Told You Have Low Iron? Why That’s Often Not the Real Problem

Lately, I’ve been seeing the same conversation come up again and again.

Women are told by their doctor:

“You’re low in iron.”

And the solution?

“Take an iron supplement.”

But here’s the problem:

In many cases… they’re not actually low in iron at all.

And I know this - not just from working with clients, but from my own experience.

Why am I told I have low iron when my iron levels are normal?

Many women are told they have low iron when only ferritin (iron storage) or hemoglobin is tested. However, normal blood iron with low ferritin often indicates issues with absorption, gut health, inflammation, or chronic infections - not a true lack of iron intake. Taking iron supplements without addressing these root causes may not improve symptoms and can even worsen inflammation.

My Story (And What Most Doctors Missed)

A few years ago, I was told I was essentially anemic and needed iron supplementation.

But when I looked closer at my labs:

• My serum iron was completely normal

• What was low… was ferritin (my stored iron)

That’s a very different situation.

Because low ferritin doesn’t automatically mean: you’re not eating enough iron or that you need to supplement it. In my case, the real drivers were:

• Chronic infections

• Mold exposure

• Gut lining issues (yes - leaky gut was part of it)

So instead of taking iron, I focused on healing the terrain.

And that’s exactly what I now see in so many women.

Why So Many Women Are “Misdiagnosed” with “Low Iron”

Here’s what’s happening in practice:

• Often only ferritin is checked

• Sometimes only hemoglobin is tested

• Rarely do we see the full picture:

  • Serum iron

  • Ferritin

  • Transferrin / saturation

  • Inflammation markers

So what happens?

• Low ferritin = “you’re iron deficient”

• Symptoms = “must be iron”

• Solution = iron supplements

But that’s an oversimplification.

Iron vs. Ferritin (Simplified)

• Iron = what’s circulating in your blood

• Ferritin = your stored reserve

You can have:

✔ Normal total iron

✔ But low ferritin

Which often means: your body isn’t absorbing, storing, or regulating iron properly - not that you’re lacking intake.

Why Taking Iron Isn’t Always the Answer

This is where I want to be very clear.

If your issue is not true iron deficiency, supplementing iron can:

• Sit unabsorbed in the gut (causing constipation and irritation)

• Increase oxidative stress

• Feed pathogens (bacteria, yeast)

• Worsen underlying inflammation

In other words:  it can make the root problem worse

This is why so many women say: “I’ve been taking iron… but I don’t feel any better.”

So What Is Causing Low Iron Status After 40?

Yes - heavy or frequent bleeding in perimenopause plays a role.

(And I’ve covered that in my previous article on changing period patterns.)

But in reality, what I see most often is a combination of:

1. Low Stomach Acid

You need stomach acid to extract iron from food.

But stomach acid declines with:

• Age

• Chronic stress

• Antacid use

So even a nutrient-dense diet may not translate into absorption.

2. Gut Lining Issues (Leaky Gut)

Your gut is where iron is absorbed and stored.

If the lining is inflamed:

• Absorption drops

• Ferritin storage is impacted

This is incredibly common in women with:

• Bloating

• Food sensitivities

• IBS-type symptoms

3. Chronic Infections & “Iron Withholding”

This is a big one - and rarely explained.

When your body detects infection, it may: intentionally lower available iron

This is a protective mechanism (often called nutritional immunity), because pathogens need iron to survive.

So if you have:

• Candida

• Bacterial overgrowth

• H. pylori

• Chronic sinus or dental issues

Your body may be hiding iron - not lacking it.

4. Mold & Environmental Toxins

From my clinical experience, this is often a missing piece.

Mold exposure can:

• Damage the gut lining

• Increase inflammation

• Disrupt liver function

• Block proper iron regulation

The Result? Low ferritin that doesn’t improve with iron supplements.

5. Chronic Stress

Stress:

• Increases nutrient demand

• Reduces digestion

• Impairs absorption

This is why so many “high-functioning but exhausted” women show up depleted.

The Bigger Pattern: It’s Not Just Iron

When I see low ferritin, I almost always also see:

• Low magnesium

• Low zinc

• Low copper

This mineral depletion:

• Affects energy

• Disrupts hormones

• Impairs iron metabolism itself

So focusing on iron alone misses the bigger picture.

When It Is About Iron Loss

Of course, we can’t ignore this piece.

In perimenopause:

• Estrogen dominance

• Lower progesterone

=> can lead to heavier, longer bleeding

And yes - this can deplete iron over time.

But here’s the key:

If absorption and gut health aren’t addressed, you won’t rebuild your levels—no matter how much iron you take.

What I Recommend Instead

1. Test Properly

Don’t rely on a single marker, look at:

• Iron

• Ferritin

• Transferrin / saturation

• Hemoglobin

• Other minerals: copper, zinc, magnesium, selenium

2. Fix Absorption First

Before supplementing:

• Support stomach acid

• Eat in a relaxed state

• Improve digestion

3. Heal the Gut

This is often the turning point:

Intact gut lining = better stored iron.

4. Investigate Root Causes

Especially if levels stay low:

• Infections/Immune function

• Candida

• Mold exposure

• Oral health

5. Rebuild Strategically

Not just iron - the full mineral picture

Final Thoughts

If you’ve been told: “You’re low in iron - just take a supplement”

Take a step back.

Because in many cases:

• It’s not an iron deficiency

• It’s an absorption and regulation problem

And that requires a very different approach.

Want to Go Deeper?

I’ve also written about:

• Iron deficiency and migraines

• Best food sources of iron

• How to improve absorption

👉 [Read my previous article here]