20/08/2026
Three months on iron tablets. Bloated, constipated, ferritin barely moved.
What’s going wrong? Well you may be putting iron into a gut that can’t absorb it. I see this ALL the time which is why I very rarely recommend iron tablets to support nutrient levels and try and find the driver (ie. gut, diet, inflammation) that could be driving it.
Only around 10% of what you swallow gets taken up. The rest carries on through, and it isn’t neutral. Iron sitting in the colon shifts the bacterial balance, which is a lot of the cramping and constipation women are told to live with.
Low iron isn’t always low intake. It can be low stomach acid, celiac, inflammation, or a bleed heavy enough to outpace any tablet.
So I don’t start with the dose. I start with the driver.
Comment DECODE if you want my health blueprint so we can understand the driver behind your low energy, heavy bleeds and low iron levels which are often interconnected.
Ref: Rusu et al., Nutrients, 2020.