Nutrients for Blood Health – More than Just Iron

Anemia is said to be the most common blood disorder, with iron deficiency being the most common cause (1). Every living organism depends on iron to transport oxygen and make cellular energy (2). Iron’s necessity for life is undeniable.

Iron makes up nearly 35% of the earth’s mass and is one of the most abundant minerals on the planet (3). It seems unlikely that we’re experiencing an epidemic of deficiency with how prevalent iron is in our environment and food chain. Morley Robbins, the founder of the Root Cause Protocol, frequently points out:

“If iron deficiency anemia is the most prevalent nutritional deficiency in the world, that would mean that humans – the most evolved species on the planet – have lost the ability to metabolize one of the most abundant and important minerals on the planet. It just doesn’t seem likely”

A lot of attention is placed on iron because of its role in blood oxygenation. Without it, we could not deliver oxygen to our tissue via red blood cells. “Iron deficiency” might make sense, given how anemia presents on many blood tests. But it doesn’t make sense that humans need more with the mass iron fortification of our foods (4).

Math reveals a different problem: More = Less

It may not be that iron intake is low. Instead, the issue often lies in what we do with the iron once inside. Our body does an excellent job of conserving iron. We do not have a direct excretion pathway for it. Only 0.05% of our iron stores are lost daily, equating to only 1-2mg loss per day (5).

  • The average daily intake of iron from foods is 12.6-18.2mg/day (6).
  • We need about 25mg of iron daily to produce new red blood cells (7), nearly double the average intake. But because iron is so important to life, our body has developed a tightly regulated recycling system for it.
  • 90% of the iron needed to make new blood cells comes from old ones (~22.5mg/d) (9).
  • Thus, we only need to consume 2.5mg/d to produce new, healthy RBCs.

It doesn’t add up that low iron is the cause of iron deficiency anemia.

More Iron than We Know What to Do With

Iron is vital to life but is also highly reactive and inflammatory when not managed properly. As such, we have developed several means to protect the body from the damage it can cause (10).

Ferritin is often assessed to determine if someone is anemic. This intracellular protein releases iron from cells when it’s needed, and stores excess to prevent it from oxidizing (10). The paradox of using ferritin to determine iron status is that it should only be found inside cells, not in the blood (11).

Seum (blood) ferritin has dumped most of its iron stores, so it may not accurately reflect overall iron status (11). High ferritin indicates cells have been destoryed, which release this molecule into the blood, making it informative for inflammation status (11, 12).

Studies show the body accumulates iron as we age (13, 14). Inflammation promotes further iron storage to protect against the Fenton reaction that causes tissue damage (5).

Inflammation itself can cause a form of anemia called “anemia of chronic disease.” In this state, the body has plenty of iron, but it hides it in tissues to prevent further damage (15). While this is a protective mechanism, it’s not ideal. Iron in the tissues is still susceptible to oxidation.

Hereditary hemochromatosis exemplifies the dangers of excess iron. Genetic mutations result in excessive iron storage in tissue and iron overload, and It’s associated with various health conditions, including heart disease, cancer, liver disease, arthritis, and diabetes (16).

Using Iron Efficiently and Effectively

Copper is just as important to life as iron. Without it, iron would not be able to function in blood health and oxygen delivery. If iron is the star of the show, then copper is the director.

Anemia can occur as a result of copper deficiency (17). Bioavailable copper is required for the ferroxidase enzymes that attach iron molecules to hemoglobin in blood cells (18). Without copper, blood cells will not have enough iron in them (18).

Ferroxidase enzymes also regulate the balance of iron in the tissue vs. in blood – where it should be. They convert iron from its reactive state (Fe 2+) to a more stable state (Fe 3+) (19, 20). Bioavailable copper stabilizes iron.

Other Nutrients that Impact Iron

We don’t get as much dietary copper as we no longer regularly eat organ meats. High dose zinc supplementation can also cause copper deficiency (17).

Some people are concerned with the potential risk of “copper toxicity.” Just as with iron, we need copper to be used effectively once consumed. Retinol makes copper bioavailable by activating enzymes that attach it to ferroxidases (21, 22). Without enough retinol, we can’t use copper effectively, without enough bioavailable copper, we can’t use iron effectively either.

Another iron-regulator is a hormone called hepcidin. It directs whether to store iron in cells or release it into blood (23). High hepcidin encourages iron storage (5). High Vitamin D3 intake increase hepcidin levels (24). Supplementing with high-dose vitamin D encourages iron storage in tissue making less available in blood (24).

Even with plenty of iron in the body, we can’t use it when hepcidin is high (5), and it increases in response to inflammation (23, 25). Vitamin D can appear low in the blood with inflammation because it’s rapidly converted to its active form (which is not assessed in most blood labs) (26). Supplemental vitamin D is often recommended for inflammation or when it’s low, but this might actually worsen inflammation in the presence of iron dysregulation (26).

The Hierarchy of Iron Metabolism.

What looks like iron deficiency anemia might really be deficiencies or excess of other nutrients.

To determine the true cause of anemia, we should first ensure we have right amount of cofactors like copper and vitamin A, address inflammation, accurately assess vitamin D levels, and balance zinc intake.

Recuperate IQ and Cod Liver IQ are foundational supplements with ingredients that support balanced iron metabolism. They supply ample amounts of copper and retinol in appropriately balanced ratios with vitamin D. Beef Liver IQ is naturally rich in zinc and balanced with adequate copper and retinol as well, making it a great nutritional source for zinc.