Fatigue, hair loss, shortness of breath, headaches, poor exercise tolerance, restless legs, brain fog, and feeling cold all the time can sometimes point toward low iron—even when hemoglobin is still “normal.” Iron is essential for oxygen delivery, energy production, thyroid function, immune health, cognition, and healthy hair, skin, and nails. When iron stores are low, the body often lets you know.
Lab testing is important—but it has limitations.
Many people are told their iron is “fine” based on a basic CBC or serum iron level, but iron status is more complex than that. A more complete picture may include markers such as ferritin (iron storage), transferrin saturation, TIBC, hemoglobin, MCV, and sometimes inflammatory markers like CRP, since inflammation can falsely elevate ferritin and mask deficiency. At the same time, lab ranges reflect broad population averages—not always what is optimal for how you feel clinically.
However, simply taking iron isn’t always the answer.
The bigger question is: why is iron low in the first place?
Low iron can be a symptom of an underlying issue such as:
- Heavy menstrual bleeding
- Low stomach acid or poor digestion affecting absorption
- Celiac disease or gut inflammation
- H. pylori infection
- Frequent blood donation
- Pregnancy or increased athletic demands
- Vegetarian/vegan diets without careful iron planning
- Chronic inflammation
- Occult gastrointestinal blood loss
In naturopathic medicine, the goal is not just to correct the number—but to understand the root cause. That may mean supporting digestion, addressing gut health, improving nutrient absorption, reducing inflammation, or investigating hidden blood loss—while using targeted iron supplementation when appropriate.
Iron deserves a deeper look than “normal” or “low.”
The right testing, proper interpretation, and a root-cause approach can make all the difference in restoring energy, resilience, and overall health.
Book an appointment today to get the whole picture.
Dr. Ryan Nakama proudly provides Naturopathic Medicine Services to Lethbridge and Southern Alberta.

