Iron is an essential trace mineral that plays a vital role in the body. It is needed for oxygen transport, energy production, immune function, cognitive health and the production of healthy red blood cells.
Iron deficiency is also one of the most common micronutrient deficiencies in the world.
When we think about iron deficiency, we often think about feeling tired. But low iron can show up in many different ways, including:
Fatigue and low energy
Brain fog and difficulty concentrating
Hair loss or thinning
Reduced immune resilience
Restless legs
Feeling cold or poor circulation
Reduced exercise tolerance
Shortness of breath, particularly when iron deficiency progresses to anaemia
In Australia, iron deficiency is more common in females than males, with approximately 22% of females, 3.5% of males and 8% of children affected.
But one of the things I often see is that iron deficiency is treated as simply a case of “you need more iron.”
Sometimes, you do need more iron.
But I believe there is value in asking a bigger question:
Why is your iron low in the first place?
Not all iron deficiency is the same
There are different mechanisms that can contribute to low iron, and understanding what is happening underneath the numbers can help us determine how best to support the body.
Absolute iron deficiency
Absolute iron deficiency occurs when the body's total iron stores are genuinely depleted.
This can happen for a number of reasons, including:
Not consuming enough iron through the diet
Increased iron requirements, such as during pregnancy
Blood loss, including heavy menstrual bleeding
Reduced absorption of iron from the digestive tract
Certain gastrointestinal conditions
In this situation, the body simply doesn't have enough iron coming in or being retained to meet its needs.
Functional iron deficiency
Functional iron deficiency is a little different.
In this situation, there may be iron stored within the body, but the body is not able to effectively mobilise and use that iron where it is needed.
Inflammation and chronic illness can influence iron metabolism and make iron less available to tissues. Gut health, infection and other underlying factors can also play a role.
This is one of the reasons why looking at the whole iron picture, rather than one number on a blood test, can be so valuable.
Understanding your iron blood tests
When I look at iron studies, I like to think about the body as a city that needs to transport iron around.
Ferritin is the warehouse.
It gives us an indication of how much iron is stored.
Serum iron is the iron currently available on the road.
It gives us an indication of the iron circulating in the blood at the time of the test.
Transferrin is the transport system.
It is the protein responsible for carrying iron through the bloodstream.
Transferrin saturation tells us how full the transport system is.
It gives us an indication of how much of the available transferrin is carrying iron.
Together, these markers give us a much more useful picture of what is happening:
How much iron is stored?
How much is available?
And how effectively is it being transported?
This is why I don't believe that one iron marker should always be looked at in isolation.
Looking beyond the iron supplement
When a blood test shows low iron, it is common to be advised to take an iron supplement.
And supplementation can absolutely be appropriate when iron stores are depleted.
But I also like to ask:
Why did the iron become low in the first place?
Because if we only replace the iron without understanding what is contributing to the deficiency, we may be missing an important piece of the puzzle.
From a naturopathic perspective, I like to explore:
Diet
Are you consuming enough iron-rich foods?
Are you eating animal sources of iron, or following a vegetarian or vegan diet where iron requirements and absorption may need particular attention?
Iron absorption
Are there dietary or digestive factors affecting iron absorption?
For example, coffee, tea and foods rich in tannins and polyphenols can reduce the absorption of non-haem iron when consumed alongside an iron-rich meal or supplement.
Medications
Are medications affecting the digestive environment or potentially influencing iron absorption?
For example, acid-suppressing medications may reduce the availability of stomach acid, which plays a role in the absorption of non-haem iron.
Gut health
What is happening in the digestive system?
Could there be inflammation, altered gut bacteria, coeliac disease or another digestive issue affecting nutrient absorption?
And how is stress affecting digestion?
Because digestion isn't simply about what we eat. It's also about whether our nervous system feels safe enough to digest, absorb and assimilate what we are giving our body.
Nutrient cofactors
Iron doesn't work in isolation.
Other nutrients, including vitamin C, vitamin B12, folate, copper and vitamin A, are involved in healthy blood formation and iron metabolism.
Inflammation
Is there an underlying inflammatory process?
Inflammation can alter the way the body handles and distributes iron, which is one reason someone can have iron present in the body but still have difficulty making it available to tissues.
Hormones and life stage
For women, I also consider the menstrual cycle, menstrual blood loss and hormonal changes across different stages of life.
Perimenopause, for example, can bring significant changes to menstrual patterns. For some women, heavier bleeding during the transition towards menopause can contribute to iron loss, while later in the menopausal transition, menstrual blood loss usually declines.
This is where looking at the person as a whole becomes so important.
But what if we looked at iron through another lens?
This is where my work as an Embodied Naturopath becomes a little different.
Alongside the physical and biochemical picture, I also like to explore the energetic experience of the person.
This isn't about saying that an emotional experience caused your iron deficiency.
Iron deficiency has physical and physiological causes that deserve proper investigation.
But our physical body and our lived experience are deeply interconnected.
From an energetic perspective, iron can be associated with strength, endurance, vitality and life-sustaining nourishment.
Iron is also traditionally associated with the root chakra.
The root chakra is often connected with themes of:
Safety.
Security.
Stability.
Grounding.
Survival.
Belonging.
Interestingly, iron itself has such an important role in sustaining the physical body. It is essential for haemoglobin and oxygen transport, helping to provide our cells with what they need to produce energy.
So when I think about iron through an energetic lens, I find myself asking:
Where in your life are you feeling depleted?
The root chakra and the experience of depletion
The root chakra is often thought of as the energetic foundation of the body.
When we don't feel grounded, safe or supported, we can spend a lot of our time in a state of doing, surviving and pushing through.
And sometimes, this can look very familiar.
Working too hard.
Putting everyone else first.
Saying yes when you really want to say no.
Overcommitting.
Ignoring the signals of your body.
Pushing through exhaustion.
Forgetting to nourish yourself.
Feeling disconnected from your physical body.
Living in your head rather than feeling grounded within yourself.
From an energetic perspective, these experiences can invite us to explore whether our foundations feel supported.
Not as a replacement for investigating the physical causes of iron deficiency—but as another layer of the conversation.
Some questions to gently consider
If your iron is low, you might ask yourself:
Have I been working too hard without giving myself enough time to restore?
Am I nourishing my body consistently, or am I constantly putting my own needs last?
Is something in my life draining my physical or emotional reserves?
Do I tend to say yes to others and overcommit, leaving myself overwhelmed?
Do I feel grounded and connected to my body?
Do I feel safe and secure in my current life circumstances?
Do I feel supported by the people and community around me?
Have I lost touch with a sense of purpose, meaning or direction?
Am I constantly in “survival mode” rather than feeling that I have space to simply be?
These questions aren't about blaming yourself for having low iron.
They are an invitation to become curious.
Because sometimes our bodies are asking us to slow down and listen to what we have been asking them to carry.
Your body is more than a blood test
Iron deficiency is a physical issue, and understanding the underlying physiological cause is important.
But you are also more than your pathology results.
Your body is influenced by your nutrition, digestion, hormones, nervous system, stress, relationships, environment and emotional experiences.
This is why I believe in looking at the whole person, rather than simply treating the number that appears outside the reference range.
Sometimes the answer is iron supplementation.
Sometimes we need to look at absorption, blood loss, inflammation, gut health or nutrient cofactors.
And sometimes there is also an opportunity to ask a deeper question:
What is my body trying to tell me about how I am living, nourishing and supporting myself?
