Iron Explained: Why It Matters, Testing and Treatment

Iron is one of the most important minerals in your body, yet most people only find out they're low once they're anaemic, and that's one of the last signs to appear. In this episode I give a general overview of iron, from why it matters to how to test and treat it. I start with what iron does: 6.5% of the body's enzymes depend on it, it sits at the centre of haem in haemoglobin, and the body uses zinc instead when iron runs short. Then how much you need: we lose 1–2 mg a day and absorb only about 10% of what we eat, and needs differ for men, menstruating women and pregnancy. I cover the best food sources and the symptoms of low iron, including restless legs and craving ice. Next, testing: why a full blood count isn't enough, what ferritin, transferrin saturation and TIBC tell you, and why inflammation can make ferritin look normal. Finally, treatment: finding the cause first, why once-daily or alternate-day dosing works better because of hepcidin, why a 65 mg tablet is repaying a debt rather than overshooting, and when IV iron is needed. Sources: NHS iron guidance, NICE CKS, British Society of Gastroenterology guidelines (Gut, 2021), AGA guidelines (2020), Moretti 2015 (Blood), von Siebenthal 2023, The Peter Attia Drive AMA #58. This is informational purposes only, not medical advice. If you can't get seen by your own physician, by all means do so, but always speak to your own healthcare provider.