Iron deficiency anaemia explained

  5 Minutes

Anaemia is a condition where your body isn’t getting enough oxygen where it needs to go. Far from being simply an iron deficiency, anaemia is your body’s way of telling you that something fundamental needs attention. Understanding the root cause could be the key to reclaiming your energy and vitality.

What is anaemia, really?

Anaemia is your body’s way of telling you that your blood isn’t carrying enough oxygen around your body. Your tissues and organs simply aren’t receiving the oxygen they need to function at their best.

While many people immediately think “iron deficiency” when they hear anaemia, it’s actually an umbrella term covering several different conditions. Each type has its own root cause and needs its own approach to healing.

The different faces of anaemia

• Iron deficiency anaemia is the most common type, affecting roughly two-thirds of all anaemia cases. This happens when your body lacks sufficient iron to produce healthy haemoglobin (a protein on red blood cells which binds and carries oxygen).
• Vitamin deficiency anaemia occurs when you’re missing crucial nutrients like vitamin B12 or folate. These vitamins are essential building blocks for healthy red blood cells.
• Chronic disease anaemia can develop when ongoing health conditions create inflammation in your body. Inflammation interferes with your body’s ability to produce red blood cells.
• Kidney-related anaemia develops when your kidneys produce less erythropoietin (EPO), the hormone that tells your bone marrow to make red blood cells. When your kidneys aren’t working properly, the signal weakens, leading to reduced red blood cell production.
• Sickle cell anaemia is when red blood cells form in an abnormal crescent shape instead of a flexible disc. Sickle-shaped cells break down much faster than healthy cells and can block blood vessels, preventing proper oxygen delivery.

Other types include conditions where the bone marrow malfunctions because of autoimmune diseases, toxins, or genetic factors, and where red blood cells are destroyed too quickly for the bone marrow to keep up with replacement needs.

Iron deficiency anaemia

Since iron deficiency is the most common cause of anaemia, this article is going to focus primarily on the type of anaemia known as iron deficiency anaemia.

Who’s most at risk?

Women face the highest risk, particularly during their reproductive years. Monthly periods, pregnancy, and breastfeeding all increase iron needs. Heavy periods can gradually deplete your iron stores over time.

During pregnancy and breastfeeding, your iron needs skyrocket. You’re maintaining your own blood supply and creating an entirely new one for your baby, plus supporting the placenta. The first 1000 days of life i.e. from conception until your child’s second birthday are critical for adequate iron nutrition. Read more about it in our guide to the first 1000 days.

Children and teenagers need extra iron during growth spurts. Their bodies are working overtime to build new tissue, and iron is essential for their growth.

Athletes need more iron owing to increased demands for oxygen transport, muscle development, and tissue recovery. Exercise-induced inflammation impairs iron absorption for hours after training. Many athletes follow restrictive or plant-based diets that compromise iron consumption.

Plant-based eaters need to monitor their iron levels because the iron in plants is much harder for your body to absorb than iron from animal sources.

Understanding haem vs non-haem iron

Haem iron, found in meat, poultry, and fish, is absorbed at rates of 15-35%. Your body recognises it easily and absorbs it readily.

Non-haem iron from plants, vegetables, and fortified foods is absorbed at lower rates (2-20%). It’s also more unpredictable. Absorption rates can vary quite a bit from one person to the next. Did you know that calcium from dairy products, tea, coffee, and certain plant compounds can reduce how much iron of plant origin your body actually absorbs?

Recognising the signs your body needs more iron

Anaemia symptoms often creep up gradually, which is why they’re easy to dismiss as just being tired or stressed. Understanding what to look for can help you recognise when it’s time to take action.

Fatigue is usually the first and most noticeable symptom. You might find yourself feeling exhausted even after a good night’s sleep, or struggling through activities that used to be easy. You might experience brain fog, difficulty concentrating, or memory problems.

Physical signs include pale skin, brittle or spoon-shaped nails, hair loss, and cold intolerance. You may develop some unusual cravings for ice, starch, or non-food items. Cravings are your body’s way of trying to signal its needs. Sleep disturbances and restless legs are also common. Recurring infections are a sign that your immune system isn’t working as it should due to iron deficiency, particularly in children.

Iron deficiency vs iron deficiency anaemia

Iron deficiency means your body’s iron stores are running low, but it hasn’t yet affected red blood cell production. Symptoms are often subtle or absent. When the shortage progresses, and the body can no longer make enough haemoglobin for healthy red blood cells, iron deficiency anaemia occurs. Symptoms like fatigue, paleness, shortness of breath, and weakness begin to appear. Not every case of iron deficiency develops into anaemia, but every case of iron deficiency anaemia begins with low iron.

What’s the difference between haemoglobin and ferritin?

Haemoglobin (Hb) and ferritin tell two very different stories about iron in the body. Both are vital for understanding your health. Haemoglobin is the oxygen-carrying protein in red blood cells. Hb levels show how well blood can deliver oxygen right now. Low haemoglobin means anaemia, with its familiar symptoms of fatigue and shortness of breath. Ferritin shows how much iron is stored for future use. Even if haemoglobin is normal, low ferritin points to depleted iron reserves, putting you at risk of developing anaemia soon. Checking both helps catch iron shortfalls early, giving an opportunity to restore iron before anaemia sets in.

The problem with traditional iron supplements

Most traditional iron tablets, like ferrous sulphate, are inefficient. Only about 10-20% of each dose makes it into your bloodstream, leaving the remaining 80-90% sitting in your digestive system. There, the surplus iron oxidises, producing free radicals that inflame and irritate your delicate gut lining. This is called oxidative stress which causes symptoms like nausea, constipation, abdominal cramps, diarrhoea and a metallic after-taste.

Excess unabsorbed iron also changes your gut microbiome. Pathogenic bacteria thrive on the readily available iron. This is why doctors will ask you to stop traditional iron supplements when you are ill with infection. Helpful bacteria decline, reducing microbial diversity and fuelling inflammation.

These side effects create a real problem. When people can’t tolerate their supplements, they stop taking them.

Practical steps for better iron health

• Choose iron-rich foods: If you eat meat, opt for organic sources when possible. Organ meats (especially liver), fish and eggs are rich in bioavailable iron. If you follow a plant-based diet, focus on legumes, seeds and dark leafy greens. Combine them with vitamin C-rich foods.
• Timing matters: Take iron supplements or eat iron-rich foods away from tea, coffee, and dairy products. These can reduce absorption, particularly of plant-based iron. Instead, pair iron with vitamin C sources like citrus fruits, berries, or bell peppers.
• Manage expectations: If you’ve had surgery, been through illness, or given birth, your body needs time to recover. The old concept of convalescence, giving your body proper time to heal with good nutrition, rest, and low stress, is still relevant today.
• Address underlying causes: If you have heavy periods, digestive issues, or chronic conditions, work with your healthcare provider to address these root causes while supporting your body’s iron needs.
• Be patient: Remember that red blood cells live for 120 days. Complete restoration of iron stores takes 3-6 months of consistent supplementation.

The Bio-Strath difference

Bio-Strath contains 61 of the 100 vital nutrients our bodies need daily, in a unique format that is highly absorbable. Included in these are 11 vitamins, 19 minerals and trace elements, 20 amino acids and 11 building substances. Building substances are special because they are the nutrients our body needs to make new cells. Bio-Strath is safe to use across all life stages, from children to adults to older people. Bio-Strath is clinically proven to support and maintain haemoglobin levels, making it especially valuable for people managing anaemia or low iron stores. Bio-Strath has been proven to enhance the absorption of iron by 5 times.

Bio-Strath Iron

Bio-Strath Iron with Vitamin C is a natural nutritional supplement that combines plasmolysed herbal yeast with fermented Koji and vitamin C. Fermented Koji is a slow-releasing form of bioavailable iron that is gentle on your system and suitable for people on a plant-based diet. Acerola is a small, cherry-like tropical fruit native to Central and South America and the Caribbean. It is renowned for its exceptionally high natural vitamin C content. When iron and vitamin C are taken together, the amount of iron absorbed increases.

Your path forward

Understanding anaemia empowers you to take control of your health in a gentle, natural way. You can work with your body’s natural processes to restore optimal iron levels and energy.

You don’t have to suffer through fatigue, brain fog, or the side effects of harsh supplements. Nature provides gentle, effective solutions that can help restore your iron levels and keep iron-deficient anaemia at bay. Your body has a remarkable capacity to heal when given the right support.

References and additional reading:

1. Cleveland Clinic (2025) ‘Erythropoietin: Production, Purpose, Test & Levels’. Available at: https://my.clevelandclinic.org/health/articles/14573-erythropoietin
2. Mediclinic (2025) ‘Sickle cell anaemia’. Available at: https://www.mediclinic.co.za/en/infohub-corporate/conditions/sickle-cell-anaemia.html
3. Manhattan Cardiology (2024) ‘Anemia vs Iron Deficiency’. Available at: https://manhattancardiology.com/blog/anemia-vs-iron-deficiency-what-is-the-difference/
4. MedicineNet (2020) ‘What Are the 3 Stages of Iron Deficiency?’. Available at: https://www.medicinenet.com/what_are_the_3_stages_of_iron_deficiency/article.htm
5. Ferosom Canada (2025) ‘Iron Deficiency vs. Iron Deficiency Anemia: What’s the Difference’. Available at: https://www.ferosomcanada.com/blogs/news/iron-deficiency-vs-iron-deficiency-anemia-what-s-the-difference
6. Mayo Clinic (2024) ‘Hemoglobin test’. Available at: https://www.mayoclinic.org/tests-procedures/hemoglobin-test/about/pac-20385075
7. Western Cape Blood Service (2021) ‘What is the Difference Between Haemoglobin, Iron and Ferritin Testing in Blood Donors?’. Available at: https://wcbs.org.za/2021/11/12/what-is-the-difference-between-haemoglobin-iron-and-ferritin-testing-in-blood-donors/
8. NCBI (2019) ‘Iron absorption from supplements is greater with alternate day than with consecutive day dosing’. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC7193469/
9. NCBI (2022) ‘The Relationship between Iron, Inflammation and Gut Microbiota’. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC9458173/
10. Consensus (2023) ‘Iron Supplement Gastrointestinal Side Effects’. Available at: https://consensus.app/questions/iron-supplement-gastrointestinal-side-effects/
11. SingleCare (2025) ‘Exercise-induced anemia: Causes, symptoms, and treatment’. Available at: https://www.singlecare.com/blog/exercise-induced-anemia/
12. Future You Health (2025) ‘Iron: The definitive guide’. Available at: https://futureyouhealth.com/blogs/knowledge-centre/iron-definitive-guide

  Listen to the podcast here: Anaemia Uncovered