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Why Iron Status Requires Careful Assessment

Assessing Iron status is something we do daily -- especially among the population of menstruating women. It is also poorly managed overall by conventional care and women are often made to feel as though it's all in their head.


Iron is very important in many processes in the body, in fact we need it for two steps just in the thyroid gland alone when making thyroid hormone. We also need it to make serotonin, melatonin, dopamine and of course - delivering oxygen to ALL cells in the body. So when you say: "I’m tired, I’m cold all the time, I don’t feel rested on waking, I’m restless at night, I feel down, I get dizzy and sometimes have heart palpitations" — this is the top of our radar. But often your lab work, will not include all the elements necessary to fully assess iron. It might just be a CBC [complete blood count] which only shows the size/shape/quantity of white and red blood cells. It might include either iron or ferritin but never both — as OHIP will only allow one or the other to be ordered at any one time.


Why should you have both assessed?


-- To get a full picture of what is going on - you need both.


-- For safety — 1 in 9 of European decent have the ‘Viking Gene’ or a tendency towards iron storage disorders otherwise known as hemochromatosis. If this is the case — it’s not safe to take iron. Women are particularly at risk here of NOT being diagnosed until later in life [usually around menopause] because their menstrual cycles will aid them in keeping iron levels lower. But once they stop having monthly cycles — they’ll start to accumulate iron and a whole host of issues ensue.



Wallet Money

Here is how I like to think about iron labs:


Ferritin is how much money you have stored in the bank


Serum Iron is how much cash you have in your wallet


Iron Saturation is how full your wallet is


Transferrin is your actual wallet, how you carry your money


Total Iron Binding Capacity is how much space is left in your wallet



If you have a high iron saturation - this means you need to be monitored for the viking gene mentioned above. If your Iron is low - it might mean the supplement you’re taking isn’t being absorbed or your diet is too low in iron. If your transferrin is low - you might not be hitting your macronutrient needs -- especially protein!


Talk to your ND today about interpreting your labs or ordering more comprehensive labs to understand where you’re at. Also, if your GP says your labs are fine and you have no flags in your results - don’t leave it at that. The reference ranges are based on population averages and way too broad. Recently - lifelabs changed the reference ranges dramatically to reflect the large disparity between low and optimal but they still require careful interpretation with someone trained at interpreting iron labs. When your ND looks at your labs, they’ll be looking for an optimal level… not a population average. They'll also be looking at many factors that influence iron status and oxygen delivery to major organs, cells, etc.


This is one of the most common concerns we deal with and can have a major impact on someone’s quality of life and overall vitality. It’s easy to treat. Let’s take a look.

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