Iron is a crucial element that plays a vital role in various bodily functions, such as the production of red blood cells and the transportation of oxygen. This article aims to delve deeper into the topic of iron levels, haemoglobin, and ferritin, providing readers with all the necessary information they need to know.
The iron value is a measure of the concentration of iron in the blood serum or plasma, and the reference value is approximately 10–30 μmol/litre. Neither values that are too low, around 5–10 μmol/litre, nor those that are too high, approximately 40-50 μmol/litre, are desirable. Iron is necessary to bind oxygen to the blood pigment haemoglobin, which is then distributed to all of the body's tissues. Iron also binds to a pigment in muscle cells known as myoglobin. Consequently, iron is essential for the proper functioning of skeletal muscles and the heart's muscles. Furthermore, iron is required for cells to divide and grow properly, as well as for the immune system. As a result, iron has a variety of functions beyond simply transporting oxygen via haemoglobin.
It is possible to have a low iron value and still have a good Hb value (haemoglobin value), and iron deficiency does not always imply anaemia, which is a reduction in the blood's ability to transport oxygen due to a shortage of red blood cells. However, untreated iron deficiency will eventually result in low Hb levels. Iron deficiency anaemia refers to low haemoglobin levels. In the past, doctors had to familiarise themselves with the term "iron deficiency anaemia," which can be somewhat misleading since a lack of iron does not always result in low Hb levels at first. Iron deficiency anaemia may have several different causes, not just a lack of iron. It can result from liver failure, kidney failure, a shortage of folate or vitamin B-12, sickle cell anaemia, and other factors. Additionally, there are various types of anaemia. Iron is transported and stored in various ways, including:
- Haemoglobin: an iron-rich protein found in red blood cells.
- Ferritin: iron stores used to keep iron within the cell.
- Transferrin: a substance that recycles iron to the bone marrow and lymph nodes, which are the organs that generate blood.
Haemoglobin or Hb value is the term used to describe the concentration of haemoglobin in the blood. It is a measure of the concentration of the iron-rich protein haemoglobin in red blood cells (erythrocytes) that binds to and transports oxygen from the lungs to all of the body's cells. Approximately 97% of a blood cell's dry weight is composed of haemoglobin. Low levels of haemoglobin are called anaemia, which occurs when there aren't enough healthy blood cells, leading to abnormal fatigue and breathing difficulties depending on the severity. Hb levels are measured in grams per litre, and normal values for men are around 130–170 g/L, 120–150 g/L for women, 110–160 g/L for children, and 110–120 g/L for pregnant women. The reason why men have higher Hb levels than women is due to their more robust body structure and greater muscle development.
The protein haemoglobin found in red blood cells is responsible for the blood's ability to transport oxygen to all cells. Low haemoglobin levels can result in weakness and fatigue, hence the term anaemia. Blood values can rise abnormally due to dehydration, high altitude exposure where oxygen content is lower, and smoking, which blocks some haemoglobin through inhaled carbon monoxide. The body compensates for this by forming more blood cells, resulting in normal effective haemoglobin levels. Continuous overproduction of red blood cells (polycythaemia vera) can occur due to bone marrow disruption.
Haemoglobin levels can decrease due to several factors, including leukemia that displaces red blood cell production, drugs and toxins that inhibit bone marrow function, severe and widespread inflammation, and kidney failure, where erythropoietin production is affected. Frequent bleeding from heavy menstrual or intestinal bleeding can gradually deplete iron stores in the body, resulting in lower haemoglobin levels. The formation of red blood cells requires iron, cobalamin (vitamin B12), and folic acid, and a deficiency in any of these can cause low haemoglobin levels.
Ferritin, which is also referred to as iron stores, is a protein that contains iron and is the primary form of iron stored inside cells. However, the ferritin test measures the small amount of ferritin that the cell releases and circulates in the blood. Ferritin levels typically increase with age. High ferritin levels are observed in liver necrosis (death of liver cells) or advanced haemochromatosis (when excessive iron is absorbed and the body cannot eliminate the excess iron). Ferritin levels can also rise due to inflammation, leading to falsely high values. In such cases, the transferrin receptor test may be a more appropriate option. These receptors are present on the surface of precursor cells for mature red blood cells. As the body tries to counteract iron deficiency by improving absorption, the number of receptors increases. Low ferritin levels are almost always caused by a lack of iron.
Negative iron balance – Not enough iron
When the body doesn't take in enough iron to meet its needs, resulting in a negative iron balance, several outcomes can occur:
- Firstly, the body's iron stores become depleted, causing a decrease in ferritin levels while increasing transferrin receptors, as the body tries to compensate for the iron loss.
- Secondly, red blood cells are formed with iron deficiency. Laboratory tests for S-Fe (iron bound to transferrin) decrease while transferrin increases, as the body tries to increase the transport of iron between the spleen and bone marrow. High transferrin levels may not only be due to iron deficiency, but also to estrogen supplementation. Low transferrin levels are often caused by inflammation, liver damage, and/or excessive iron intake. However, the transferrin saturation decreases because the proportion of transferrin that is saturated with iron decreases.
- Finally, anaemia can occur, and the average size of red blood cells decreases, a condition detected by the mean corpuscular volume (MCV) test.
Why do people develop iron deficiency?
Iron deficiency usually occurs due to insufficient iron intake or the body's inability to absorb iron properly, often caused by conditions such as coeliac disease (gluten intolerance) or inflammatory diseases in the small intestine. During pregnancy, the body has higher demands for iron intake.
What can be done to improve iron levels?
- To improve iron levels, it is recommended to take either Blood Builder from MegaFood or Iron Response from Innate Response with a meal (These are the same products, just with different labels.) Begin with one tablet per day, and if there is no improvement in blood levels, temporarily increase the dosage to two tablets per day, preferably spread out over two meals. After 2–3 weeks, take new blood tests.
- During the meal when taking Blood Builder or Iron Response, avoid consuming cereals (wheat, rye, barley, oats, brown rice), legumes (soy beans, beans, lentils) or nuts and seeds that contain phytic acid as it can negatively affect iron absorption. It is also advised to avoid black tea, coffee, dairy products, soy, whey protein, casein, egg whites, and spinach tomaximise absorption.
- For optimal absorption, take Blood Builder or Iron Response with a meal that includes animal protein such as meat, fish, or seafood, and a salad. Additionally, take extra whole food vitamin C with the same meal.
- Iron is mostly absorbed in the duodenum and proximal jejunum (the part of the small intestine between the duodenum and the ileum). Therefore, it is important to have a healthy and functional small intestine. Therefore, following a healthy animal based diet and taking a daily dose of high-quality probiotics is recommended.
- If you suffer from hypothyroidism, it is important to manage it immediately. In people with hypothyroidism, the reduced levels of thyroid hormone can result in reduced production of stomach acid, which in turn can lead to decreased iron absorption. Additionally, people with hypothyroidism may have decreased red blood cell production and turnover, which can contribute to lower iron levels. If you require a protocol for hypothyroidism, email the provider for a free one. Thyroid Strength is specifically designed for individuals with hypothyroidism.
According to our experience, there is no better supplement than Blood Builder from MegaFood and Iron Response from Innate Response for improving iron levels. Our customers have also testified to the same.