Feeling tired, mentally foggy, or out of breath during routine activity? If so, it’s worth considering iron deficiency—even if your hemoglobin is technically “normal.” True iron health is about more than red blood cells. It’s about iron availability, storage, and demand—and sometimes, it’s about how well your body is absorbing what you’re taking.
At our practice, we recommend BioTE Iron+, a high-bioavailability oral iron supplement designed for better absorption and less GI upset. Many over-the-counter iron supplements cause constipation or nausea, and often aren’t absorbed efficiently. But there are a lot of choices for oral iron! If you are pregnancy planning be sure to use a prenatal vitamin. BioTE Iron+ offers a gentler, more effective way to correct mild to moderate deficiency or maintain optimal iron levels for active individuals. if your tummy is upset with oral iron, try taking on alternate days.
For more severe deficiency, or when oral iron isn’t effective or tolerated, we use intravenous iron, typically Venofer (iron sucrose). IV iron is particularly helpful for:
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Severe fatigue, brain fog, restless legs or anemia
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Malabsorption (e.g., post-bariatric surgery, IBD) poor gut microbiome
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Urgent repletion needs (e.g., preoperative correction, ongoing heavy menstrual bleeding)
Be Mindful: Situations That Increase Iron Need
Even without obvious symptoms, your body may require more iron under certain conditions:
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Hot yoga, high-heat exercise, and endurance training (sweat increases trace mineral losses, including iron)
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Menstruation, especially with heavy flow or uterine abnormalities like fibroids or polyps
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Frequent blood donation
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Pregnancy, postpartum recovery, or breastfeeding
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High-altitude living or training
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Post-surgical recovery, particularly orthopedic or GI procedures
What to Test: Go Beyond the CBC
Iron deficiency can exist without anemia. A basic CBC (complete blood count) might appear normal, even when storage and transport markers are suboptimal. For a full picture, we recommend testing:
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CBC – To assess hemoglobin, hematocrit, MCV (mean cell volume)
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Ferritin – Reflects stored iron (low = deficiency, high = inflammation)
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TIBC (Total Iron Binding Capacity) – Measures your body’s capacity to bind iron
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TSAT (Transferrin Saturation) – Indicates how much iron is available for use
Takeaway
Iron is essential, but balance is key. Too little leads to fatigue, impaired cognition, and exercise intolerance. Too much may promote inflammation or oxidative stress. Whether you’re training hard, recovering from illness, or simply not feeling your best, checking and correcting iron the right way can make a world of difference.
Ask us if testing your iron profile—including ferritin, TIBC, and TSAT—might help explain lingering symptoms. And if you need support, we can guide you toward the right oral or IV treatment plan.
