May 26th 2026
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WellBeing Magazine
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A 35-year-old woman visited the clinic. She had been suffering with low energy for some time, and the symptoms were getting worse. Her GP had recommended an iron supplement that she bought from the pharmacy. She had been taking this for some time with little improvement and it made her very constipated, as many iron supplements do.
A full blood count showed that her haemoglobin and hematocrit were low and she had smaller red cells than normal (microcytic anaemia), but taking the iron hadn’t helped. When testing iron, her ferritin was also low.
She had classic symptoms of anaemia — exhausted, short of breath, recurrent headaches and dizziness — and felt her memory and concentration were deteriorating. Her skin was dry, she experienced the occasional rapid heartbeat and she was very pale. She had cold hands and feet even in warm weather. With her menstrual cycle, her periods were heavier than normal — a common symptom of low iron, which exacerbates the deficiency.
She had been suffering repeated bouts of low-grade respiratory viral infections, felt constantly ill and was prescribed various courses of antibiotics to reduce the risk of secondary infections. Unfortunately, the antibiotics increased her digestive symptoms.
As the iron supplements were ineffective and her GP was starting to talk about iron infusions to bring her levels up, she had come to get another opinion as she was not comfortable with this idea. There is the potential risk of iron toxicity if supplementing for long periods of time or in high doses.
While iron-deficient anaemia is common in young menstruating women, it is often more complex than it appears. Prescribing an iron supplement can fail to remedy the problem and when this happens, it is necessary to investigate further and diagnose why the person has low iron. There are various causes that may need to be dealt with before her blood levels increase.
Iron is primarily regulated at absorption level. If a person has digestive symptoms, they may not be absorbing iron effectively, even when supplemented.
Iron obtained from food does not trigger digestive issues, however constipation triggered by iron supplementation occurs because only a small percentage of the supplemented iron is absorbed. The residue remains in the gut — slowing down gut activity, hardening stools by drawing out water and disrupting the microbiome — increasing the growth of pathogenic E coli and inhibiting beneficial bacteria such as Lactobacillus and Bifidobacterium. Not only can this imbalance cause constipation, bloating and cramping in about 40 per cent of people, the excess iron can also cause increased oxidative stress and inflammation.
In dietary terms, she rarely ate animal foods, and vegetarians (particularly vegans) rarely get enough iron in their diet. Up to 35 per cent of the heme iron from animal proteins is bioavailable as it is relatively easily absorbed. Although blue, purple, black and red vegetables contain non-heme iron, it only has a two to 10 per cent absorption rate. Vegetables also contain other compounds such as phytates that inhibit the absorption of iron. Obtaining adequate iron from vegetables can require vitamin C to be taken simultaneously.
On discussion, she was prepared to eat seafood — the best choices being oysters, sardines, mackerel and red-coloured fish. Increasing her protein intake with fish and seafood while taking a protein-digesting enzyme (also anti-inflammatory for the gut) was a good option.
Correcting the inflamed digestive system and the subsequent leaky gut was important. For this, she was prescribed a formula containing slippery elm, aloe vera, turmeric, liquorice root and glutamine. Adding an organic coconut-based kefir into her diet also provided much-needed probiotics along with a prescribed probiotic (Saccharomyces boulardii/cerevisiae) that assisted in the repair of the gut after antibiotics.
Being vegetarian, she was eating reasonable amounts of prebiotic foods and was advised to increase these to feed beneficial gut bacteria.
For her headaches, she was taking aspirin or ibuprofen regularly — contributing to inflammation of the gut lining, thereby potentially exacerbating the symptoms. Acetaminophen was not necessarily an alternative as it can damage the liver if taken regularly. Correcting the iron deficiency would help reduce the headaches.
As iron supplements were causing constipation, another approach was needed, so she was recommended Lactoferrin supplementation instead of iron. Lactoferrin regulates iron absorption and transport. It helps repair the gut, improves immunity against various infections, including viral, and supports bone health.
She was also recommended a tissue salt called Ferrum phos — homoeopathic iron. It reduces inflammation, improves immunity, supports energy and improves iron absorption, utilisation and metabolism. Ferrum phos can improve both haemoglobin and ferritin in persons who are anaemic, without the side effect of constipation, or the risk of excess iron.
Initially the results were dramatic. Her symptoms improved within a couple of weeks and, several months later, her blood levels had normalised.
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