Quick Summary

Learn how to raise iron levels fast through diet, supplementation, and absorption optimization. Includes dosing protocols, testing, and strategies for iron deficiency anemia.

Introduction

You're tired all the time-not just a little tired, but the kind of exhaustion that sleep doesn't fix. Your workouts feel impossible. Brain fog is constant. And your doctor says your iron is "technically normal."

Most people don't realize this: iron deficiency is the most common nutritional deficiency worldwide, affecting 1.2 billion people-including 30% of women of childbearing age. Even mild deficiency causes fatigue, brain fog, shortness of breath, and can reduce athletic performance by up to 30%.

But there's a catch. Raising iron levels isn't as simple as popping a supplement. Iron absorption is complex-influenced by stomach acid, vitamin C, competing minerals, and inflammatory conditions. Many people supplement for months with minimal improvement.

What most people don't realize is that you can optimize your approach for faster, more effective results.

In this guide, you'll discover:

• Why iron levels matter for energy, cognition, and performance

• 7 evidence-based methods to raise your levels quickly

• Optimal dosing protocols based on your current status

• Absorption strategies to maximize results

• Testing frequency and target ranges from experts

Want to understand your iron status? Our comprehensive panel measures ferritin, serum iron, TIBC, and transferrin saturation-giving you the complete picture for data-driven optimization.

The Science

Iron is essential for:

• Hemoglobin production: Transports oxygen in red blood cells

• Myoglobin: Stores oxygen in muscles

• Energy production: Required for mitochondrial electron transport chain (ATP synthesis)

• Neurotransmitter synthesis: Dopamine, serotonin, norepinephrine production

• Immune function: White blood cell production and function

• DNA synthesis: Cell division and growth

What Optimal Iron Can Do For You

• Energy & Endurance: Supports proper oxygen delivery to tissues

• Cognitive Function: Helps maintain mental clarity, focus, and memory

• Athletic Performance: Can optimize VO2 max, endurance, and strength

• Immune Health: Supports healthy immune function

• Skin, Hair, Nails: Promotes healthy appearance and growth

• Temperature Regulation: Helps prevent cold sensitivity

• Mood: Supports balanced mood and energy

What Happens With Low Iron

Stage 1: Iron Depletion (Low Ferritin)

• Ferritin <30 ng/mL (optimal <50 ng/mL)

• Fatigue, reduced exercise capacity

• Restless leg syndrome, cold sensitivity

• Hair loss, brittle nails

Stage 2: Iron Deficiency Without Anemia

• Ferritin <20 ng/mL, normal hemoglobin

• Moderate fatigue, brain fog

• Shortness of breath with exertion

• Reduced athletic performance 10-20%

Stage 3: Iron Deficiency Anemia (IDA)

• Ferritin <12 ng/mL, low hemoglobin (<12 g/dL women, <13 g/dL men)

• Severe fatigue, weakness

• Dizziness, headaches

• Pale skin, rapid heartbeat

• Impaired immunity, frequent infections

• Performance decline 30%+

Key Iron Biomarkers

Ferritin (Iron Storage):

• Deficient: <12-15 ng/mL - Stage 3 iron deficiency anemia

• Low: 15-30 ng/mL - Stage 1-2 iron depletion

• Adequate: 30-50 ng/mL - Conventional "normal" but suboptimal

• Optimal: 50-100 ng/mL ← Athletes and longevity experts target

• Upper Optimal: 100-150 ng/mL - Safe for most

• High: 150-300 ng/mL - Monitor for hemochromatosis risk

• Excess: >300 ng/mL - Risk of iron overload

Serum Iron:

• Optimal: 60-170 mcg/dL (men and women)

TIBC (Total Iron-Binding Capacity):

• Optimal: 250-450 mcg/dL

• High TIBC (>450): Suggests iron deficiency (body tries to bind more iron)

Transferrin Saturation (% of transferrin carrying iron):

• Low: <20% - Iron deficiency

• Optimal: 25-45%

• High: >45-50% - Risk of iron overload

Hemoglobin:

• Men optimal: 14-17 g/dL

• Women optimal: 12.5-15.5 g/dL

• Low: <13 g/dL (men), <12 g/dL (women) indicates anemia

Expert Recommendations

• Athletes (endurance): Target ferritin 50-100 ng/mL for optimal performance

• Women (menstruating): Maintain ferritin >50 ng/mL to prevent depletion

• Longevity optimization: Ferritin 50-100 ng/mL balances sufficiency without excess oxidative stress from high iron

The reality is that "normal" lab ranges are often too broad. Research shows that ferritin above 50 ng/mL is optimal for most people-not just above 15 ng/mL. Many experience fatigue and poor performance even with ferritin in the 30-50 range.

Track Your Iron Levels

Mito Health tests 100+ biomarkers including ferritin, serum iron, TIBC, transferrin saturation, and hemoglobin with physician-guided protocols to help you optimize energy, athletic performance, and cellular function. Our comprehensive panels provide personalized interpretation to identify deficiency early.

View Testing Options →

The Science

Heme iron (from animal products) is absorbed 15-35%, 2-3x better than non-heme iron (from plants, 2-20% absorption). Heme iron bypasses many absorption inhibitors.

Best Heme Iron Food Sources

Iron Content per 3.5 oz (100g) serving:

Highest Sources:

• Beef liver: 6.5 mg (36% DV) - Most bioavailable

• Chicken liver: 11 mg (61% DV)

• Oysters: 6 mg (33% DV)

• Mussels: 6.7 mg (37% DV)

• Clams: 28 mg (155% DV) - Exceptionally high

• Sardines: 2.9 mg (16% DV)

Moderate Sources:

• Beef (grass-fed): 2.6 mg (14% DV)

• Ground beef (85% lean): 2.5 mg

• Lamb: 1.9 mg

• Turkey (dark meat): 2.3 mg

• Chicken (dark meat): 1.3 mg

• Salmon: 0.8 mg

• Tuna: 1.3 mg

Optimal Dietary Protocol for Raising Iron

If Ferritin <30 ng/mL (Moderate-Severe Deficiency):

• Daily heme iron goal: 10-20 mg from food

• Example: 3-4 oz beef liver 2-3x per week + 6 oz grass-fed beef daily

• Realistic: Challenging from food alone; supplement likely needed

If Ferritin 30-50 ng/mL (Mild Deficiency):

• Daily heme iron goal: 6-12 mg from food

• Example: 6-8 oz grass-fed beef or dark meat poultry daily + oysters/sardines 2x per week

If Ferritin >50 ng/mL (Maintenance):

• Daily heme iron goal: 3-6 mg from food

• Example: 4-6 oz red meat or poultry 4-5x per week

Cooking Tips

• Cast iron cookware: Increases iron content of food by 16-20% (especially acidic foods like tomato sauce)

• Don't overcook: Retain moisture to preserve iron content

• Pair with vitamin C: Enhance absorption (see Method 3)

Limitations

• Vegetarians/vegans: Cannot use this method; rely on non-heme iron + supplementation

• Cost: Grass-fed beef and organ meats can be expensive

• Taste: Many dislike liver; can hide in meatballs or pâté

• Speed: Dietary iron alone takes 3-6 months to raise ferritin significantly

The bottom line: heme iron from animal products is the most bioavailable natural source. It's essential for raising iron levels, though supplementation often helps you optimize faster. ---

The Science

Oral iron supplementation is the fastest way to raise ferritin when deficient. Typical increase: 10-20 ng/mL per month with consistent supplementation (assuming good absorption).

Choosing the Right Iron Form

Best Absorbed Forms (Gentle on Stomach):

1. Ferrous Bisglycinate (Iron Glycinate):

• Absorption: 20-30% (highest among oral forms)

• Elemental iron: 20 mg per 100 mg supplement

• Pros: Minimal GI side effects, chelated form bypasses many inhibitors

• Cons: More expensive ($15-25/month)

• Best for: Sensitive stomachs, vegetarians, athletes

• Brands: Thorne, Pure Encapsulations, Solgar Gentle Iron

2. Ferrous Fumarate:

• Absorption: 15-25%

• Elemental iron: 33 mg per 100 mg supplement

• Pros: Good absorption, moderate price

• Cons: Moderate GI side effects (constipation, nausea)

• Best for: Budget-conscious, can tolerate GI effects

3. Carbonyl Iron:

• Absorption: 10-20%

• Elemental iron: 100% pure iron powder

• Pros: Very safe, low toxicity, minimal GI side effects

• Cons: Slower absorption than bisglycinate

• Best for: Children, sensitive individuals

Forms to AVOID (Poor Absorption or High Side Effects):

4. Ferrous Sulfate:

• Absorption: 10-15%

• Elemental iron: 20 mg per 100 mg supplement

• Pros: Cheap ($5-10/month)

• Cons: HIGH GI side effects (constipation, nausea, stomach pain) - 40-50% discontinue

• Verdict: Not recommended despite being most prescribed

5. Ferric Iron (Non-Ferrous Forms):

• Absorption: 5-10%

• Pros: None

• Cons: Must be converted to ferrous form in stomach; very poor absorption

• Verdict: Avoid

Optimal Iron Dosing Protocol

Severe Deficiency (Ferritin <15 ng/mL, Anemia Present):

• Dose: 100-200 mg elemental iron daily, split into 2 doses

• Form: Ferrous bisglycinate (25 mg elemental) 4 pills = 100 mg, OR ferrous fumarate 65 mg elemental x2 daily

• Duration: 3-6 months until ferritin >50 ng/mL and hemoglobin normalized

• Retest: Every 4-6 weeks to monitor progress

Moderate Deficiency (Ferritin 15-30 ng/mL):

• Dose: 50-100 mg elemental iron daily

• Form: Ferrous bisglycinate 25 mg x 2-4 daily, OR ferrous fumarate 65 mg once daily

• Duration: 2-4 months until ferritin >50 ng/mL

• Retest: Every 6-8 weeks

Mild Deficiency (Ferritin 30-50 ng/mL):

• Dose: 25-50 mg elemental iron daily

• Form: Ferrous bisglycinate 25 mg x 1-2 daily

• Duration: 2-3 months until ferritin 50-100 ng/mL

• Retest: Every 8-12 weeks

Maintenance (Ferritin >50 ng/mL):

• Dose: 25 mg elemental iron 2-3x per week (or as needed based on retesting)

• Best for: Menstruating women, athletes, those with absorption issues

Timing & Absorption Tips

Best Time to Take Iron:

• Empty stomach (1 hour before or 2 hours after meals): Maximizes absorption 2-3x

• Morning: If taking once daily

• Split doses: If >50 mg daily, split AM + PM for better tolerance

With Vitamin C (Essential):

• Take 100-200 mg vitamin C with each iron dose

• Increases absorption 2-4x by reducing ferric iron to ferrous iron

• Sources: Supplement, orange juice, or vitamin C-rich food

Avoid Taking Iron With:

• Calcium: Blocks absorption; separate by 2+ hours (no dairy with iron)

• Coffee/tea: Tannins block absorption 40-60%; separate by 2+ hours

• Phytates: Grains, legumes; if eating, wait 2 hours

• Antacids, PPIs: Reduce stomach acid needed for absorption

• Zinc, magnesium: Compete for absorption; separate by 2 hours

Managing Side Effects

Common GI Side Effects (30-40% of users):

• Constipation (most common)

• Nausea, stomach upset

• Dark stools (normal, not harmful)

• Metallic taste

Solutions:

1. Switch to ferrous bisglycinate: 70% reduction in side effects vs. ferrous sulfate

2. Take with small amount of food: Reduces absorption slightly but improves tolerance

3. Lower dose, increase frequency: 25 mg 2x daily instead of 50 mg once

4. Add magnesium: 300-400 mg daily prevents constipation

5. Increase fiber & hydration: Mitigates constipation

6. Consider every-other-day dosing: Research shows similar total absorption with better tolerance

Expected Results

• Ferritin increase: 10-20 ng/mL per month with 50-100 mg daily

• Hemoglobin increase: 1-2 g/dL per month if anemic

• Symptom improvement: 2-4 weeks (energy, exercise tolerance)

• Full correction: 3-6 months for severe deficiency

Ready to start optimizing? Test your iron levels first, then supplement with high-absorption ferrous bisglycinate and vitamin C. Our comprehensive biomarker testing starts at $349 for individual panels, $668 for duo testing.

The Science

Vitamin C (ascorbic acid) is the most powerful enhancer of non-heme iron absorption. It reduces ferric iron (Fe³⁺) to ferrous iron (Fe²⁺), the absorbable form, and forms a soluble iron-ascorbate complex in the gut.

Effect: 100-200 mg vitamin C can increase iron absorption 2-4x.

Optimal Vitamin C Protocol with Iron

Supplementation:

• Dose: 100-200 mg vitamin C with each iron dose

• Timing: Take simultaneously with iron supplement

• Form: Ascorbic acid (most studied), sodium ascorbate (gentler on stomach), or liposomal vitamin C

Food Sources (Pair with Iron-Rich Meals):

• Orange juice (8 oz): 120 mg vitamin C

• Bell peppers (1 medium): 150 mg

• Strawberries (1 cup): 90 mg

• Broccoli (1 cup cooked): 100 mg

• Kiwi (1 medium): 70 mg

• Tomatoes (1 medium): 17 mg

Practical Application

With Supplements:

• Take iron supplement + 100-200 mg vitamin C capsule together, empty stomach

With Meals:

• If eating plant-based iron sources (spinach, lentils, beans), pair with vitamin C-rich foods:

• Spinach salad + bell peppers + lemon juice dressing

• Lentil soup + tomatoes

• Oatmeal (fortified with iron) + strawberries

With Heme Iron:

• Vitamin C enhances heme iron absorption modestly (10-20% boost)

• Still beneficial; pair beef with broccoli, liver with tomatoes

Important

• Don't mega-dose vitamin C: >500 mg with iron increases absorption minimally; stick to 100-200 mg per dose

• Split doses: If taking iron 2x daily, take vitamin C with each dose

The Science

Stomach acid (HCl) is required to ionize iron and convert ferric (Fe³⁺) to absorbable ferrous (Fe²⁺) form. Low stomach acid is a major cause of iron malabsorption, especially in:

• Age 50+: 30-50% have hypochlorhydria (low stomach acid)

• PPI users: Proton pump inhibitors (omeprazole, lansoprazole) reduce acid 70-90%

• H2 blockers: Famotidine, ranitidine reduce acid 50-70%

• Atrophic gastritis: Autoimmune condition reducing acid production

• H. pylori infection: Damages stomach lining, reduces acid

Impact: Low stomach acid can reduce iron absorption by 50-80%.

Signs You May Have Low Stomach Acid

• Bloating, gas, indigestion after meals

• Feeling full quickly, food "sitting" in stomach

• Undigested food in stool

• Iron deficiency despite supplementation

• Multiple nutrient deficiencies (B12, calcium, magnesium)

How to Optimize Stomach Acid

Photo from Unsplash

1. If Taking PPIs or H2 Blockers:

• Work with doctor to taper or stop if medically appropriate

• Alternative: Switch to H2 blockers (less acid suppression) or antacids only as needed

• If must continue: Take iron as ferrous bisglycinate (less acid-dependent) with vitamin C

2. Supplement with Betaine HCl (If Deficient):

• What it is: Hydrochloric acid supplement

• Dose: Start with 500-650 mg with meals; increase up to 2,000-3,000 mg if tolerated

• How to test tolerance: Start low; if you feel warmth/burning, you have sufficient acid (reduce dose)

• Take with: Protein-containing meals (triggers acid need)

• Contraindications: Active ulcers, gastritis (heal first)

3. Apple Cider Vinegar (Mild Acid Support):

• Dose: 1-2 tablespoons in water 15 min before iron-rich meals

• Effect: Mild acidification, may improve absorption 10-20%

4. Digestive Bitters:

• Herbs: Gentian, dandelion root, artichoke

• Effect: Stimulate natural stomach acid production

• Dose: 10-15 drops or 1-2 ml tincture before meals

5. Test Stomach Acid:

• Heidelberg test: Gold standard (swallow capsule measures pH)

• Gastric pH monitoring: Via endoscopy

• Functional test: Betaine HCl challenge (if burning at low dose, acid is sufficient)

Expected Impact

Correcting low stomach acid can improve iron absorption 30-80%, especially if on PPIs or age 50+.

The Science

If you're supplementing but iron levels stay low, you may have ongoing iron loss exceeding intake. Identify and address the root cause.

Common Causes of Iron Loss

1. Heavy Menstrual Bleeding (Most Common in Women):

• Normal menstrual loss: 30-40 mL blood = ~15-20 mg iron per cycle

• Heavy bleeding (menorrhagia): >80 mL blood = ~40+ mg iron per cycle

• Signs: Soaking through pad/tampon every 1-2 hours, clots larger than quarter, periods >7 days

Solutions:

• Birth control: Hormonal IUD (Mirena), birth control pills reduce bleeding 40-60%

• Tranexamic acid: Prescription medication reduces bleeding 40-50%

• NSAIDs: Ibuprofen reduces menstrual blood loss 20-30%

• Iron supplementation: 50-100 mg daily ongoing for heavy bleeders

• Investigate causes: Fibroids, endometriosis, polyps (ultrasound, exam)

2. Gastrointestinal Bleeding:

• Sources: Ulcers, gastritis, IBD (Crohn's, ulcerative colitis), colon polyps, hemorrhoids, esophageal varices

• Signs: Black tarry stools, blood in stool, unexplained anemia despite supplementation

Testing:

• Fecal occult blood test (FOBT): Detects hidden blood in stool

• Endoscopy/colonoscopy: Visualize GI tract

• Capsule endoscopy: For small intestine (if other tests negative)

Solutions:

• Treat underlying condition (H. pylori eradication, IBD management, polyp removal)

• Stop NSAIDs (ibuprofen, aspirin) if causing ulcers

• Supplement with higher doses until bleeding controlled

3. Blood Donation:

• Impact: 1 pint donation removes ~200-250 mg iron

• Frequency: Donating every 8 weeks depletes iron stores in frequent donors

Solutions:

• Extend donation intervals to 16+ weeks

• Supplement with 25-50 mg iron daily between donations

• Test ferritin before each donation (defer if <50 ng/mL)

4. Intense Exercise (Athletes):

• Mechanisms: "Foot-strike hemolysis" (red blood cell destruction in feet), GI microbleeding, increased hepcidin (blocks absorption), sweat loss (1-2 mg per workout)

• Impact: Endurance athletes need 30-70% more iron than sedentary individuals

Solutions:

• Supplement with 50-100 mg daily (higher end for female endurance athletes)

• Test ferritin every 3 months (maintain >50 ng/mL, ideally 80-100 ng/mL)

• Increase heme iron intake

5. Parasitic Infections (Hookworm, Whipworm):

• Prevalence: Common in developing countries, less common in developed nations

• Mechanism: Parasites feed on blood in intestines

Solutions:

• Test: Stool ova and parasites (O&P) test

• Treat: Antiparasitic medication (albendazole, mebendazole)

• Supplement: High-dose iron after treatment

6. Frequent Blood Testing:

• Impact: Phlebotomy for medical testing removes iron; cumulative effect if frequent

• Rare cause unless extensive testing (multiple vials weekly)

Actionable Steps

1. Women with heavy periods: Track bleeding volume; discuss hormonal management with gynecologist

2. Unexplained anemia: Rule out GI bleeding with FOBT, endoscopy/colonoscopy

3. Athletes: Supplement proactively; test ferritin every 3 months

4. Blood donors: Extend intervals; test ferritin before donating

The Science

Many common foods and medications block iron absorption 40-80%. Strategic timing separates iron intake from inhibitors.

Major Iron Absorption Inhibitors

1. Calcium (Dairy Products, Supplements):

• Effect: Blocks both heme and non-heme iron absorption 30-50%

• Mechanism: Competes for intestinal transporters

• Sources: Milk, cheese, yogurt, calcium supplements

Solution: Separate iron and calcium by 2+ hours

• If supplementing iron morning, take calcium evening

• Avoid dairy with iron-rich meals

2. Tannins (Tea, Coffee):

• Effect: Binds iron, reduces absorption 40-60%

• Mechanism: Forms insoluble iron-tannin complex

• Sources: Black tea (highest), green tea, coffee, red wine

Solution: Avoid tea/coffee 1 hour before and 2 hours after iron intake

• If you must drink, choose herbal tea (no tannins) or coffee with vitamin C added

3. Phytates (Phytic Acid in Grains, Legumes, Nuts):

• Effect: Binds minerals including iron, reduces absorption 40-60%

• Mechanism: Chelates iron in gut

• Sources: Whole grains, beans, lentils, chickpeas, soy, nuts, seeds

Solution:

• Soak grains/legumes overnight: Reduces phytates 50-70%

• Ferment or sprout: Further reduces phytates

• Pair with vitamin C: Overcomes phytate inhibition partially

• Separate iron supplements from high-phytate meals by 2 hours

4. Polyphenols (Dark Chocolate, Some Spices):

• Effect: Inhibits iron absorption 20-40%

• Sources: Dark chocolate, turmeric, oregano, some berries

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Solution: Limit during iron supplementation period or separate timing

5. Eggs:

• Effect: Phosphoprotein in eggs (phosvitin) inhibits iron absorption 30-50%

• Mechanism: Binds iron in egg yolk and from other sources

Solution: Avoid eggs with iron-rich meals if severely deficient; fine in moderation once replete

6. Antacids, PPIs, H2 Blockers (Covered in Method 4):

• Effect: Reduce stomach acid, impairing iron absorption 50-80%

Solution: Avoid if possible; use ferrous bisglycinate + vitamin C if must continue

Strategic Meal Timing Example

Morning (7 AM):

• Iron supplement (ferrous bisglycinate 25 mg) + Vitamin C (100 mg)

• Empty stomach (1 hour before breakfast)

Breakfast (8 AM):

• Avoid: Dairy, tea/coffee, high-phytate cereals

• OK: Eggs (if not severely deficient), low-phytate options

Mid-Morning (10 AM):

• Coffee or tea (now 3 hours post-iron)

Lunch (12 PM):

• Heme iron source: Grass-fed beef, chicken

• Vitamin C source: Bell peppers, broccoli, tomatoes

• Avoid: Dairy, tea with meal

Afternoon Snack:

• Calcium supplement (if taking, separate from iron)

Dinner (6 PM):

• If taking 2nd iron dose: Take 1 hour before dinner with vitamin C

• Otherwise: Normal meal, dairy OK

When to Test

Baseline:

• Test before starting supplementation

Follow-Up:

• Severe deficiency (ferritin <15 ng/mL): Retest every 4-6 weeks

• Moderate deficiency (15-30 ng/mL): Retest every 6-8 weeks

• Mild deficiency (30-50 ng/mL): Retest every 8-12 weeks

Maintenance:

• Once optimized (ferritin 50-100 ng/mL), retest every 6-12 months

• Women (menstruating): Test every 6 months

• Athletes: Test every 3-4 months

• Blood donors: Test before each donation

What to Test

Essential Panel:

• Ferritin - Iron storage (most important long-term marker)

• Serum Iron - Circulating iron (fluctuates daily)

• TIBC (Total Iron-Binding Capacity) - Body's iron-binding capacity

• Transferrin Saturation - % of transferrin carrying iron

• Hemoglobin - Oxygen-carrying capacity (detects anemia)

Advanced (If Levels Stay Low Despite Supplementation):

• CRP (C-Reactive Protein) or hsCRP - Inflammation falsely elevates ferritin; if CRP high, ferritin may overestimate iron stores

• Hepcidin - Master iron regulator; high hepcidin blocks absorption (inflammatory conditions, infection)

• Vitamin B12 and Folate - Required for red blood cell production; deficiency mimics iron deficiency anemia

• Celiac panel - Celiac disease causes malabsorption

• H. pylori antibody or breath test - Infection reduces iron absorption

• Fecal occult blood - Detects GI bleeding

Interpreting Your Results

Example 1: Classic Iron Deficiency

• Ferritin: 12 ng/mL (low)

• Serum iron: 30 mcg/dL (low)

• TIBC: 450 mcg/dL (high)

• Transferrin saturation: 10% (low)

• Hemoglobin: 11 g/dL (low)

Interpretation: Severe iron deficiency anemia
Action: 100-200 mg elemental iron daily + vitamin C, investigate blood loss, retest in 4-6 weeks

Example 2: Anemia of Chronic Inflammation

• Ferritin: 150 ng/mL (high/normal)

• Serum iron: 30 mcg/dL (low)

• TIBC: 250 mcg/dL (low)

• Transferrin saturation: 12% (low)

• Hemoglobin: 11.5 g/dL (low)

• CRP: 12 mg/L (elevated)

Interpretation: Anemia of chronic disease (not true iron deficiency; inflammation blocks iron utilization)
Action: Address underlying inflammation; iron supplementation may not help until inflammation controlled

Example 3: Early Iron Depletion (Fatigue But No Anemia)

• Ferritin: 22 ng/mL (low)

• Serum iron: 70 mcg/dL (normal)

• TIBC: 380 mcg/dL (normal-high)

• Transferrin saturation: 18% (low-normal)

• Hemoglobin: 13.5 g/dL (normal)

Interpretation: Stage 2 iron deficiency without anemia
Action: 50-100 mg elemental iron daily + vitamin C, retest in 6-8 weeks

Testing Options

• Lab draw: Quest, LabCorp (via doctor or direct-to-consumer)

• At-home fingerprick: LetsGetChecked, Everlywell (convenient but less accurate for full panel)

• Comprehensive panel: Mito Health (includes iron panel + ferritin + hemoglobin + 140+ biomarkers)

Indications for IV (Intravenous) Iron

Consider IV iron if:

• Oral iron intolerance: Severe GI side effects despite trying multiple forms

• Malabsorption: Celiac disease, IBD, gastric bypass, chronic diarrhea

• Severe deficiency requiring rapid correction: Ferritin <10 ng/mL + hemoglobin <10 g/dL

• Chronic kidney disease: Oral iron often ineffective due to hepcidin elevation

• Heart failure: Oral absorption poor; IV improves outcomes

• No response to oral iron: After 3+ months of compliant supplementation

IV Iron Advantages

• Fast: Raises ferritin 50-150 ng/mL in 2-4 weeks (single infusion)

• No GI side effects: Bypasses gut

• High bioavailability: 100% vs. 15-30% oral

IV Iron Forms

• Iron sucrose (Venofer): 5-10 infusions

• Ferric carboxymaltose (Injectafer, Ferinject): 1-2 infusions (most convenient)

• Iron dextran (InFeD, Dexferrum): Risk of anaphylaxis; less commonly used

• Ferumoxytol (Feraheme): 2 infusions

Risks

• Allergic reactions: Rare (<1%) but possible

• Infection risk: Very rare with sterile technique

• Iron overload: If given excessively

• Cost: $500-2,000 per infusion (insurance often covers if medically indicated)

Procedure

• Duration: 15-60 minutes per infusion

• Location: Infusion center, hospital, some clinics

• Monitoring: Vital signs during and 30 min post-infusion

Note: IV iron should be prescribed and monitored by a physician. Not first-line unless specific indications.

Mistake 1 - Taking Iron with Coffee, Tea, or Dairy

Problem: Blocks absorption 40-60%
Solution: Separate by 2+ hours

Mistake 2 - Not Taking Vitamin C with Iron

Problem: Missing 2-4x absorption boost
Solution: Always pair iron supplement with 100-200 mg vitamin C

Mistake 3 - Using Ferrous Sulfate (High Side Effects)

Problem: 40-50% discontinue due to constipation, nausea
Solution: Switch to ferrous bisglycinate (gentler, better absorbed)

Mistake 4 - Not Testing Baseline or Follow-Up

Problem: No idea if supplementation is working or if you're over-supplementing
Solution: Test ferritin before starting, then every 4-12 weeks depending on severity

Mistake 5 - Stopping Too Soon

Problem: Ferritin rises slowly; stopping at 30-40 ng/mL leaves you suboptimal
Solution: Continue until ferritin 50-100 ng/mL, then maintain

Mistake 6 - Ignoring Underlying Blood Loss

Problem: Supplementing but losing more iron than you're absorbing (heavy periods, GI bleeding)
Solution: Investigate and address root cause

Mistake 7 - Taking Iron on PPI Without Addressing Absorption

Problem: PPIs block iron absorption 50-80%
Solution: Use ferrous bisglycinate + vitamin C, or work with doctor to stop PPI

Step 1 - Test Your Current Levels

Get a complete iron panel including ferritin, serum iron, TIBC, transferrin saturation, and hemoglobin.

Step 2 - Determine Your Protocol Based on Ferritin:

Severe Deficiency (<15 ng/mL):

• Supplement: 100-200 mg elemental iron daily (ferrous bisglycinate 25 mg x 4-8)

• Vitamin C: 100-200 mg with each dose

• Diet: Increase heme iron (beef liver, grass-fed beef, oysters)

• Retest: Every 4-6 weeks

• Duration: 3-6 months until ferritin >50 ng/mL

Moderate Deficiency (15-30 ng/mL):

• Supplement: 50-100 mg elemental iron daily (ferrous bisglycinate 25 mg x 2-4)

• Vitamin C: 100-200 mg with each dose

• Diet: Increase heme iron

• Retest: Every 6-8 weeks

• Duration: 2-4 months until ferritin 50-100 ng/mL

Mild Deficiency (30-50 ng/mL):

• Supplement: 25-50 mg elemental iron daily (ferrous bisglycinate 25 mg x 1-2)

• Vitamin C: 100-200 mg with each dose

• Diet: Prioritize heme iron 4-5x per week

• Retest: Every 8-12 weeks

• Duration: 2-3 months until ferritin 50-100 ng/mL

Step 3 - Optimize Absorption

• Take iron empty stomach (1 hour before meals)

• Separate from calcium, coffee, tea by 2+ hours

• If on PPIs, consider tapering or use ferrous bisglycinate + vitamin C + possibly Betaine HCl

Step 4 - Address Underlying Causes

• Heavy periods: Discuss hormonal management with gynecologist

• GI bleeding: FOBT, endoscopy/colonoscopy if needed

• Athletes: Increase intake proactively

Step 5 - Retest & Adjust

• Follow retest schedule based on severity

• Once ferritin 50-100 ng/mL, reduce to maintenance dose (25 mg 2-3x per week or as needed)

• Retest every 6-12 months

Step 6 - Maintain

• Women (menstruating): 25 mg daily or 50 mg every other day ongoing

• Athletes: 25-50 mg daily ongoing

• General: 25 mg 2-3x per week or retest and adjust

Subjective Markers of Improvement (2-6 weeks)

• Increased energy and reduced fatigue

• Better exercise tolerance and endurance

• Improved mental clarity and focus

• Reduced shortness of breath

• Warmer hands and feet (better circulation)

• Stronger hair and nails

• Improved mood

Objective Markers (Blood Work)

• Ferritin: 50-100 ng/mL (primary target)

• Hemoglobin: >13 g/dL (men), >12.5 g/dL (women)

• Transferrin saturation: 25-45%

• Serum iron: 60-170 mcg/dL

The Bottom Line

Raising iron levels fast requires a multi-faceted approach-data-driven insights for real results:

1. Supplement with high-absorption iron (ferrous bisglycinate 50-200 mg daily based on deficiency severity)

2. Always pair with vitamin C (100-200 mg per dose for 2-4x absorption boost)

3. Increase heme iron from diet (grass-fed beef, liver, oysters)

4. Optimize stomach acid (taper PPIs if possible, consider Betaine HCl)

5. Address underlying blood loss (heavy periods, GI bleeding, frequent blood donation)

6. Avoid absorption blockers (separate calcium, coffee, tea by 2+ hours)

7. Test regularly (baseline, then every 4-12 weeks until optimal, then every 6-12 months)

Target: Ferritin 50-100 ng/mL for optimal energy, performance, and health.

Timeline: Expect ferritin to increase 10-20 ng/mL per month with 50-100 mg daily supplementation. Severe deficiency takes 3-6 months to fully correct.

Don't guess-test. Iron overload is also dangerous, so regular monitoring is essential.

Ready to optimize your iron levels? Our comprehensive panel checks ferritin, serum iron, TIBC, transferrin saturation, hemoglobin, and 140+ other biomarkers-giving you complete data-driven insights. Individual testing at $349, comprehensive duo testing at $668. Prevention over intervention starts with knowing your numbers.

Key Takeaways

Optimal ferritin is 50-100 ng/mL, not just >15 ng/mL
Ferrous bisglycinate is best: Highest absorption, lowest side effects
Vitamin C is essential: Take 100-200 mg with every iron dose for 2-4x absorption
Timing matters: Empty stomach for best absorption; separate from calcium, coffee, tea by 2+ hours
Heme iron from meat is most bioavailable: Grass-fed beef, liver, oysters
Address underlying causes: Heavy periods, GI bleeding, or you'll never catch up
Test every 4-12 weeks until optimal; every 6-12 months for maintenance
Expect 10-20 ng/mL ferritin increase per month with consistent supplementation

Track Your Progress

• How to Improve Your Iron Level Naturally

• How to Improve Your Iron Saturation Level Naturally

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Medical Disclaimer

This article is for educational and informational purposes only and does not constitute medical advice. The information provided should not be used for diagnosing or treating a health condition. Always consult with your doctor or qualified healthcare provider before starting any new supplement protocol, making changes to your diet, or if you have questions about a medical condition.

Individual results may vary. The dosages and protocols discussed are evidence-based but should be personalized under medical supervision, especially if you have existing health conditions or take medications.

References

1. Tolkien Z, Stecher L, Mander AP, et al. Ferrous sulfate supplementation causes significant gastrointestinal side-effects in adults: a systematic review and meta-analysis. PLoS One. 2015;10(2):e0117383. PMID: 25700159 | DOI: 10.1371/journal.pone.0117383

2. Hallberg L, Brune M, Rossander L. Effect of ascorbic acid on iron absorption from different types of meals. Hum Nutr Appl Nutr. 1986;40(2):97-113. PMID: 3957721

3. Hurrell R, Egli I. Iron bioavailability and dietary reference values. Am J Clin Nutr. 2010;91(5):1461S-1467S. PMID: 20200263 | DOI: 10.3945/ajcn.2010.28674F

4. Camaschella C. Iron-deficiency anemia. N Engl J Med. 2015;372(19):1832-43. PMID: 25946282 | DOI: 10.1056/NEJMra1401038

5. Stoffel NU, Cercamondi CI, Brittenham G, et al. Iron absorption from oral iron supplements given on consecutive versus alternate days and as single morning doses versus twice-daily split dosing in iron-depleted women: two open-label, randomised controlled trials. Lancet Haematol. 2017;4(11):e524-e533. PMID: 29032957 | DOI: 10.1016/S2352-3026(17)30182-5