Heme Iron and Iron Deficiency

If you haven’t read The Gut Health Protocol you are probably asking yourself what Iron and Iron Deficiency have to do with gut health. Quit a bit actually, studies follow.

First lets start with Iron Deficiency. SIBO and poor stomach acid are often associated, and without good stomach acid you will have poor iron absorption. If you have inflammation of the intestinal lining (enteritis) you will also have poor iron absorption. Both also cause poor Vitamin B12 absorption as well.

Unabsorbed iron goes on to cause stomach discomfort and to feed pathogenic yeasts and bacteria. In fact some strains of pathogenic bacteria use iron to create biofilms. This is why the protocol uses lactoferrin, lactoferrin binds to the iron making it impossible to use by bacteria, but humans can still use it.

If you have an iron deficiency, but you eat red meat or seafood, or take a multivitamin, the problem probably isn’t too little iron, it’s bad absorption. Adding more iron than the body can absorb doesn’t help iron levels, it just feeds microbes and gives you a stomach ache.

Though many plants are high in iron they contain a poorly absorbed form (non-heme) as well as iron-absorption inhibitors, such as polyphenols and oxalates. Both substances, in levels found in food, can prevent 90% or more of the iron in those foods from being absorbed. Here are some foods that that inhibit iron absorption: whole grains (including whole wheat) as they are very high in phytic acid (which has a high chelating activity, binding to iron and preventing absorption). Spinach, kale, coffee, teas high in tannins (e.g. black, green, white teas are all high in tannins. Kombucha is lower because the bacteria feed off the tannins), nuts also have antinutrients that prevent iron absorption. In fact green leafy vegetables are very high in iron, but very little of it is available for absorption, and thus is rarely recommended any more for iron deficiency. Most of these foods only inhibit non-heme iron (plant based iron), not heme (animal based). So as long as you’re consuming lots of tasty animals you don’t have to worry about iron-absorption inhibitors. Heme iron is also much easier for the body to absorb. Combine this with a lactoferrin to keep the microbes from eating it and you’ve got a Win-Win-Win.

There aren’t too many companies making heme iron supplements, look for “Proferrin” , this is the least expensive one that I found that is shipped from the U.S. http://amzn.to/1e1WMY8 (there is a product that ships from Japan that is a lot cheaper http://amzn.to/1cUoy8R). If anyone knows of other inexpensive sources of heme iron please post them in the comments.

This is one of those areas that quality really does count, invest in a good iron source, either grassfed organ meat or a heme iron supplement. Otherwise you’re not helping your body, in fact you might be making other conditions worse (e.g. SIBO, yeast, constipation, etc). Also, too much iron (of any form) is probably worse for you than too little (with not a very large margin of error). Studies show that it can increase the chances of colon cancer, and it appears to be from iron that was not absorbed into the bloodstream. So focus on absorption and probably supplementing around the RDA of 18mg for premenopausal women and 8mg for men and postmenopausal women.

“bLf is a more effective and safer alternative than ferrous sulfate for treating ID and IDA (iron deficiency (ID) and ID anemia).” — PubMed #20646353

“The results show that bovine lactoferrin has the same efficacy as ferrous sulfate in restoring iron deposits with significantly fewer gastrointestinal side effects.” — PubMed #19639462

“Absorption of iron from recombinant human lactoferrin in young US women.” “Iron is equally well absorbed from lactoferrin (whether heat-treated or untreated) and ferrous sulfate. Thus, iron provided by dietary lactoferrin is likely to be well utilized in human adults.” — PubMed #16469988

“Unabsorbed dietary iron may increase free radical production in the colon to a level that could cause mucosal cell damage or increased production of carcinogens.” — PubMed #9989688

“Accumulating evidence indicates that excess of unabsorbed iron that enters the colonic lumen causes unwanted side effects at the intestinal host-microbiota interface. The chemical properties of iron, the luminal environment and host iron withdrawal mechanisms, especially during inflammation, can turn the intestine in a rather stressful milieu. Certain pathogenic enteric bacteria can, however, deal with this stress at the expense of other members of the gut microbiota, while their virulence also seems to be stimulated in an iron-rich intestinal environment.” — PubMed #25205464

“Increases in the concentrations of available iron in response to dietary iron supplementation are associated with changes in crypt cell proliferation in rat large intestine.” “High concentrations of iron in the diet have been shown to increase chemically induced colorectal tumors in rats. It is therefore important to understand the influence of dietary iron on the concentration of unabsorbed iron in the large intestine” — PubMed #9446839

“Iron deficiency occurs in about 60-80% of patients with inflammatory bowel disease (IBD), and anemia manifests in approximately one-third of patients.” — PubMed #PMC3959949

“Concurrent repletion of iron and zinc reduces intestinal oxidative damage in iron- and zinc-deficient rats…compared to rats that were teated with iron or zinc alone” — PubMed #PMC4171256 So make sure you are getting enough Zinc (especially zinc carnosine)





6 thoughts on “Heme Iron and Iron Deficiency”

    1. Jenny,

      I’m sure there are times that iron IV treatment is needed, the goal should be to try to prevent getting to that point. But if you’re already there you should know that there is a fairly substantial risk of an allergic reaction. Be sure to work with a hematologist if possible. If you self administer it is


      important to follow the instructions exactly, administering the IV no faster than than what the instructions say (going to fast often leads to a reaction).

      If your doctor is simply talking about IV treatment now is the time to try to turn things around. My nutritional advice in the article should work for a large percentage of people. Using heme iron supplements, avoiding iron-absorption inhibitors (whole grains, raw leafy vegetables), consuming red meat (especially grass-fed), and taking lactoferrin should go a long way to restoring iron levels.


  1. This is all good info. I have concerns about lactoferrin because of food sensitivities. And, the heme iron products all seem to have lots of additives and artificial coloring. Are there any sources of clean heme iron out there? Because it doesn’t appear that there is. Thank you for your help.

  2. Kim I spoke with a rep from Proferrin company and they are about to release a capsule without all the colorants! Happy dance~

  3. Hello John,

    I enjoyed reading your book. Important question though. I read Lactoferrin lowers Ferritin and I suffer from low Ferritin and need to raise it to help stop my hair from falling out. Is it true that Lactoferrin lowers Ferritin levels? What should I do? I would like to get rid of my Sibo as well. Thanks.

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