How do you know if your iron supplement is working? Dr Libby explains.
One of the most common questions I hear is:
"How do I know if my iron supplement is working?"
Often, it's because someone has seen their ferritin rise a little rather than a lot, and they wonder whether enough is changing. But while ferritin is an important marker, it's only one part of the story.
How are you feeling?
The body is remarkably intelligent when it comes to iron. It tightly regulates how much it absorbs and uses because both too little and too much can create problems. That's why rebuilding iron stores can be a gradual process for some, rather than an overnight transformation. If your ferritin is moving upward after a time of deficiency, even slowly, that's one sign things may be heading in the right direction. But it's not the only sign.
→ Are you noticing improvements in your energy?
→ Do you feel more resilient throughout the day?
→ Is your concentration improving?
→ Are you recovering more easily?
→ Are you noticing less hair loss?
Often, these changes emerge before blood test results show dramatic shifts.
Blood test markers beyond ferritin
I also encourage people to look beyond ferritin alone. Markers such as transferrin and transferrin saturation can provide clues about how strongly the body is still seeking iron. Elevated transferrin, or a result on the higher side of the normal range, is a sign of "iron hunger" – the body increasing its capacity to transport iron because it needs more of it. Note that the normal range for adults is 2 – 3.6g/L and a transferrin above 2.6g/L typically indicates your body is seeking more iron. If your ferritin is increasing and your transferrin is within normal range, that can indicate that your body is quite happy to absorb iron at the pace it is. If transferrin is low (e.g. 1.8g/L) your body is letting you know it doesn't want more iron right now – either you have enough or there are some other health scenarios that need to be addressed first, such as an infection or inflammation.
What if you’re doing all the right things and nothing is changing?
If your results aren't improving despite doing all the right things, it's worth remembering that iron absorption doesn't occur in isolation. Digestive issues, inflammation, unaddressed coeliac disease, H. pylori infection, parasites and other underlying factors can all influence how well iron is absorbed, utilised and stored.
If you're taking Iconic Iron, the ground-breaking form of iron it contains – ferritin-iron –utilises a different absorption pathway to all other types of iron and conventional iron supplements, helping to overcome the common challenges associated with iron uptake. But if your iron levels remain stubbornly low, it is worth looking beyond iron itself. For example, testing for inflammation, coeliac disease, H. pylori or parasites (which take the iron for themselves meaning you miss out and your test results stay low) can offer insight. Further investigation can often provide valuable answers. Understanding what’s standing in the way of your body receiving, utilising or retaining iron can be invaluable and once you address that, your dietary iron and your iron supplement can get to work inside you doing all of the jobs iron is needed for.
When it comes to your iron status, it's important to look at the whole picture rather than a single number. Your symptoms, your iron studies and your broader health story all provide clues. When viewed together, they can reveal far more than your blood test for ferritin alone ever could.
