Iron deficiency is an incredibly common health concern affecting millions worldwide. There can be many causes of low iron such as simply not incorporating enough haem rich foods into your diet.
However, there are also lesser known causes which rarely get talked about. One of these is poor gut health, often the result of leaky gut syndrome or the overgrowth of bad gut bacteria.
In this article, we will discuss why traditional treatments often fail, how the root cause of low iron starts in the gut and how colostrum is well equipped at restoring gut integrity and therefore can provide a root cause solution to low iron.
The Problem With Traditional Iron Treatments
Typically when you find out that you have low iron or anaemia, a Dr will recommend two treatment options:
1. Iron Tablet or;
2. Iron Transfusion
In either case, both of these treatment options use synthetic forms of iron which for the fast majority of women come with unwanted side effects including constipation, stomach cramps, gas, bloating and sometimes diarrhoea (1)(2).
On top of this, many women experience no symptom relief or improvement. While traditional approaches can sometimes work they often fail at the absorption level:
- Issue 1: Iron tablets contain too much iron. Large doses found in iron tablets elevate hepcidin levels which lowers iron absorption the following day (3).
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Issue 2: You are deficient in or are not getting adequate amounts of iron boosting co-factors. Iron needs B12, Vitamin A, Folate & Copper for absorption (4)(5)(6)(7). Deficiencies in any of these nutrients may significantly alter iron absorption.
- Issue 3: You have a pre-existing gut issues. In this case, your body cannot absorb the iron and co-factors it needs to regulate iron levels (8)(9). On top of this, taking synthetic iron tablets can make gut issues worse, which in turn can make absorbing iron more difficult (10).
In the case of issue 1, taking your iron tablet once every second day may improve absorption by limiting hepcidin release. However, many women are non responders to this approach as-well.
In the case of issue 2, incorporating foods high in iron and iron cofactors can effectively resolve low iron levels, which for many women is the primary cause of their deficiency. For instance, many of our customers have successfully tackled low iron by using a beef liver supplement. Beef liver stands out not only as a good source bioavailable haem iron but is also the richest source of iron co-factors such as B12, Vitamin A, Folate, and Copper.
In the event where issue 1 or 2 do not work, it is likely that you have gut issues and will need an approach which combines incorporating iron rich foods with gut healing measures.
The Link Between Gut Health & Low Iron
One of the primary drivers of low iron and anaemia is intestinal permeability or leaky gut syndrome (11)(12)(13)(14).
Common causes of leaky gut include antibiotic overuse, processed foods, sugar, stress, medications and other lifestyle habits like being sedentary.
When leaky gut syndrome occurs, the protective lining of the gut becomes damaged or leaky. When this happens, toxins, bacterial metabolites and other particles leak across the intestinal wall and into the bloodstream causing chronic inflammation and immune activation.
When you have increased intestinal permeability, your ability to absorb iron is severely impaired. With an increase in immune cells comes the damage to carrier proteins and the release of inflammatory molecules called cytokines (15). These cytokines upregulate the expression of liver hepcidin, which decreases iron uptake from gut enterocytes (16).
To further complicate the matter, taking an iron tablet when you have gut issues is like adding fuel to the fire.
This is because oral iron supplementation activates reactive oxygen species in the gut, which can further increase intestinal permeability (17). It also stimulates the expression of pro inflammatory cytokines which is often why iron supplementation can worsen IBD symptoms and is not recommended for those with the condition (18).
On top of this, it is believed that only 10% of oral iron is absorbed with the remainder passing into the intestine unbound. This is a problem given oral iron supplements often contain large doses. Unfortunately, pathogenic bacteria, fungi and protoza feed on iron which can further reduce beneficial microbes and also promote leaky gut syndrome (19).
How Do I Know It's A Gut Issue?
There are often quite a-lot of obvious and subtle signs which can alert you to gut issues.
The first sign you should pay attention to is how to feel after taking a synthetic iron supplement. Do you experience any gut related side effects like gas, cramping, bloating or constipation? Or do your symptoms relating to your low iron levels get worse? Or, do any of your unrelated health conditions get worse? If the answer is yes to any of these it is likely your gut is an issue.
Otherwise, the more obvious signs of gut issues include symptoms like:
- Bloating
- Constipation
- Gas
- Irregular Bowel Movements
- Diarrhoea
- Unformed Stools
- Burping
- Acid Reflux
Less common signs to pay attention to include:
- Brain fog
- Low Energy
- Fatigue
- Any autoimmune condition
- Skin conditions like acne
- Depression
- Anxiety
- Poor sleep
Colostrum: A Root Cause Treatment Option
One supplement that is incredibly underrated for low iron is a bovine colostrum supplement.
Often referred to as "first milk," bovine colostrum is produced by mother cows within the initial days after giving birth to a calf. Recognized as "liquid gold," colostrum holds over 250+ bioactive compounds including growth factors, immunoglobulins, lactoferrin and polypeptides.
Colostrum may improve low iron in two ways:
1. It has been shown to heal intestinal permeability which is the primary driver of low iron. Several studies show that colostrum can heal intestinal permeability (20)(21)(22)(23)(24)(25). For example, one study showed that just 500mg was able to significantly improve markers of leaky gut (26)
2. It contains Lactoferrin, which scavenges iron in the gut and has been shown to be more effective than iron tablets at increasing iron levels (27).
Colostrum is the only supplement which has the ability to both heal the gut and increase iron levels at the same time - even in the absence of dietary iron.
A combination of colostrum while incorporating iron rich whole foods like beef liver or meats, is perhaps going to be your best combination for tackling low iron.
You are tackling two of the most common root causes.
Limiting processed foods, getting sunlight, moving your body and avoiding sugar/gluten is only going to enhance your results.
References
1. Tolkien Z, Stecher L, Mander AP, Pereira DI, Powell JJ. Ferrous sulfate supplementation causes significant gastrointestinal side-effects in adults: a systematic review and meta-analysis. PLoS One. 2015;10(2)
2. Bloor SR, Schutte R, Hobson A. Oral Iron Supplementation—Gastrointestinal Side effects and the Impact on the gut microbiota. Microbiology Research. 2021;12(2):491-502.
3. Moretti D, Goede JS, Zeder C, et al. Oral iron supplements increase hepcidin and decrease iron absorption from daily or twice-daily doses in iron-depleted young women. Blood. 2015;126(17):1981-1989.
4. da Cunha MSB, Campos Hankins NA, Arruda SF. Effect of vitamin A supplementation on iron status in humans: A systematic review and meta-analysis. Crit Rev Food Sci Nutr. 2019;59(11):1767-1781.
5. Carmel R, Weiner JM, Johnson CS. Iron deficiency occurs frequently in patients with pernicious anemia. JAMA. 1987;257(8):1081-1083.
6. Reeves PG, DeMars LC. Copper deficiency reduces iron absorption and biological half-life in male rats. J Nutr. 2004;134(8):1953-1957; Blakley BR, Hamilton DL. The effect of copper deficiency on the immune response in mice. Drug Nutr Interact. 1987;5(2):103-111.
7. Juarez-Vazquez J, Bonizzoni E, Scotti A. Iron plus folate is more effective than iron alone in the treatment of iron deficiency anaemia in pregnancy: a randomised, double blind clinical trial. BJOG. 2002;109(9):1009-1014.
8. Li Y, Hansen SL, Borst LB, Spears JW, Moeser AJ. Dietary Iron Deficiency and Oversupplementation Increase Intestinal Permeability, Ion Transport, and Inflammation in Pigs. J Nutr. 2016;146(8):1499-1505.
9. Malesza IJ, Bartkowiak-Wieczorek J, Winkler-Galicki J, et al. The Dark Side of Iron: The Relationship between Iron, Inflammation and Gut Microbiota in Selected Diseases Associated with Iron Deficiency Anaemia-A Narrative Review. Nutrients. 2022;14(17):3478.
10. Fleming RE, Ponka P. Iron overload in human disease. N Engl J Med. 2012;366(4):348-359.
11. Yilmaz B, Li H. Gut Microbiota and Iron: The Crucial Actors in Health and Disease. Pharmaceuticals (Basel). 2018;11(4):98.
12. Rusu IG, Suharoschi R, Vodnar DC, et al. Iron Supplementation Influence on the Gut Microbiota and Probiotic Intake Effect in Iron Deficiency-A Literature-Based Review. Nutrients. 2020;12(7):1993.
13. Malesza IJ, Bartkowiak-Wieczorek J, Winkler-Galicki J, et al. The Dark Side of Iron: The Relationship between Iron, Inflammation and Gut Microbiota in Selected Diseases Associated with Iron Deficiency Anaemia-A Narrative Review. Nutrients. 2022;14(17):3478.
14. Kaitha S, Bashir M, Ali T. Iron deficiency anemia in inflammatory bowel disease. World J Gastrointest Pathophysiol. 2015;6(3):62-72.
15. Malesza IJ, Bartkowiak-Wieczorek J, Winkler-Galicki J, et al. The Dark Side of Iron: The Relationship between Iron, Inflammation and Gut Microbiota in Selected Diseases Associated with Iron Deficiency Anaemia-A Narrative Review. Nutrients. 2022;14(17):3478.
16. Ibid.
17. Ibid.
18. Stein J, Dignass AU. Management of iron deficiency anemia in inflammatory bowel disease - a practical approach. Ann Gastroenterol. 2013;26(2):104-113; Stein J, Walper A, Klemm W, Farrag K, Aksan A, Dignass A. Safety and efficacy of intravenous iron isomaltoside for correction of anaemia in patients with inflammatory bowel disease in everyday clinical practice. Scand J Gastroenterol. 2018;53(9):1059-1065.
19. Fleming RE, Ponka P. Iron overload in human disease. N Engl J Med. 2012;366(4):348-359.
20. Marchbank T, Davison G, Oakes JR, et al. OC-083 Clinical trial: influence of bovine colostrum on intestinal permeability in healthy athletes after heavy exercise. Gut. 2010;59(Suppl 1):A34.2-A35.
21. Eslamian G, Ardehali SH, Baghestani AR, Vahdat Shariatpanahi Z. Effects of early enteral bovine colostrum supplementation on intestinal permeability in critically ill patients: A randomized, double-blind, placebo-controlled study. Nutrition. 2019;60:106-111.
22. Davison G, Marchbank T, March DS, Thatcher R, Playford RJ. Zinc carnosine works with bovine colostrum in truncating heavy exercise-induced increase in gut permeability in healthy volunteers. Am J Clin Nutr. 2016;104(2):526-536.
23. Prosser C, Stelwagen K, Cummins R, Guerin P, Gill N, Milne C. Reduction in heat-induced gastrointestinal hyperpermeability in rats by bovine colostrum and goat milk powders. J Appl Physiol (1985). 2004;96(2):650-654.
24. Marchbank T, Davison G, Oakes JR, et al. The nutriceutical bovine colostrum truncates the increase in gut permeability caused by heavy exercise in athletes. Am J Physiol Gastrointest Liver Physiol. 2011;300(3):G477-G484.
25. March DS, Jones AW, Thatcher R, Davison G. The effect of bovine colostrum supplementation on intestinal injury and circulating intestinal bacterial DNA following exercise in the heat. Eur J Nutr. 2019;58(4):1441-1451.
26. Hałasa M, Maciejewska D, Baśkiewicz-Hałasa M, Machaliński B, Safranow K, Stachowska E. Oral Supplementation with Bovine Colostrum Decreases Intestinal Permeability and Stool Concentrations of Zonulin in Athletes. Nutrients. 2017;9(4):370.
27. Zhao X, Zhang X, Xu T, Luo J, Luo Y, An P. Comparative Effects between Oral Lactoferrin and Ferrous Sulfate Supplementation on Iron-Deficiency Anemia: A Comprehensive Review and Meta-Analysis of Clinical Trials. Nutrients. 2022;14(3):543