TOBINintel · Condition

Iron Deficiency & Anemia

Iron deficiency is the most common nutrient deficiency worldwide. Ferritin under 30 ng/mL indicates depleted stores even before anemia; hemoglobin falls later. A cause — blood loss, malabsorption (celiac, H. pylori) or low intake — should always be sought.

Key points

H. pylori is a true bacterial cause here — test and treat it when iron deficiency is unexplained.
Test to discuss: Ferritin (with CRP)
Test to discuss: CBC: hemoglobin, MCV
Test to discuss: Transferrin saturation
Test to discuss: Celiac serology (tTG-IgA)
Test to discuss: H. pylori testing; GI evaluation for men and post-menopausal women
Heme-iron foods or legumes with vitamin C
Screen in heavy menstrual bleeding and pregnancy
Avoid tea/coffee with iron-rich meals

Root-cause chain

Blood loss (menstrual, gastrointestinal) → Depleted iron storesA

N · Established causal · Each mL of blood lost removes about 0.5 mg of iron.

H. pylori or celiac disease → Iron malabsorptionA

I · Established causal · Mucosal damage and reduced gastric acid impair non-heme iron absorption; eradication or gluten-free diet restores it.

Chronic inflammation → Functional iron restriction via hepcidinA

I · Established causal · IL-6 raises hepcidin, blocking iron export; ferritin may be falsely normal when CRP is high.

Iron deficiency → Fatigue, low mood, restless legsB

B · Randomized evidence · Iron repletion improves fatigue in non-anemic women with low ferritin (RCTs).

Protocols by lane

Evidence grade + regulatory status

Conventional: Oral iron on alternate days; IV iron when oral fails or is not toleratedA

Alternate-day dosing improves absorption (Stoffel 2017); AGA 2020 guideline.

Status: FDA-approved · Cautions: Find the cause; never give iron without testing — risk of overload in hemochromatosis.

Functional: Evaluate gut causes (celiac, H. pylori)A

Treating the cause restores absorption.

Status: Lifestyle · Cautions: Do not start a gluten-free diet before celiac testing.

Integrative: Manage heavy menstrual bleeding with gynecologyA

Most common cause in premenopausal women.

Status: FDA-approved · Cautions: Evaluate for fibroids and bleeding disorders.

Orthomolecular: Vitamin C with iron-rich mealsC

Increases non-heme iron absorption.

Status: Supplement · Cautions: Not a substitute for iron repletion.

Traditional: Cooking in cast-iron cookwareC

Modest increases in food iron content.

Status: Lifestyle · Cautions: Not adequate alone for established deficiency.

Energy / Physical: No energy modality treats iron deficiencyE

Listed for completeness only.

Status: Investigational · Cautions: Must not be presented as a treatment.

Monitoring

Ferritin and hemoglobin 8–12 weeks after starting iron
Symptom trend
TOBIN score change over time

Go deeper

Full condition page →Library: formulas & sources →All TOBINintel entries

iDetection of an exposure does not establish that it caused a disease. This platform separates exposure, association, plausible mechanism, clinical evidence and demonstrated causation.