Do you feel constantly run down and tired, have an anemia diagnosis, or have just been told you have low iron? If your doctor’s advice is for you to take iron supplements, and the only solution for no improvement is to “take more iron pills”, it’s time to look beneath the surface. There are more angles on anemia to explore, so let’s discuss the sneaky, potential root causes of anemia your doctor probably hasn’t checked for…but should.
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Why Your Iron Pills Aren’t Working
You probably already know the signs of anemia all too well:
- Brain fog that refuses to lift
- he kind of tired that a good night’s sleep never fixes
- The room spinning when you stand up too fast
- Gnawing anxiety of bouts of depression
- Thinning hair and hair loss
- Lack of stamina and endurance
So if your ferritin levels (that’s the measure of your body’s iron storage) can’t get above 50 and your symptoms aren’t getting any better, popping more iron supplements isn't going to cut it. The quantity isn’t the issue, but rather the leakage and whether your body is even absorbing the iron in the first place.
The Real Culprit: Leaky Gut
The #1 overlooked cause of poor iron absorption is leaky gut. Most people hear “leaky gut” and think it’s just some buzzword or fringe internet diagnosis, but there’s actual science here. When the lining of your intestines is more permeable than it should be, it lets undigested food particles sneak into the bloodstream. Those particles can trigger inflammation and autoimmune responses that race to the gut like sirens. When your immune system is busy working that traffic jam, it can ignore the iron you’re trying to absorb. The result? More pills and the same tired, blurry you.
The Takeaway: Your gut is meant to serve as a selective gate, ushering in the good stuff while keeping harmful substances at bay. If you have leaky gut, that gate swings open for the wrong particles, and your body starts forfeiting critical nutrients, iron among them.
There are many contributors to leaky gut and poor iron absorption, but let’s focus on the Big 3:
1. Dysbiosis (Gut Bacteria Imbalance)
Your digestive tract is home to trillions of microorganisms that help you break down food, absorb micronutrients, and modulate your immune response. Disruption of that population can result from antibiotics, proton pump inhibitors (like Nexium or Prilosec), and steroids, and this abnormal ratio of bacteria is called dysbiosis. This leads to inflammation and poor nutrient absorption, including iron.
2. Gallbladder Problems (Or No Gallbladder)
Most people underestimate the gallbladder’s role in digestion, but this small, tucked-away organ is critical for fat emulsification. Whether due to surgery or gallstones, compromised gallbladder function leads to inadequate flow of bile into the intestine.
Why is this important? Bile’s job is to emulsify fats and, in the process, help keep the microbial roster balanced. When bile is short or stagnant, harmful species can flourish. The result is a leaky gut that can siphon off iron that the body can’t afford to waste.
3. Insulin Resistance & Blood Sugar Issues
Tired after every meal? Craving sweets all day? Those flags often mean your blood sugar is off. When your blood sugar creeps up, it messes with the enzymes your gut depends on. Without digestive enzymes, minerals like iron can slip right through you. You don’t need a diabetes label for this to matter. Even mild insulin resistance can spin the body into a loop of fatigue, low iron, and persistent inflammation.
Next Steps: Don’t Settle for “Just Take Iron”
Does all of this sound familiar? Don’t panic, because there is a solution. The fix is about understanding the root causes of anemia, not just loading up on iron pills. Once you discover what’s really behind your anemia, you can finally start feeling like yourself again and reclaim vibrant health, clarity, and daily energy that you lost.
Reach out to the team here at Dr. Autoimmune, and our autoimmune specialists can help you get to the bottom of your symptoms. We’re here to give you answers when you’re ready to get started.
