Latest / The Health Revival Show / #1012: Why Is My Ferritin Low? The 5 Patterns Doctors Miss

Transcript

#1012: Why Is My Ferritin Low? The 5 Patterns Doctors Miss · The Health Revival Show

• 0:00
  Liz Roman: There's so many people struggling with this, and your doctors
• 0:04
  are just gonna tell you that it's normal.
• 0:06
  Becca Chilcz: Just take iron.
• 0:07
  Liz Roman: Yeah, that too.
• 0:08
  Just take iron.
• 0:09
  We're gonna watch it.
• 0:10
  Becca Chilcz: And at the end of the day, guys, we have to understand
• 0:12
  that unfortunately, the doctors don't have the tools or the capacity
• 0:16
  to dive deeply into this for you.
• 0:18
  Liz Roman: And it's like, okay, did anybody look at how they're doing with
• 0:22
  their cycles and the heavy bleeding?
• 0:23
  Becca Chilcz: Because if you are be- like, even if you're below a 50 of
• 0:27
  ferritin, you're not feeling great.
• 0:28
  We're not in a place where we're gonna be growing hair well, and
• 0:30
  hair, you know, skin and nails are gonna be healthy, and energy and
• 0:33
  recovery and all of those things.
• 0:35
  Liz Roman: And there's five different patterns that we're gonna go through today
• 0:37
  and help you understand what your body and the pattern is trying to tell you.
• 0:42
  So women will have this miss for decades.
• 0:45
  Becca Chilcz: And so you kind of have to fight for yourself and
• 0:47
  find your own answers sometimes.
• 0:48
  Liz Roman: Hello, and welcome back to the Health Revival Show.
• 0:52
  We're talking all things iron anemia and low ferritin, because
• 0:58
  y'all don't seem to get it yet.
• 1:01
  Mm-mm.
• 1:02
  No.
• 1:02
  There's so many people struggling with this, and your doctors are just
• 1:07
  gonna tell you that it's normal.
• 1:08
  Your ferritin is above a 15, and it's not flagging low on your blood work, or even
• 1:13
  sometimes it is flagging low, and they're like, "Oh, we'll just keep an eye on it.
• 1:16
  We'll just watch it."
• 1:16
  Becca Chilcz: Like- Just take iron
• 1:19
  Liz Roman: Yeah, that too.
• 1:20
  Just take iron, we're gonna watch it, come back and let us know in three months.
• 1:26
  And it's like, okay, did anybody look at how they're doing with
• 1:30
  their cycles and the heavy bleeding?
• 1:32
  Because low iron, low ferritin can result in heavier menstrual periods and bleeds
• 1:38
  and clotting and all kinds of things.
• 1:40
  Uh, so that's what we're gonna get into today, and we're gonna talk about
• 1:43
  the different patterns, because you would see this as one problem, and
• 1:49
  there's five different patterns that we're gonna go through today and help
• 1:52
  you understand what your body and the pattern is trying to tell you.
• 1:55
  If your body is looking for iron, if it's sequestering iron because
• 2:00
  there's an infection and it's trying to protect you, it will lock it up.
• 2:04
  Or if you have a true anemia here and you really need to consider potentially
• 2:10
  an infusion, oral iron, a patch, sublingual, lactoferrin, all the types
• 2:17
  of things, and then we'll also talk about hemochromatosis, uh, at the end
• 2:20
  here and what o- iron overload is.
• 2:22
  And I don't know if you've experienced this, Becca, but I have
• 2:25
  gotten several people who's like, "Well, what about this pattern?
• 2:27
  What about this pattern?" It's like, these are the main five, and you need to
• 2:30
  look at the ranges, and so we're gonna walk you through all of that today.
• 2:33
  If you wanna grab a pen and paper.
• 2:34
  If you're watching us on YouTube, you can follow along.
• 2:38
  Also, we have a great guide that you can download for free and be able to
• 2:42
  go through this and understand your pattern, and then we'll also share with
• 2:46
  you some of the things that we do and implement and things that you may want
• 2:49
  to watch out for and things that we don't recommend doing, which is a lot of
• 2:52
  what your doctor's gonna tell you to do.
• 2:54
  Becca Chilcz: Yeah, and a- at the end of the day, guys, we have to understand
• 2:57
  that unfortunately, the doctors don't have the tools or the capacity to dive
• 3:03
  deeply into this for you, and so that is why it is a Your options are take iron,
• 3:09
  come back later, or an iron infusion, which neither actually solve the
• 3:13
  problem of what's going on at the root.
• 3:15
  So that's what we wanna talk about today is where, where these patterns
• 3:19
  essentially originate from, what they look like on your blood work,
• 3:22
  tighter blood work ranges so that you know what you should be looking for
• 3:24
  versus what your LabCorp thing says.
• 3:26
  Because if you are be- like, even if you're below a 50 of
• 3:30
  ferritin, you're not feeling great.
• 3:32
  We're not in a place where we're gonna be growing hair well, and
• 3:34
  hair, you know, skin and nails are gonna be healthy, and energy and
• 3:37
  recovery and all of those things.
• 3:38
  And yes, timing of when you test this does matter because obviously if you just had
• 3:42
  a period, you're gonna have lower iron.
• 3:44
  Like, don't time it around that.
• 3:46
  Time it leading into your cycle, which is also about when you usually wanna
• 3:50
  get hormones tested if you're testing hormones in a preme- uh, premenopausal
• 3:54
  female and they're having a normal cycle and consistent cycle, you usually wanna
• 3:57
  test around day 19 to 22 or so if you have that, like, 26 to 28-day cycle.
• 4:02
  So timing of when you test matters, and then trends matter, too.
• 4:06
  I would say that I see iron flip pretty frequently, and so if we see
• 4:10
  something kinda low, I'm looking for other patterns to go along with it.
• 4:14
  Ferritin's a little bit more of a storage shedding, right?
• 4:16
  And then we're looking at hemoglobin, we're looking at hematocrit, and these
• 4:19
  other markers that give us clues into, like, true deficiencies that have
• 4:23
  reached other parts of the system, right?
• 4:25
  So let's first talk about what's measuring what, um, and, you know, explain the
• 4:30
  markers that we're looking at here.
• 4:32
  So Typically, we run four markers with an iron panel, and then we
• 4:36
  also run an additional marker that gives us insight into inflammation,
• 4:40
  a, a general insight, right?
• 4:42
  So serum iron is first.
• 4:43
  That's obviously, like, what's in your bloodstream right now
• 4:46
  of iron, your tank, you know?
• 4:48
  Ferritin is what's in storage.
• 4:50
  What has your body been able to kind of put away into storage?
• 4:53
  And a big reminder here is that if your body is under chronic
• 4:56
  stress, if you are under chronic inflammation, it doesn't have the
• 5:00
  capacity to put anything in storage.
• 5:02
  Like, you're burning through things.
• 5:04
  It's just keeping it what it can into circulation.
• 5:07
  So it's a huge clue for a lot of people, if you have chronically low ferritin,
• 5:12
  a lot of times it's a cellular problem.
• 5:14
  It's a problem of what is going on that's not allowing you to even put
• 5:17
  anything in storage because it's so needed in actual circulation right now.
• 5:22
  So we'll get into that, obviously.
• 5:24
  Total iron binding capacity is how hard your body is hunting for iron.
• 5:28
  Percent saturation is how much of the ride is actually occupied, so, like,
• 5:32
  how much of the little cars taking iron around are actually consumed with iron.
• 5:37
  And then CRP.
• 5:38
  We run CRP, HS-CRP, a little bit different, but same general idea, whether
• 5:43
  inflammation is kind of faking the numbers, because CRP measures IL-6, which
• 5:48
  is produced by the liver, and so the liver tends to be very heavily involved
• 5:53
  in iron, in sequestri- sequestering of iron, in production and release of iron.
• 6:00
  So we'll get into all of that.
• 6:01
  But those are the big numbers that we're looking at.
• 6:03
  That's what we're gonna give kind of ideas around, um, in terms of, you
• 6:06
  know, ranges and what we wanna see.
• 6:08
  So now you understand what we're looking for.
• 6:11
  Liz Roman: Yeah.
• 6:12
  So if you have your labs and you wanna get them out right now, I'm gonna take
• 6:14
  you through what our optimal ranges are.
• 6:16
  And again, this is very different than what you're gonna see on
• 6:18
  a LabCorp or a Quest panel.
• 6:20
  So as Becca mentioned, your ferritin, which is your storage tank, if we are
• 6:25
  very low, we're gonna feel exhausted.
• 6:27
  We're gonna be depleted.
• 6:28
  We're gonna have hair loss and low energy, brain fog.
• 6:31
  All kinds of things can be associated with low ferritin.
• 6:34
  But also on the flip side, if it's really high, it can be
• 6:37
  an indicator of inflammation.
• 6:40
  So the functional range, and now I will say that functional
• 6:44
  ranges definitely vary.
• 6:45
  There are different schools of thoughts on this.
• 6:48
  I have been trained that over 100 is a sign of inflammation.
• 6:52
  I've also been trained that it can go up to 150 if we're looking at
• 6:56
  the broader picture to say, "Okay, no, things are actually okay."
• 7:00
  I would say both of us would agree that a sweet spot for ferritin is in the ballpark
• 7:05
  of 80 to 120, even though a functional range that has been provided through
• 7:09
  various blood chemistry courses says 50 to 100 When we look at hair specifically,
• 7:17
  I wanna see at least an 80, and this is also for cycling females because we
• 7:23
  don't wanna have those heavy periods.
• 7:24
  And when ferritin gets low, iron gets low, that is going to cause heavier bleeding,
• 7:29
  and we obviously don't wanna do that.
• 7:30
  And heavier bleeding over long periods of time is going to
• 7:33
  deplete your iron stores as well.
• 7:36
  So 50 to 100, we would say really the sweet spot is 80 to 120.
• 7:40
  Beck, I don't know if you have anything different there to share, but I don't
• 7:44
  like that top end being so high, and I also think 100's a bit too low.
• 7:48
  You have to look at, at the pattern and the trend and everything else, right?
• 7:51
  'Cause we'll also look at your hemoglobin, hematocrit, right,
• 7:55
  on your complete blood count.
• 7:56
  There's some markers that can be indicative of anemia there.
• 7:59
  Serum iron, this is your total iron that you're looking on your labs, 85 to 130.
• 8:05
  If we're looking at transferrin, this is not one that we
• 8:09
  always run, but 200 to 350.
• 8:11
  This is the iron delivery driver.
• 8:13
  Um, and so if your iron is high, this is your body kind of
• 8:17
  scrambling to move more iron.
• 8:20
  So think of that as your delivering driver.
• 8:22
  Transferrin saturation, so this is how full those delivery driver trucks are.
• 8:28
  If it's low, there's not enough iron being delivered, and this is
• 8:31
  a key deficiency marker as well.
• 8:33
  Then we have total iron binding capacity.
• 8:36
  So this is total seats on the bus, if you will, for iron.
• 8:40
  Lots of empty seats can point to a deficiency, so we would wanna see
• 8:43
  that somewhere between 250 and 400.
• 8:46
  And then we have UIBC as well, and this is unfilled seats, and if it's high, there's
• 8:52
  room to spare, so there's a deficiency.
• 8:53
  So it's kind of flip-flopped here.
• 8:55
  And low would be inflammation and overload.
• 8:57
  So you might see some of those other markers that we didn't mention, 'cause
• 9:01
  typically on our panel it's gonna be total iron, ferritin, binding
• 9:04
  capacity, and percent saturation.
• 9:06
  All right.
• 9:07
  So when we look at five anemia patterns that women show, I think this is really
• 9:12
  important to understand, and we're gonna specifically for the first couple
• 9:16
  highlight the binding capacity because again, as Becca mentioned before,
• 9:21
  this is going to be telling us how hard your body is hunting for iron.
• 9:25
  So if we have, let's go in the empty tank here, low iron, low ferritin,
• 9:33
  high binding capacity, and low percent saturation, this is your body asking for
• 9:38
  iron High total iron binding capacity is the tell that your body needs it.
• 9:46
  This is a true, you know, deficiency.
• 9:48
  The body is building more, uh, drivers because there's nothing left to haul
• 9:54
  essentially, so we need to find the leak.
• 9:56
  Is this heavy cycles?
• 9:57
  Is it malabsorption, so low stomach acid, need for vitamin C?
• 10:01
  All of those things in your gut microbiome are gonna be imperative to
• 10:04
  you absorbing the iron from your foods, but also thinking about things that would
• 10:09
  block iron absorption from those foods.
• 10:13
  Becca Chilcz: Yeah,
• 10:13
  Liz Roman: absolutely.
• 10:14
  This can be … I also wanna say here, sometimes you don't wanna ignore this
• 10:17
  if this is ongoing and there's a lot of GI issues, because it could be an
• 10:20
  internal bleed in the GI tract or, like, an ulcer or something along those lines.
• 10:23
  So again, this is just a caveat.
• 10:25
  Like, these are patterns, but you may have further investigation to do.
• 10:30
  When we look at a low or normal binding capacity, this is gonna tell us that
• 10:36
  your body is not absorbing this.
• 10:39
  So we wanna think here in terms of, you know, thyroid.
• 10:43
  Iron builds thyroid hormone, and low thyroid means heavier periods
• 10:46
  and worse absorption as well.
• 10:48
  So this is gonna be a pattern of normal iron, low ferritin, normal binding
• 10:53
  capacity, and normal percent saturation.
• 10:56
  So the only thing in this pattern is that your ferritin is low, so we
• 11:00
  need to focus on your conversion.
• 11:02
  What helps conversion?
• 11:03
  Lactoferrin, vitamin C, stomach acid.
• 11:07
  And then we could argue things like folate and B12 and all the different
• 11:11
  B vitamins, but this is really where iron is moving fine, but you're just
• 11:15
  not converting it and storing it.
• 11:17
  So for me, when I see this pattern, I'm gonna go and I'm gonna look at other
• 11:21
  patterns and trends on blood work to say how many markers indicate a gut infection
• 11:27
  or inflammation or malabsorption, right?
• 11:30
  Does she show other deficiency patterns in terms of a need for
• 11:33
  magnesium, a need for vitamin D, right?
• 11:36
  There's a lot of things that we can see, and we talk about this in our,
• 11:40
  uh, webinar series that we did, Labs Decoded, and that's in our FitMom Society.
• 11:44
  So if you want to understand, this is one panel that we look at amongst many.
• 11:50
  If you wanna understand that, you can go to fitmomsociety.com.
• 11:52
  There's a seven-day free trial.
• 11:54
  Access that.
• 11:55
  It's an hour, uh, five hours essentially, but it's split up into,
• 12:00
  uh, one-hour segments that you can go through the different panels, and
• 12:04
  you can understand all those other patterns and trends outside of this.
• 12:07
  So fitmomsociety.com.
• 12:09
  And pattern three.
• 12:11
  Becca Chilcz: Yes.
• 12:11
  So pattern three is an anemia of chronic disease.
• 12:15
  So this is typically more of an inflammatory pattern.
• 12:17
  You have iron, but inflammation ultimately locks it inside a storage,
• 12:21
  and it's an inflammation problem, not really an iron problem here.
• 12:24
  So here you're gonna see ferritin is gonna be normal or high.
• 12:28
  Serum iron and saturation will be low.
• 12:30
  Total iron binding capacity and UIBC will be low.
• 12:34
  We will usually see CRP, and we also test ESR, uh, sedimentation rate.
• 12:39
  Those are often elevated.
• 12:40
  We want sedimentation rate under a 10.
• 12:44
  Usually conventional's not gonna flag it until it's like a 25 or 30.
• 12:47
  We like it under a 10.
• 12:49
  CRP, again, is not the end-all be-all, because what CRP was designed
• 12:54
  to measure was it was designed to measure acute infections, injuries,
• 12:58
  and ultimately, you know, active large amounts of inflammation.
• 13:04
  If you have chronic low-grade inflammation, CRP might not
• 13:07
  be elevated, which is why we cannot lean on CRP by itself.
• 13:10
  We have to go off symptoms.
• 13:11
  We have to go off of other labs.
• 13:13
  And so CRP often is elevated, ESR is often elevated, but it might not be
• 13:17
  as much as you would think, right?
• 13:19
  Hemoglobin and hematocrit are often also low And in these situations,
• 13:24
  again, oral iron is not the fix here because it's not the problem.
• 13:28
  You usually have an issue where the inflammation is going on, and so ferritin
• 13:32
  is an acute phase inflammatory response in the body, and so your ferritin is going
• 13:37
  up and up, and you feel exhausted, and you feel like, "Okay, maybe because my iron
• 13:42
  is low, that's the answer." No, no, no.
• 13:45
  Iron is not low.
• 13:46
  Your body is responding to something.
• 13:47
  We have to figure out what it's responding to, right?
• 13:50
  This is an inflammatory process, and so in these cases, this is where we would
• 13:54
  be looking at, like, potentially a GI map test if there's nothing obvious going on.
• 13:58
  We would be looking at liver enzymes.
• 13:59
  We would be looking at our CBC.
• 14:01
  What's going on with the immune system?
• 14:02
  Do we have, you know, elevated or low white blood cells?
• 14:05
  Do we have neutrophils, lymphocytes, monocytes, all of our different types of
• 14:09
  white blood cells, are they dysregulated?
• 14:10
  Is vitamin D low?
• 14:12
  How long has this been going on?
• 14:13
  What I will often see is that ferritin will go acutely high when it is
• 14:19
  somewhat of an active infection.
• 14:21
  When the infection is ongoing and the immune system becomes exhausted, we over
• 14:25
  time start to see ferritin drop low.
• 14:27
  And so it kind of is like an indication that something is currently pretty acute,
• 14:32
  um, is what I actually tend to see.
• 14:34
  And then we also look to the liver, because the liver plays a really large
• 14:37
  role in essentially ferritin levels.
• 14:40
  And so if the liver is very stressed, if we're dealing with fatty liver,
• 14:43
  if we're dealing with liver burden, detoxification issues, we will also,
• 14:47
  also often see this go elevated.
• 14:48
  Sometimes I'll actually see ferritin go high and everything else is
• 14:51
  somewhat normal because it's more of a liver problem than it is
• 14:55
  even an iron or ferritin problem.
• 14:57
  Liz Roman: Yeah, so let's talk about that.
• 14:58
  So what's happening in the liver is that we have hepcidin, which is iron
• 15:03
  gatekeeper, if you will, and this is a hormone actually made by the liver.
• 15:08
  Its job is to decide how much iron gets into your bloodstream and how
• 15:12
  much stays locked away in storage.
• 15:14
  And so when we have an acute infection or there's a chronic infection and
• 15:20
  the body knows that these pathogens, because there's a variety of pathogens
• 15:24
  that can feed off of iron, including parasites and candida, the body
• 15:28
  knows it's going to sequester it.
• 15:30
  So what happens here is hepcidin goes up, and it shuts down a
• 15:34
  protein called ferroportin.
• 15:36
  Ferroportin is basically the door that allows your iron to move out of your
• 15:41
  intestines into your blood, out of the storage in your liver into your blood,
• 15:46
  and from macrophages that recycle old blood cells back into circulation.
• 15:50
  So if we have elevated hepcidin, that hormone from the liver, this is shutting
• 15:54
  down ferroportin, so things aren't gonna go into transportation appropriately.
• 16:00
  We have less iron absorption and more trapped in storage.
• 16:02
  This is iron sequestration We're going to see that ferritin high
• 16:07
  typically, and then everything else, like Becca was saying, normal.
• 16:11
  And so again, this is really important, and this is where we're gonna look at all
• 16:14
  of those other markers that she mentioned in terms of the inflammatory markers,
• 16:18
  because those signals tell the liver to produce more hepcidin to lock iron up.
• 16:25
  So hepcidin is the iron gatekeeper.
• 16:27
  When inflammation rises, hepcidin rises as well and your body closes the gate.
• 16:31
  You absorb less iron from the gut, and you lock more inside storage.
• 16:35
  So again, this is really where, as you mentioned before earlier,
• 16:38
  Becca, it's trends over time.
• 16:40
  We don't wanna overreact to something, because typically
• 16:44
  we'll see this when people start with us or after an infection.
• 16:47
  You know, like, hey, they just got the flu, 24-hour bug, whatever this
• 16:51
  is, which is kind of silly, guys.
• 16:53
  Like, really don't do your labs close to being sick, because we
• 16:58
  are gonna see typically white blood cells are gonna be elevated.
• 17:01
  Other things are just gonna be off because there's an active infection.
• 17:04
  Sometimes we'll also see this with an injury, right?
• 17:06
  So injuries create inflammation in the body.
• 17:09
  It's a healing response that we need.
• 17:11
  And so I like to see at least a week, if not longer, maybe two, away from
• 17:15
  an infection or an injury inflammation that's, you know, again, more acute.
• 17:19
  Becca Chilcz: Mm-hmm.
• 17:21
  So the next trend is what's called B12 folate anemia or macrocytic anemia,
• 17:26
  where red blood cells actually get too big but not enough, so there aren't
• 17:30
  enough of them, and they grow in size.
• 17:32
  And this is not iron.
• 17:33
  It's low B12 and folate and poor absorption issues.
• 17:37
  So you watch for kind of tingling and brain fog and memory changes.
• 17:41
  MCV is a big marker that we'll look for.
• 17:43
  I actually see this, I would say, in more labs than not.
• 17:46
  Like MCV in almost all of my labs that I look at is high.
• 17:52
  So in this situation, a lot of times you will actually see red blood
• 17:56
  cells, hemoglobin, and hematocrit low.
• 17:59
  Iron and ferritin are normal.
• 18:01
  Homocysteine can be high.
• 18:04
  Sometimes it can also be low, too.
• 18:06
  This is like … This is a tricky one, 'cause homocysteine can be low when
• 18:09
  there's a B12 folate need, and it can be high when there's a trimethylglycine need.
• 18:13
  Like, it is kind of dependent.
• 18:15
  Um, so homocysteine we want around, like a 7.2 or so.
• 18:19
  If it's in the 8, 9, 10 plus, definitely a need for homocyst-
• 18:23
  I'm sorry, for B12 and folate.
• 18:24
  When it's low though, a lot of times there's deficiencies as
• 18:26
  well, so something to consider.
• 18:28
  And then MMA, if it is measured, a lot of times will be high.
• 18:32
  So in this situation, it's a little bit different of an
• 18:34
  anemia, um, and still a problem.
• 18:37
  It will still reflect in red blood cells, hemoglobin, hematocrit, these
• 18:40
  different things, but it typically is not reflected in iron and ferritin.
• 18:45
  Um, so just something to watch out for in terms of another
• 18:49
  trend that we will sometimes see.
• 18:51
  And then the fifth one is
• 18:53
  Liz Roman: It is important, though, to check your folate and check your B12.
• 18:56
  And by the way, guys, B12 also has a very wide range on- Yes … LabCorp.
• 19:01
  It's, like, laughable.
• 19:02
  I had someone on Instagram the other day like, "Oh, my B12
• 19:04
  is, like, 470-something." I was like, "Yeah, that's great.
• 19:07
  That's about half of where we wanna see it, around 900.
• 19:11
  850 to 950 for B12 is what we wanna see.
• 19:12
  And here's a caveat.
• 19:14
  You need to stop your B12 or all, you know, biotin, any B vitamins 72
• 19:20
  hours or three days prior to your lab draw because it's not only gonna
• 19:25
  throw your B12 off, and some people freak out, like, their B12 is 1,600.
• 19:29
  It's like, okay, this is a water-soluble vitamin, and you took that.
• 19:32
  You didn't, you know, pause it for three days before it's going to show high.
• 19:37
  You're gonna pee it out.
• 19:38
  Don't freak out.
• 19:39
  It's fine.
• 19:39
  Obviously, if you're not taking B12 and B12 is elevated, that's a
• 19:43
  different cause for concern, right, and you're seeing that pattern.
• 19:45
  Uh, but I think this is wise to not only look at your iron panel with everything
• 19:51
  and your complete blood count with everything, the CRP, the homocysteine.
• 19:56
  Look at everything else, a full thyroid panel.
• 19:58
  All of it matters because it can really tell us a story that we can
• 20:02
  start to piece together, you know, that puzzle for you essentially.
• 20:06
  So a lot of times we talk about deficiency, we talk about low
• 20:09
  iron, low ferritin, all of that.
• 20:11
  And again, we've helped you now distinguish, do I have a true deficiency?
• 20:14
  Is my body locking iron up?
• 20:16
  Maybe there's inflammation, infections going on here.
• 20:19
  Maybe it's more of, you know, the B12, folate, uh, anemia.
• 20:24
  There's multiple patterns.
• 20:26
  But what about over like over, uh, high iron, right?
• 20:30
  And so when we look at this and everything is spilling over, um, this is overloaded.
• 20:35
  That's the word I was looking for.
• 20:36
  Uh, hemochromatosis.
• 20:38
  And so your body absorbs iron and it can't stop.
• 20:40
  Now, there's genetic factors here to this.
• 20:43
  Um, and ferritin alone will totally miss this.
• 20:46
  You need to have that saturation.
• 20:48
  Um, and that's really gonna be the tell here.
• 20:50
  So if you're looking at your iron saturation, hemochromatosis,
• 20:54
  like a true hemochromatosis, you're gonna see that over 45%.
• 20:58
  You are likely going to see high iron, high ferritin, low total
• 21:03
  iron-binding capacity, but you can't say this is hemochromatosis if
• 21:06
  you're not looking at the saturation.
• 21:09
  So women will have this miss for decades.
• 21:12
  I remember, Becca, we won't share the client's name live, but we had a
• 21:16
  client with this pattern, and she was having a lot of heaviness in her legs.
• 21:20
  She was getting winded she-- when she would go up the stairs.
• 21:23
  And as soon as we had her go and donate blood, a lot of that improved.
• 21:27
  Um, and so this is something that, you know, we do wanna watch out for.
• 21:32
  Uh, if you do have iron overload, and this is more genetic in your
• 21:35
  family, then there's, you know, ways you need to watch how much iron, you
• 21:40
  know, rich foods you're consuming.
• 21:41
  Not cooking in an iron skillet.
• 21:44
  Uh, the cast iron skillet, specifically when there's acid added to it,
• 21:48
  like a tomato sauce, it's going to leach more iron into your cooking.
• 21:52
  You would want to, you know, think about avoiding supplements that have
• 21:56
  iron in them and giving blood, donating blood, and also potentially using
• 22:01
  lactoferrin because that can help with transporting things appropriately, uh,
• 22:05
  and helping your body process that.
• 22:07
  Lactoferrin also has a lot of great benefits though, even for your
• 22:10
  gut microbiome, uh, the epithelial cells, healing up leaky gut.
• 22:14
  So if we're seeing on labs high zonulin, high calprotectin, a lot of inflammation
• 22:19
  in the gut, lactoferrin can be really great, um, actually for most cases.
• 22:24
  Again, this is not medical advice.
• 22:25
  We would wanna evaluate this, you know, person to person.
• 22:28
  And then in our guide, so if you wanna click the link in the show
• 22:31
  notes for Uh, you know, our iron anemia guide, we do talk a little
• 22:36
  bit about why we avoid oral iron, and I'll give it to you straight here.
• 22:41
  Simply, it can feed pathogens, and it's very harsh on the gut.
• 22:44
  We can get into the debate about different types of iron and how that
• 22:48
  goes and, you know, sometimes there are situations where we do need oral iron,
• 22:52
  and in that situation, we would want iron that's very gentle on the gut.
• 22:56
  We would wanna have it be paired with copper.
• 22:58
  Copper deficiency is a big thing with iron deficiency as well, and it
• 23:03
  really impacts your body's ability to utilize the iron appropriately.
• 23:08
  So vitamin C, copper, stomach acid support, those are three big players when
• 23:14
  we're seeing a true anemia, uh, you know, iron anemia, ferritin is low, all of that.
• 23:20
  We want to make sure that we're supporting your body.
• 23:22
  But on the flip side, if you have too much iron, right, then you
• 23:25
  have to go the opposite direction.
• 23:27
  Um, and again, you would wanna obviously be partnering with your
• 23:29
  doctor or your practitioner for your individualized protocols here and
• 23:33
  how often you need to donate blood.
• 23:35
  I know at Vital Medical, our nurse practitioners and our partners there
• 23:38
  are fantastic with this, where we'll have clients donate blood, lab,
• 23:43
  uh, draw labs at about six weeks.
• 23:46
  Conversely, iron infusions, if that's the case, I have a few of those right now
• 23:50
  where we truly needed to have, their iron anemia was gone that far, an infusion,
• 23:56
  then we're checking again, typically at four weeks, this is what I'm sending them
• 23:59
  in for, and we're monitoring symptoms between, and we're still using things
• 24:04
  that are going to support them in terms of the oral iron strips, so the Kaave Melts.
• 24:08
  Those have folate in them and then iron, which is great, very gentle.
• 24:12
  It's going sublingual through the tongue and just melts in your
• 24:14
  mouth, tastes like raspberry.
• 24:17
  I don't personally love it.
• 24:18
  A lot of people haven't complained about it.
• 24:19
  It's not terrible, but it has a metallic taste to it.
• 24:22
  Mm-hmm.
• 24:22
  Uh, and then lactoferrin.
• 24:25
  So lactoferrin, I have a lot in a lot of my cases.
• 24:27
  Um, I am starting it myself because I have a l- bit low ferritin, uh,
• 24:31
  and everything else is fine, but I'm seeing my ferritin, I think it was 42.
• 24:36
  I don't have heavy periods, but I wanna get ahead of this.
• 24:38
  I do see other markers that are depleted, and that has to do with previous stress
• 24:44
  of moving and all of that, not eating enough for sure, as I'm learning, as
• 24:48
  I'm retracking my food and all of that.
• 24:50
  But we often don't realize how much we burn through when we are stressed.
• 24:56
  And so if you're somebody who has this pattern and you, you know,
• 25:00
  kinda have this tendency to fall on that low side Here's the real truth.
• 25:05
  You're probably going to have to work hard to get this up and keep it up.
• 25:10
  Some people say, "Well, can't we take, you know, just everything through food?
• 25:14
  And why do we have to use so many supplements?" And I get it, but when
• 25:19
  you're in a state of dysfunction, there's a reason for a season.
• 25:23
  And when we know the person's genetics, we know they've had a compromised
• 25:27
  gut for many years, maybe a lot of stress, trauma, dysregulation of
• 25:32
  nervous system, whatever it might be Then this is where supplements come to
• 25:37
  play to be supplemental to your diet.
• 25:39
  Yes, we take a diet first approach, and you should take a diet first approach.
• 25:43
  However, sometimes that's not enough, and so you need to
• 25:46
  rebuild your stomach acid levels.
• 25:48
  We love the HCL Guard by HealthyGut or Betaine HCL and
• 25:51
  our stomach acid resource pack.
• 25:52
  We have a ton of different ways that you can support that with bitters and
• 25:56
  apple cider vinegar and all those things.
• 25:58
  I like to just keep it simple and take a capsule.
• 26:00
  Then you would wanna think about vitamin C, so vitamin C rich
• 26:04
  foods, vitamin C with your meals.
• 26:06
  So you could either take this in a liquid form, a powder form.
• 26:09
  I prefer buffered vitamin C. It's easier on the gut.
• 26:12
  But for me personally, if you've watched my stories over the past almost
• 26:15
  three years now, I believe maybe…
• 26:17
  No, two years, going into my third year, we've taken camu camu every day.
• 26:21
  My son takes it as well.
• 26:23
  It's great, uh, f- source of natural vitamin C, naturally higher in iron,
• 26:28
  so I include for my iron anemia gals.
• 26:31
  Put it in your smoothies.
• 26:32
  Put it in your drink.
• 26:33
  You can use a camu camu powder.
• 26:35
  Those are very cheap and affordable.
• 26:37
  They do have, like, a little bit of a sour taste.
• 26:39
  Sometimes I just found that they were kinda chalky, so I opt to just keep the
• 26:43
  IO1 dropper in, and it's just so easy.
• 26:45
  My kids don't even notice that it's going in their drinks.
• 26:48
  Um, so just remember there's a lot of things that we can do here, and
• 26:52
  then it's important that you recheck.
• 26:55
  So look at your labs, see the pattern, identify what you need,
• 26:59
  implement that, and take consistent action for at least four weeks.
• 27:02
  Recheck.
• 27:03
  Watch your menstrual cycles too.
• 27:05
  So if you are somebody who is having those really heavy bleeds, go into the
• 27:09
  guide and look at everything else we talk about related to your thyroid.
• 27:13
  Iodine's a crucial player here because that regulates growth, and we know that
• 27:18
  typically when iron is low, we're gonna see iodine deficiency and typically
• 27:22
  more on the slow hypothyroid, uh, side.
• 27:25
  So Beck, I don't know if you wanna add anything to that, but this
• 27:27
  is definitely a broader, complex picture, and sometimes we do have
• 27:31
  to work hard to get these stores up.
• 27:33
  Becca Chilcz: Yeah, and I, I think the last piece that we haven't
• 27:35
  expanded on too much is around how ferritin can a lot of times be because
• 27:39
  of mitochondrial and cell issues.
• 27:41
  So iron isn't just for making red blood cells.
• 27:44
  Like, it's required for the raw material inside of individual cells for jobs that
• 27:49
  have nothing to do with oxygen support.
• 27:51
  One of them is in the electron transport chain, which is basically
• 27:54
  how your cells make energy.
• 27:56
  And so if there is a lot of struggle happening at a cellular level due
• 28:00
  to, you know, immune based issues, chronic stress on the system, the
• 28:04
  iron is going to be essentially worked through, and mitoch- mitochondria
• 28:09
  can't run that chain efficiently.
• 28:11
  And so your cells make less energy regardless of what hemoglobin looks like,
• 28:14
  and that's why people a lot of times don't have hemoglobin and hematocrit
• 28:17
  issues, but, like, they're exhausted, they have brain fog, they're cold.
• 28:20
  Because if their ferritin's low A lot of times it's a cellular
• 28:23
  problem, not necessarily an iron and iron storage problem.
• 28:26
  And iron's also a cofactor, which we didn't talk too much about, but it's
• 28:29
  a cofactor for enzymes outside the mitochondria that convert T4 to T3.
• 28:34
  So it's needed for enzymes that essentially synthesize dopamine
• 28:37
  and serotonin, and low ferritin will contribute to sluggish thyroid
• 28:41
  conversion, low mood, low motivation.
• 28:44
  So it's kind of this vicious cycle of, like, it affects a lot of different
• 28:47
  systems, and ferritin is a reserve.
• 28:49
  It's not real-time measurement like iron is, you know?
• 28:52
  So it tends to drop well before your hemoglobin or MCV or these other
• 28:56
  markers, and the body prioritizes iron for hemoglobin production
• 28:59
  above almost everything else, so it will drain ferritin, essentially
• 29:03
  to protect red blood cell output.
• 29:05
  So we're looking at iron, we're looking at the gut, we're looking at all these
• 29:09
  things, and that's not wrong, but sometimes it gets to a place where we
• 29:13
  have to look at the cellular health and what ultimately is depleting the
• 29:16
  cellular health, which can be, you know, chronic viral, it can be GI
• 29:20
  issues, it can be chronic stress, it can be chronic undereating, right?
• 29:22
  There's so many things that can stress out a system, and that's a
• 29:25
  case-by-case basis of what we look for.
• 29:27
  But this was something that was really interesting that we kind
• 29:30
  of, uh, came upon a little bit more recently on with the mitochondria
• 29:34
  being such a big piece of low ferritin and having to be addressed as well.
• 29:38
  Um, but yeah, it's why you have to look at things as a whole.
• 29:41
  You can't just isolate an iron panel.
• 29:43
  You can't just isolate ferritin.
• 29:44
  Like, you have to look at the entire system.
• 29:47
  It's why we run so much blood work.
• 29:48
  It's why we look at health history and dive deep into this with people.
• 29:51
  Because again, you're just not gonna get it anywhere else.
• 29:54
  Like, we've had the … Liz and I had this conversation offline.
• 29:57
  People are like, "I learned more in this conversation than I've
• 29:59
  learned in months/years working with different doctors." And
• 30:03
  it's, again, no fault to people.
• 30:05
  Like, some people, it's just not their expertise.
• 30:07
  It's not what they've learned.
• 30:08
  It's not that they don't have the time, right?
• 30:10
  I mean, I had a client a wh- a while ago, I remember, and she had a very
• 30:14
  clear hemochromatosis pattern, and I told her to go to her, her hematologist.
• 30:17
  Mm. And she came back and said the hematologist basically said, "We're
• 30:20
  not gonna do anything until it gets worse." And so, um, you know, you
• 30:25
  kinda have to fight for yourself and find your own answers sometimes,
• 30:28
  which is what our team helps with.
• 30:29
  Uh, and so we advise, obviously, utilize things that are helping with, you know,
• 30:35
  not absorbing so much iron, like Liz went through, um, and then giving blood.
• 30:38
  Some people need to give blood every month, every other month.
• 30:41
  Like, sometimes it needs to be a little bit more regular,
• 30:43
  especially if it's gotten kinda bad.
• 30:45
  Um, but yeah, that heaviness, that leg heaviness, that feeling like you're
• 30:49
  huffing and puffing, like, it almost feels like you're working through quicksand, um,
• 30:53
  can be really common with hemochromatosis 'cause iron is very heavy on the system.
• 30:58
  When it gets too high, it stresses out the liver a ton.
• 31:00
  Um, so yeah, it's, uh, we gotta find our own answers sometimes, and
• 31:05
  that's what we do the podcast for.
• 31:06
  That's what we try to help you guys with.
• 31:08
  Um, and if you want those answers and you feel like you're not getting them,
• 31:11
  go to the show notes, book a call with our team, set up a lab review with us.
• 31:15
  We're more than happy to go through this all with you and help you
• 31:17
  understand what your patterns are.