In Part 1, I covered the main reasons why iron levels can stay low despite supplementation—low stomach acid, inflammation, poor absorption, and the wrong form of iron. Now, let’s go deeper into how to fix these issues so iron actually gets into your cells and stays there.
If you’ve been struggling with chronic low iron, it’s not just about taking more. It’s about addressing the underlying reasons why your body isn’t absorbing or using it properly.
Step 1: Reduce Inflammation to Improve Iron Absorption
Inflammation is one of the biggest roadblocks to proper iron metabolism. If inflammation is high, the body increases hepcidin, a hormone that blocks iron absorption and prevents iron from being released from storage.
Signs inflammation is affecting your iron levels:
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Your ferritin is normal or high, but your iron is still low
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You feel exhausted, foggy, and inflamed despite taking iron
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You have a history of autoimmune conditions, chronic infections, or gut issues
How to check for inflammation:
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CRP (C-reactive protein) – A key marker for systemic inflammation
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Homocysteine – Can indicate oxidative stress and poor methylation
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Gut markers – Chronic inflammation in the gut can prevent nutrient absorption
If inflammation is driving iron issues, increasing iron intake isn’t the solution. The real fix is reducing the inflammatory load so iron metabolism can normalise.
Step 2: Fix Gut Health to Absorb More Iron
Iron is absorbed in the small intestine, so if you have gut issues, bloating, or a history of IBS, your iron uptake is probably being impacted.
Common gut issues that affect iron:
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SIBO or dysbiosis – Overgrowth of bacteria can consume iron before your body absorbs it.
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Leaky gut – Increases inflammation, further blocking absorption.
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Low stomach acid – Prevents iron from being properly broken down.
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H. pylori infections – Reduce stomach acid and impair iron uptake.
How to improve gut health for better iron absorption:
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Lactobacillus plantarum 299v – This probiotic has been shown to improve iron absorption by supporting beneficial gut bacteria.
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Digestive bitters before meals – Help stimulate stomach acid and improve breakdown of iron-rich foods.
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Increase fibre intake – Supports gut bacteria and helps with oestrogen detox (important for women with heavy periods).
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Consider stool testing – If gut issues persist, checking for dysbiosis or infections can help pinpoint the problem.
Step 3: Choose the Right Iron Supplement (and When to Take It)
Many people don’t realise that timing and formulation make a big difference in how well iron is absorbed.
Best forms of iron:
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Ferrous bisglycinate – Gentle on digestion and well-absorbed.
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Lactoferrin – Supports iron metabolism without causing inflammation.
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Iron glycinate – Well-tolerated and less likely to cause constipation.
Avoid ferric iron, which is poorly absorbed and more likely to cause side effects.
When to take iron for best absorption:
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Take iron on an empty stomach or with vitamin C to enhance uptake.
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Avoid tea, coffee, and calcium-rich foods around iron supplements, as they block absorption.
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If taking zinc, magnesium, or calcium, space them out from iron, as they compete for absorption.
Step 4: Optimise Key Co-Factors for Iron Absorption
Iron doesn’t work in isolation—your body needs other nutrients to help absorb and use it properly.
Essential nutrients for iron metabolism:
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Vitamin C – Converts iron into a more absorbable form. Found in citrus fruits, capsicum, and leafy greens.
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Copper – Helps transport iron. Found in liver, cashews, and sesame seeds.
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B Vitamins (B6, B9, B12) – Essential for red blood cell production.
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Magnesium – Helps prevent oxidative stress linked to high iron levels.
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Zinc – Plays a role in iron transport but competes for absorption, so take separately.
Step 5: Increase Iron-Rich Foods (and Absorption Strategies)
Iron comes in two forms: haem iron (from animal sources) and non-haem iron (from plant sources). Haem iron is more easily absorbed, but non-haem iron can still be effective if paired with the right foods.
Haem Iron Sources (Highly Absorbable)
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Grass-fed red meat
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Liver (one of the best sources)
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Wild-caught fish and seafood
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Chicken and turkey
Non-Haem Iron Sources (Needs Vitamin C for Absorption)
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Lentils, chickpeas, and beans
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Tofu and tempeh
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Spinach, kale, and broccoli
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Pumpkin seeds and sesame seeds
How to increase absorption from plant-based iron:
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Pair iron-rich foods with vitamin C (e.g., spinach + lemon juice).
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Soak and sprout grains and legumes to reduce phytates, which block iron.
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Cook in a cast iron pan, which can increase iron content in food.
Step 6: Be Cautious of Iron and Cancer Risk
While iron is essential, too much iron can drive inflammation and oxidative stress, particularly in conditions like cancer or chronic disease.
If inflammation is high, excess iron can:
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Increase oxidative stress, which contributes to cellular damage.
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Feed pathogenic bacteria in the gut, worsening dysbiosis.
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Create an environment that promotes tumour growth.
For individuals with cancer or chronic inflammation, iron needs to be managed carefully. Rather than pushing high-dose iron, I focus on improving iron metabolism naturally with gut support, inflammation reduction, and co-factors.
How to Know if Your Iron Plan is Working
If your iron levels haven’t improved despite supplements, it’s time to dig deeper. In my clinic, I check:
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Serum iron & ferritin – Shows stored and circulating iron levels.
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CRP & inflammatory markers – High inflammation can block iron uptake.
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Gut health markers – To assess digestion and iron absorption.
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B12 & folate – Needed for red blood cell production.
Simply adding more iron isn’t always the answer—addressing absorption, gut health, and inflammation is key.
Need a Personalised Approach to Iron?
If you’ve been struggling with low iron, frequent infusions, or poor absorption, there’s a reason why. Rather than just supplementing blindly, I help women identify the root cause of their iron issues and develop a personalised plan to fix it for good.
At Her Earth Medicine, we focus on:
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Finding the real reason your iron won’t increase.
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Choosing the right supplement and ensuring proper absorption.
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Addressing gut health, inflammation, and nutrient co-factors.
If you’re waiting for an appointment, start by:
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Checking for gut issues and inflammation markers if iron isn’t improving.
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Switching to a better iron supplement and adding vitamin C.
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Supporting stomach acid and gut health for better absorption.
If you're ready for a tailored iron plan, book a consultation at Her Earth Medicine and get your iron levels working properly again.