And then there's the problem that hypoT causes achlorydia, low stomach acid, and that causes iron def in itself.
The following is fascinating if you are an iron deficiency geek. Which you will be soon. (!) Obviously, they are talking about anemia here, but iron depletion short of anemia would be caused in the same way.
© 2015 American Society for Nutrition
Is achlorhydria a cause of iron deficiency anemia?1
Andrea L Betesh, Carol A Santa Ana, Jason A Cole, and John S Fordtran*
Department of Internal Medicine, Baylor University Medical Center, Dallas, TX
We re-evaluated the old hypothesis that gastritis-induced achlorhydria is a cause of iron deficiency anemia (IDA) in humans. First, we analyzed the currently available research on the association between achlorhydria and IDA. When gastric acid secretion was measured after maximal stimulation, the frequency of achlorhydria (or severe hypochlorhydria) was 44% in patients with idiopathic IDA and 1.8% in healthy controls. In some patients with pernicious anemia, presumed achlorhydria preceded the development of IDA in time. However, we found no credible evidence that IDA caused gastritis or that IDA preceded the development of achlorhydria. Thus, correlational results favor achlorhydria as the causal factor in the association between achlorhydria and IDA. (OK, I THINK WE WOULD ALL HAVE WORKED THAT OUT.)
Second, we sought to determine whether gastritis and achlorhydria cause negative iron balance. When biosynthetic methods were used to isotopically label iron in food, (THIS IS THE GOOD BIT) achlorhydric patients were found to have severe malabsorption of nonheme iron, (THAT IS IRON FROM VEG, NOT MEAT) which persisted after the development of IDA. In 1 study, achlorhydria reduced the normal increase in heme-iron absorption from hemoglobin in response to iron deficiency. (SO BASICALLY VEGGIES WHO ARE HYPOT ARE AT HUGE RISK OF IRON DEF - BUT IT LOOKS LIKE ALL 35 per cent of HYPOTs WITH GASTRITIS ARE AT GREATER RISK, THEY DISCOVERED WHEN THEY GOT DOWN TO ANALYSING THE POO.) After an injection of isotopic iron into normal men, the physiologic loss of iron from the body was found to be 1 mg/d. Patients with chronic gastritis had excess fecal loss of isotopically tagged plasma iron. Calculations based on these results indicate that the absorption of iron from a typical Western diet by achlorhydric patients would be less than physiologic iron losses, creating a negative iron balance that could not be overcome by the adaptive increase in duodenal iron absorptive capacity that occurs in response to iron deficiency. The combination of results from these correlational and pathophysiologic studies supports the hypothesis that gastritis-induced achlorhydria can be an independent cause of IDA.
OK, so have they tested you for antibodies to intrinsic factor, parietal cells and serum gastrin - as a starter?