitamin A levels are inadequate, ceruloplasmin will be low and impact this system. 

The other interesting thing is that while iron gets all the credit for transporting oxygen in hemoglobin, copper is the mineral that is responsible for moving oxygen and is the only metal that activates oxygen and turns it into water. We also use copper to make ATP, or energy, in the body. One heartbeat requires one billion ATP. If we don’t have enough copper in the body or have too much iron, we won’t produce enough energy. The balance between copper and iron is critical for adequate energy production, which means it’s essential for healthy hormones. 

Inflammation & Iron 

There has been a link between inflammation and iron for many years. I remember learning about the anemia of chronic disease when I was studying to be a dietitian. We were told that this is rare and only happens in extreme conditions. After working with hundreds of women and seeing many of the same signs, I now realize that it’s not that rare, and if anything, in the society we live in, it’s likely pretty common. 

Anemia of Chronic Disease is also known as Anemia of Chronic Inflammation (ACI). While iron and ferritin stores can look low, it’s essential to understand that this typically means iron stores in the tissue are high. Iron is an inflammatory metal. It’s crucial for our health but has to be tightly regulated in our bodies to keep us healthy. 

When iron appears low, but inflammation is involved and stored in our tissues, the body releases more pro-inflammatory and anti-inflammatory cytokines. Inflammation and iron increase hepcidin production–this means more iron storage, decreased iron in blood work, iron gets stored in the tissues, copper metabolism is compromised, and iron metabolism is compromised.

What Does Copper Have to Do with Iron?

As I stated above, minerals work together and are affected by each other.  Iron and copper are the only two metals that regulate oxygen.  Iron carries oxygen, and copper activates that energy and turns it into water.  Copper is also responsible for regulating the amount of iron that enters the blood.  If copper levels are too low, iron remains stored in tissues.  This is what causes the anemia, or lack of iron “in the blood.”  Therefore, copper deficiency leads to iron deficiency.  Focusing your energy on correcting the iron deficiency leaves you neglecting the underlying cause, copper deficiency.  For this reason, in 1954, after trying iron supplements, bread, fruit, and even arsenic, scientists were able to cure pernicious anemia and other types with beef liver.  

What Copper Deficiency Looks Like

Adequate copper intake is essential for a healthy metabolism, bone strengthening, and immune system support.  Some copper deficiency causes include increased farming pesticides, zinc consumption, surgery on the digestive tract, and Celiac disease.  Low copper levels lead to other issues, iron deficiency anemia, for example.  Symptoms of copper deficiency include:

  • Weak and brittle bones
  • Difficulty learning and remembering
  • Fatigue and weakness
  • Vision loss
  • Difficulty walking
  • Poor liver function
  • Pale skin
  • Cold sensitivity
  • Anemia

How Does Iron Relate to Hormones?

To add another complex layer to this whole iron thing, a growing body of research shows that there is also a connection between estrogen and iron levels. This study looks at how estrogen impacts hepcidin. Estradiol, the most potent form of estrogen, in excess, can lead to a decrease in hepcidin, which leads to an increase in iron absorption from food. This leads to more iron being stored in the tissues and exacerbates estrogen dominance while making our bodies appear as if they need more iron. 

Iron is complex but not confusing. We know how the iron recycling system works and what impacts it. It’s pretty frustrating that we don’t apply this information inside a doctor’s office. I can’t tell you how many women come to me taking iron when the real issue is more profound. I hope this information is enlightening and helps you on your healing journey. 

As I mentioned, having cold hands and feet is a symptom of iron deficiency.  One study showed that cold sensitivity, due to iron deficiency anemia, was accompanied by inadequate thyroid responses.  Dr. Broda Barnes’s discovery that measuring body temperature is an excellent thyroid function measurement is a practical, inexpensive way to monitor hormone health.  For more info on measuring BBT and other ways to track your hormone health, check out my Helpful Data Tracking blog. 

 Minerals have an impact on each other and play multiple roles in the body.  This is especially true of iron. Iron deficiency is likely more than simply low iron levels, it is probably due to low copper levels.  If you’ve been diagnosed with iron deficiency anemia, completing an HTMA can give us more insight into what’s going on under the hood with your minerals—like iron and copper—which impact everything from metabolism and thyroid health to liver health and hormones. To learn how to interpret your own HTMA and build a healing protocol based on your unique results, make sure you check out our Master Your Minerals course!

Amanda Montalvo

Amanda Montalvo is a women's health dietitian who helps women find the root cause of hormone imbalances and regain healthy menstrual cycles.

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