What Causes Iron Deficiency & Anemia?

Common Risk Factors That Cause Low Iron

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So if Low Iron is the Most Common Nutrient Deficiency in the World…You Might Wonder What Causes Iron Deficiency Or Am I at Risk of Becoming Anemic?  

Sometimes the culprit is easy to identify but other times it takes good detective work!  So today we’re gonna talk about the common risk factors that can cause your iron levels to drop.

With this information you’ll be able to work with your doctor and be proactive in identifying the problem so you can focus on raising your iron back to healthy levels through iron supplementation, so stick around to learn about these hidden risk factors. (Click here to learn about the iron supplement I use & recommend.)

I also included a printable checklist of common causes and the special blood tests you’ve got to ask for to identify iron deficiency in the Iron Repair Manual that you can use and even take with you to your doctor, so just click here to get a free copy.

The risk factors for low iron fall into several categories and we’ll talk about each category individually:  They are increased iron demand, frequent blood loss, inflammation, or poor absorption.

The first Risk category is increased iron demand.

Our bodies rely on iron for a huge number of our cellular and metabolic functions every single day.  But what happens if our body starts to NEED more iron than it has available to USE?    

What can cause us to start needing more iron than usual?  

The physical demands of pregnancy and breastfeeding.

This happens because not only are you supplying your own needs, but now your body is responsible for supplying the essential nutrients for the growth of your baby as well.  

I have been pregnant 5 times and I was iron deficient every single time!

It is estimated that around 77% of pregnant women experience some level of iron deficiency during their pregnancy! 

Periods of rapid growth

The growth spurts children and teenagers go through dramatically increase the body’s iron needs to allow for healthy growth.

BUT there’s a big problem with that… routine lab work doesn’t identify the first stages of low iron, this problem is usually not identified until the advanced stages of iron deficiency which is anemia! 

Nearly 50-60% of children and adolescents may become iron deficient.

Honestly, I actually think that some of the fatigue or sluggishness that teenagers are kinda famous for may actually be a symptom of low iron caused by the rapid growth they’re experiencing!

Another factor that increases iron demand is endurance athletics or intense exercise.

This happens because not only is iron lost through sweat and sloughing of skin cells during exercise, but the inflammation caused by intense exercise raises hepcidin levels which thereby decreases iron absorption from the diet.  So to make up for these losses the body needs more iron to maintain optimal athletic performance.

The second risk category is frequent loss of blood.

Our bodies work hard to keep iron at a healthy level, but when the body loses blood it may wind up struggling to compensate for that loss and iron deficiency will develop.

In women, heavy menstrual blood loss is the most common and obvious cause of iron deficiency

This happens because your body is constantly trying to restore optimal iron levels to make up for the blood loss you experience each and every month.

Also, many women unknowingly have uterine fibroids which can cause heavy monthly bleeding. Fibroids are abnormal growths within the uterus that increase the surface area of the uterus. This additional surface area increases the amount of blood lining your body produces each month.

If you experience heavy monthly bleeding, it is a good idea to discuss this with your doctor, so he or she can perform an ultrasound to identify the possible presence of fibroids.

Another common factor that can affect both women and men, is  blood loss from the gut.

This can include gastric ulcers, intestinal bleeds, or even hemorrhoids.  Even very small or slow loss of blood will add up over time and can cause iron deficiency. 

Its entirely possible that you may not be aware of these small blood losses.  Your doctor can order several exploratory procedures to discover whether or not blood loss from the intestine is causing your low iron levels.

 Finally, loss of blood from surgery, childbirth, and frequent blood donations may contribute to low iron levels.

The next risk category that can cause low iron is chronic inflammation.

 People with certain long term inflammatory conditions frequently develop iron deficiency.  

These conditions include digestive disorders like inflammatory bowel disease, crohn’s, celiac, also rheumatoid arthritis, heart failure, and chronic kidney disease.

This happens because the inflammation caused by these conditions triggers the body to increase hepcidin levels and hepcidin’s job is to block iron absorption….and eventually iron deficiency will occur.

Certain cancers also lead to low iron levels.

It’s estimated that up to 90% of IBD patients experience iron deficiency!

The next risk category is reduced absorptive capacity or malabsorption.

Iron is an essential mineral, that means that our bodies can’t make it…we have to get it from our diets. 

 BUT if our ability to absorb it is reduced that can quickly lead to low iron levels.

So again, those with compromised digestive systems like IBS, IBD, crohn’s and celiac have a hard time absorbing iron because of the inflammation in the gut.

Surgeries that alter the digestive tract like gastric bypass or vertical sleeve gastrectomy.

These procedures can reduce your body’s ability to absorb iron and you can wind up iron deficient.

 Intestinal infection, bacterial overgrowth like h pylori, or the presence of parasites.

The presence of these unwanted pathogens can affect the iron your body is able to absorb, so you doctor may need to order tests to identify or rule out these possible causes.

Another factor that is often overlooked, is frequent use of antacids or PPI’s (proton pump inhibitors)

These medications are designed to reduce the acidity of the stomach and alleviate the symptoms of GERD or acid reflux…BUT the problem is that non-heme iron requires an acidic environment for absorption. 

So by reducing the acidity of the stomach through the use of antacids, you are greatly reducing your ability to absorb non-heme iron.

Another factor that affects iron absorption is simply dietary intake.

Vegans and vegetarians are at high risk for iron deficiency because their diet lacks heme iron from meat,  which is much more readily absorbed than non-heme or plant based iron.

This is because there are a number of compounds in many of our food and drinks that  inhibit or block non-heme iron absorption.  

For example,  if you frequently drink coffee, tea, or milk, the tannic acid and calcium in these drinks actually binds to the iron in your intestines and greatly reduces absorption.

As you can see, some of the things that cause iron deficiency are easy to identify…but others may require detective work to find the root of the problem.

It’s definitely worth taking the time to discover what is causing your low iron levels. Here’s a quick recap of the common causes of iron deficiency we discussed:

Increased Iron Requirement:  Physical demands of pregnancy, rapid growth, or endurance athletics increase the iron required for healthy function.

  • Pregnancy
  • Breastfeeding
  • Rapid growth
  • Athletes

Blood Loss:  In pre-menopausal women, menstrual blood loss is the most common cause.  In men and post-menopausal women, blood loss from the gut is the most common cause. 

  • Menstrual blood loss 
  • Blood loss from the gut
  • Surgical Patients
  • Kidney dialysis
  • Gastric ulcers

Reduced Absorption of Iron (Malabsorption):  Those with damage to their gut have a reduced ability to uptake iron and are at risk of developing iron deficiency and iron deficiency anemia.

  • Antacids, PPIs (proton pump inhibitors)
  • Partial or total removal of the gut (ie: bariatric surgery)
  • Inflammatory bowel disease
  • Vegetarian or Vegan

Despite the fact that iron deficiency affects millions throughout the world, it still goes unrecognized and undiagnosed far too often. 

If you feel you are at risk of iron deficiency or you are experiencing the symptoms of low iron, it is important to request the important blood tests necessary to identify iron deficiency and work with your doctor to identify what is causing your deficiency.


World Health Organization on micronutrient deficiency

Herrmann, Wolfgang, Heike Schorr, Rima Obeid, and Jürgen Geisel. “Vitamin B-12 status, particularly holotranscobalamin II and methylmalonic acid concentrations, and hyperhomocysteinemia in vegetarians.” The American journal of clinical nutrition 78, no. 1 (2003): 131-136.

Gibson S, Ashwell M. The association between red and processed meat consumption and iron intakes and status among British adults. Public Health Nutr. 2003;6:341–350

Public Health Nutr. 2003 Aug;6(5):485-96.

*Disclaimer: This content is strictly the opinion of Krystal Moore or Three Arrows Nutra, LLC  and is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of medical advice or treatment from a personal physician. All viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. Neither Krystal Moore, Three Arrows Nutra, LLC  nor the publisher of this content takes responsibility for possible health consequences of any person or persons reading or following the information in this educational content. All viewers of this content, especially those taking prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement or lifestyle program.

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