In a not very helpful fashion, the simple answer is either that you are not absorbing enough. Or you are losing too much.
Absorption issues start with whether your food has enough in the first place. Then whether your digestion can extract the iron that is present and transfer it into your bloodstream.
Loss issues include the very obvious but also potentially nasty issues like internal bleeding.
Correction of either absorption or loss will, in time, see improvement. But you might well need to be active in addressing the deficiency. Otherwise improvement can take years.
Also, red blood cell issues can affect how much you appear to have. For example, low B12 results in large red cells. Iron deficiency results in small red cells. Traits such as sickle cell affect the shapes of the red cells.
I suggest another site (don't think it was mentioned in your previous post):
I do now now that I am working in raising my ferritin.
As helvella notes, it’s simple math. You are either not getting enough in… or you are losing too much out.
Keep in mind, we shed about 2-4 mgs a day (higher when on our periods)
Getting enough in begins with 1) ingesting iron and 2) absorbing that iron.
When you do the math, it’s actually incredibly hard to ingest and absorb enough iron.
Heme iron absorbs at about a rate of 15-35%, while non heme is 1/3 that. When you look at naturally “iron rich” non-heme foods a serving is around 1.5-2 mgs… maybe some have 3 mgs. Fortified foods are better - maybe 10 mgs. Animal organ meat can be 6-10 mgs a serving.
Remember that vitamin C will increase non- heme absorption. But these things will block absorption of both: high fiber, calcium, coffee and a few other things. Our faulty thyroid doesn’t help either.
Recommended daily value is about 18 mgs. And that’s just to maintain.
Net net - from my experience trying, I found it impossible to ingest enough iron from food to break through my anemia, without consuming entirely too many calories and needing every single serving of food to be iron rich.
It’s really easy to not get enough iron, and anemia is very very common, with a higher than average rate of hypos being anemic.
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