Understanding Iron Anemia: A Deeper Dive into Iron Functionality
Iron anemia is a prevalent topic, particularly among women, and is often misunderstood. While many believe that iron anemia is solely due to an iron deficiency, the reality is more complex. It is more accurately an issue of iron functionality. In this blog post, we will explore the misconceptions surrounding iron anemia, explain why low iron levels is not be the problem, and highlight the importance of understanding iron function in the body.
The Misconception of Iron Anemia
In both conventional and functional medical spaces, there is a significant misunderstanding of how iron functions in the body and how to properly test for it. Iron anemia, or the lack of iron in the blood, is not merely an iron deficiency issue but rather a functionality issue. Here are three major reasons why low iron is not the root problem in iron anemia:
Iron Recycling System: Our bodies constantly recycle 24mg of iron daily, regulating it from our bone marrow to red blood cells, which then transport it to various tissues. This system is tightly regulated unless there is significant blood loss. Copper-dependent enzymes keep iron in motion and regulated. However, modern life depletes our copper levels, resulting in a poor iron recycling system that can appear as low iron.
Excess Iron Intake: We are exposed to iron-fortified foods, medications, and other external sources of iron, often leading to excess iron in the body. The body is designed to incorporate only 1 mg of iron from food. Excess iron, especially in a copper-deficient body, can trigger an immune response, causing iron to be stored in tissues to protect against potential infections. This sequestration of iron from the blood into tissues is a protective mechanism, as unregulated iron can feed pathogens.
Iron Fortification: About 36% of the planet is made of iron, making it the fourth most common element in the world and there are eight different types of iron fortified into the foods we eat. So how is it that there is an issue with iron deficiency? Most say that it's because of the vegetarian diets. However, 20% of the population is considered anemic and only 8% are considered vegetarian plus those people would be most likely eating iron-fortified foods like grains, cereal, and flour. The other reason historically used is that women lose blood every month but that would indicate that the natural design of female physiology is flawed, which I don’t buy. So why is iron deficiency an issue? Cause iron isn’t the problem, it’s a deficiency in copper from our soil to our animals and our bodies in addition to a surplus of external iron.
Why Low Ferritin Does Not Determine Iron Status
Ferritin is a protein made inside our cells to help store iron. It releases iron when the body needs it. There are two types of Ferritin: heavy chain (HC) and light chain (LC). HC is loaded with iron using a copper dependent enzyme. When inflammation is present LC ferritin discharges iron in the cell and gets excreted into the blood – this is what gets tested as “serum ferritin” on a blood test. Ferritin is measured and considered stored iron but that’s only a small aspect of the story.
Ferritin does store iron, however, it stores it inside the cells meaning that ferritin levels outside the cells should actually be lower. When we measure ferritin in the blood, we’re looking at ferritin outside the cells. The iron recycling system and copper will help to move iron from ferritin storage into the red blood cells when the body signals it to do so.
Understanding Iron Status Through Testing
When ferritin appears low in the blood but inflammation is present, there will be an increase in hepcidin, a hormone that regulates iron balance and suppresses iron absorption when there is too much iron to store. This leads to more iron storage in tissues, decreased iron in blood work, compromised copper metabolism, and compromised iron metabolism. This is a protective mechanism designed by the body.
Ferritin is not an accurate representation of iron status. Instead, hemoglobin should be measured since 70% of iron is in hemoglobin. Copper levels are also important because copper helps attach iron to hemoglobin and loads ferritin with iron. To truly understand iron functionality, we need to understand copper functionality: is it bioavailable? What is the ceruloplasmin status? Is there enough retinol to support copper bioavailability?
This is why I utilize the Full Blood Iron Panel which helps to determine the level of inflammation that is created from iron-copper dysregulation. To learn more about the Full Blood Iron panel, click here.
The Beauty of the Female Menstrual Cycle
As women we have a natural way to support our iron recycling system and get rid of excess iron monthly. This is part of the female body’s natural intelligence in regulating our metabolic system and is theorized why women historically live longer than men. This is another aspect to why having a healthy menstrual cycle is key in women’s health and wellbeing. When we take birth control that hinder having a cycle or have mineral imbalances that cause hormone disruption that leads to irregular cycles, it impacts the iron recycling system and generally results in higher stored tissue iron causing oxidative stress and an inflammatory response.
Conclusion:
If you've been diagnosed with iron anemia or told you have a iron deficiency, it’s most likely because it's being stored in your tissues (which is not tested) and is based on incorrect markers that don't represent iron status. When an iron supplement or sometimes even infusions are introduced, this actually causes more disruption within the iron recycling system and increases oxidative stress (inflammation), especially in a copper deficient body. This is often at the root of hormone imbalances and metabolic conditions.
The best way to regulate the functionality of iron is through bioavailable copper, retinol, and a foundation of nutrients that support a healthy menstrual cycle and overall metabolic system.