What Causes Iron Deficiency Anemia might surprise you because most people are simply unaware of the complexities of iron absorption and metabolism. But keep reading and you’ll soon know more than your doctor about the causes of iron deficiency anemia. Remember, this page is just about the causes of iron deficiency and iron deficiency anemia, it’s not about the causes of other types of anemia, which usually have entirely different causes. Please see our page on the Definition of Anemia to understand the difference between iron deficiency anemia and other types of anemia.

When someone has Iron Deficiency Anemia, a doctor will most often look for a couple of things, particularly increased iron requirements, such as occurs from bleeding, or not getting enough in diet. What about when it’s not so straightforward? There are other causes of iron deficiency, but it’s unlikely your doctor will look for them and you’ll be left to suffer or be sent to a hematologist to worry that you have some rare blood disease. However, in most situations, it’s just a problem that your doctor has not been educated to find. So, we’ll help you find it. Are you up for the challenge?

Iron Deficiency Is Extremely Common

Iron Deficiency is the number one nutritional deficiency in the world, so this is a problem that is universal and not limited to third world countries or poor people.

Unfortunately, unless it’s an acute anemia from serious loss of blood, few doctors will catch iron deficiency until it becomes anemia. But anemia is the late stage of iron deficiency. In many cases, if doctors were looking out for your best interests, once you felt tired, had brain fog, or any of the other Symptoms of Iron Deficiency, they would take blood tests called Iron and Ferritin levels and catch it in the stage that it is Iron Poor Blood, long before actual anemia sets in anyway.

Most of the Time, What Causes Iron Deficiency Anemia is pretty straightforward, but sometimes it’s a mystery that needs solving. We’ll go over the vast majority of these problems, attempting to put them categories for easier understanding.

#1: What Causes Iron Deficiency Anemia is
Increased Iron Requirements

Increased iron requirements while not increasing dietary iron intake sufficient to meet the body’s needs are one of the causes of iron deficiency anemia. They are things that don’t need a lot of explanation such as:

  • Blood loss
  • Menstruation
  • Blood donation
  • Childhood growth
  • Pregnancy
  • Surgeries or trauma
  • Certain cancers and other illnesses

It just seems obvious that growing children and pregnant and menstruating women would have higher iron requirements. In fact, up to 1 in 5 premenstrual women have Iron Poor Blood because they don’t get enough iron in their diet, or they are not able to absorb enough of the iron in their diet in order to meet their needs. As a result of this, iron levels slowly trend downwards over time, which could cause many Symptoms of Iron Deficiency that are rarely caught by doctors until they reach the point of actual anemia, which is a very late sign of iron deficiency.

#2: Impaired Absorption of Iron,
Even if You Don’t Think It’s a Problem

If someone’s diet is determined to be ‘good’, based on the ridiculous standards of most doctors (see the page Iron from Spinach which discusses the difficulty of getting iron from most diets), and there are no bleeding issues, most doctors will end their search for what causes iron deficiency anemia, and refer people to a hematologist. But impaired absorption is a common issue that primary doctors could easily solve if they were simply to do a little further investigative testing. Some common absorption issues are:

  • Celiac Disease
  • Gut inflammation
  • Low stomach acid levels
  • Increased intestinal permeability
  • Food sensitivities
  • Gastric surgery
  • Digestive tract infections such as the H Pylori Bacteria and Parasites
  • Finding the Best Iron Supplements

Antacid Medications are another common, but overlooked reason for impaired iron absorption. Antacid medications are one of the most commonly prescribed drugs in western cultures. Unfortunately, the Side Effects of Pantoprazole and other antacid drugs reduce iron absorption. Combine this with the fact that many people on antacids have undiagnosed H pylori infection, which also reduces both stomach acid levels and impairs iron absorption, then you have a recipe for anemia.

You see, iron, as well as other nutrients like calcium and magnesium, require an acidic environment in order to be absorbed. When acid levels in the stomach are reduced, you are asking for a lot of trouble with digestion, absorption of nutrients, and even fighting infections. There is a reason that our stomachs are so acidic that they rival battery acid, and one of those reasons is that most nutrients are absorbed better in an acidic environment.

#3: Almost Everyone Has a Diet Low in Iron

Not getting enough iron in the diet is a common problem for those with anemia, however, almost everyone believes that their diet is good, or even great. A closer look reveals that most people eat sugar and processed foods on a regular basis, precluding getting enough iron or even being able to call their diet ‘good’. Iron Poor Blood is also a common problem in those who ingest alcohol chronically.

Iron is a difficult nutrient to get, as you’ll see if you read the page on Iron from Spinach, showing that the daily needs of most people are not able to be met by either meat OR vegetables, although iron stores are generally much higher in omnivores than vegetarians.  As we mentioned earlier, though, true iron deficiency anemia is a late sign, and millions of people suffer from Iron Poor Blood long before they become anemic. But since they are not ‘yet’ anemic, those with iron poor diets simply do not know that their iron levels are incrementally decreasing year after year because no one checks them.

#4: Inflammation Causes Iron Deficiency Anemia

Inflammation is possibly one of the most overlooked causes of iron deficiency anemia. Virtually every chronic disease state has, at its core, widespread inflammation. Inflammation is such a common cause of anemia that there is even a condition called Anemia of Chronic Illness where inflammation has been determined to be the cause of the anemia.

With such high rates of chronic illness in western countries today, I suspect that this is more common than people are aware of, but doctors rarely check markers of inflammation, such as the CRP and ESR, to find out why someone is experiencing anemia. Even worse, they would be unlikely to know what to do about it except to prescribe dangerous drugs like Prednisone. Some of the Side Effects of Corticosteroid drugs actually CAUSE chronic illnesses such as diabetes, and don’t address the cause of the inflammation. So, this is not a real solution to the inflammatory causes of iron deficiency anemia.

#5 Deficiency of Iron Cofactors

Cofactors of nutrients are nutrients that are necessary for the absorption or ‘activation’ of a particular nutrient. For instance, a substance called a ‘methyl donor’ is often missing in a genetic condition called the MTHFR Gene, that makes certain people B12 deficient despite getting plenty of B12.

Iron has cofactors as well, with Vitamin D being one of them. Vitamin D and Iron are actually related in two ways. First, Vitamin D decreases a substance called Hepcidin, allowing iron to be absorbed more readily. Additionally Vitamin D helps to bring down inflammation and, as we saw above, inflammation is a well-known cause of iron deficiency.

We’ve tried to cover all of the Causes of Iron Deficiency Anemia, but if we’ve missed any, please let us know in the comments so that we can have the most accurate information for our readers! Additionally, if you are taking iron, be sure to get the Best Iron Supplements, the increased absorption and lack of side effects can be a HUGE game-changer for those with difficult to manage iron deficiency or for those who can’t tolerate oral supplements due to the side effects.