The Iron Clinic

08/01/2026

what tablets do I take?
The main ingredient for an iron tablet is Iron sulphate / gluconate / fumarate / bisglycinate. These are termed 'iron salts' and there is no real difference between them. These ingredients are the basis of most iron tablets or liquids - the rest is marketing.

What dose?
The important bit: - its all about the amount of 'elemental iron' i.e. the dose:
If a 200mg tablet, you need to read the ingredients on the back to see the actual 'dose' of 'elemental iron it may be the dose is 65mg. The table here is very helpful.
Note there is a LOT of marketing but in reality little if any difference in the tablets, those promoting 'haem' iron professes better absorption but in reality when tested in clinical trials no benefit has been shown. So go with the well proven tablets - below.

WHAT DO YOU NEED
If your ferritin < 30 then you are 1000mg behind on iron in the body.
Treatment is 50-100mg elemental iron once a day. Most people tolerate this dose and one tablet a day is enough. The problem is that you only absorb about 10% of the dose so about 6-10mg per day - about 200mg -250mg per month. So you need a minimum of 6 months to get replenished (1000mg +)

If you do get side effects then stop for a few days then try half the dose or a tablet alternative days. Overall, while there may more absorbed per day as you are only taking half the dose the absorption per month is 150-200mg.

Struggling to find which iron tablets to choose? Checkout the information from Lifeblood Australia

06/01/2026

IRON and DIET
If iron deficient (Ferritin < 30) then you are 1000mg of iron behind
Diet alone will not suffice as normal absorption of iron is LOW.

One 325-mg ferrous sulfate tablet ≈ 13 mg absorbed iron
=🥩 3.3 lb steak = 🥬 18 lb spinach

Here 1Kg of spinach and there is more iron in Prof's left hand :-( !
( like or not those are the facts)
(Steak assumes ~25% heme absorption; spinach ~5% non-heme)

You cannot eat your way out of and do need treatment dose Oral iron tablets 200-300mg once a day (works out to about 200-240mg absorbed per month so you need 4-6 months treatment)

Food is important, but for iron deficiency, tablets are doing a very different job

04/01/2026

is common in pregnancy and about half of women become anaemic. A normal pregnancy requires about 1000mg of iron for normal baby growth (500mg in the last month when the baby doubles in size). This is a lot of iron and can use a mothers entire reserve stores of iron (held in Ferritin).

A Ferritin below 30 is iron deficiency and can lead to symptoms and anaemia.
Often mothers are advised to take oral iron - but is this enough?? - perhaps not!

A large clinical trial has shown IV iron infusion is better that iron tablets for both mother and baby - more details below: -

In this large clinical trial they compared IV iron infusions with oral iron for women with , not anaemic, at second trimester (11-20 weeks pregnant).
Intravenous iron for non-anaemic iron deficiency in pregnancy: a multicentre, two-arm, randomised controlled trial: The Lancet Haematology; Volume 13, Issue 1e22-e29 January 2026. DOI: 10.1016/S2352-3026(25)00315-1

600 mothers, average 26 years old (23-30) about 65kg (10) with Hb 11·8 (0·6) and Ferritin 14·8 (6·8) received either ORAL iron or IV IRON (1000mg)
Most mothers on ORAL iron had anaemia at delivery - few with IV iron - (Picture)

Haemoglobin at delivery 11·6 (0·5) 10·8 (0·7) 0·74 (0·64– 0·85)

04/01/2026

IRON DEFICIENCY IN PREGNANCY

Visit the post for more.

03/01/2026

Hugely important trial showing how IV iron is far superior to oral iron for pregnant women with (without anaemia) IF you have Ferritin < 15 in pregnancy 3/4women will be anaemic at delivery and the baby is more likely to be low birth weight. Those having IV iron were far less likely to get anaemia and the babies were better.

Among non-anaemic iron deficient pregnant women, intravenous iron therapy significantly improved maternal haemoglobin before delivery, compared with oral iron prophylaxis. Ferritin screening should be considered in early pregnancy, as intravenous iron therapy is effective in those tested positive fo...

31/12/2025

Here's hoping for an Iron rich year ahead - Iron is the core building block for Haemoglobin (the red stuff in your blood) to carry oxygen around the body. Iron is also vital to make energy in the muscles and heart - The enzymes of aerobic metabolism all contain iron.

Being iron Deficient will reduce your energy and cause a range of symptoms.

Hoping everyone gets treated in 2026

24/12/2025

This review on by my good friend Tom DeLoughery with whom we wrote the recent US guidelines - was a top 10 article in the Journal of The American Medical Association .
Through 2026 we will be launching a series of educational posts summarising these works and providing the correct evidence and guidance for people with

htps://jamanetwork.com/journals/jama/article-abstract/2832131

This narrative review examines the screening, diagnosis, and treatment of adults with absolute iron deficiency without anemia and iron-deficiency anemia.

12/12/2025

bbc.co.uk/news/articles/cx2peeljp1po

Iron deficiency is a relatively common problem, especially in women. Here's how to spot the symptoms.

30/11/2025

and
Symptoms of are 3 more common in women at risk of
The symptoms of : brain fog, forgetfulness, difficulty to think clearly, failure to process, inability to cope, social anxiety etc. are similar to ADHD.

Iron is a key component in cellular function and important for neurotransmitter synthesis i.e. to make Dopamine and Serotonin. These are responsible for well being and brain function. Low iron reduces the ability of brain cells to talk to one another so confusions, fogginess, forgetful and anxiety etc.

Prof Richards's team screened 600 university students for iron deficiency -those at risk were 3x more likely to score positive for ADHD. suggesting that symptoms of ADHD may well be related to The Iron Clinic every week we see women told they have ADHD and the symptoms resolve following an iron infusion.

what is your story?

26/11/2025

Today we start the change: - https://www.shinefoundation.org.uk/ We have donated £10,000 for initial set up and funding and all the work / time / etc pro bono.

Iron deficiency is one of the most common – and most overlooked – health issues affecting women and girls. It causes exhaustion, brain fog, low mood, poor concentration, and frequent illness. But it is preventable, treatable, and often missed.

26/11/2025

Supporting the Launch of the SHINE Foundation for Women’s Health

Iron is an essential nutrient that carries oxygen and makes energy for the body. Iron is an important part of haemoglobin (Hb), the red pigment which gives blood its colour. Haemoglobin is the substance that carries oxygen around your body. Iron is also a key component of enzymes that manufacture energy in every cell in your body this is particularly important for: …...

Iron is an essential nutrient that carries oxygen and makes energy for the body. Iron is an important part of haemoglobin (Hb), the red pigment which gives blood its colour. Haemoglobin is the sub…

25/11/2025

SHINE FOUNDATION for
Iron Deficiency is very common affecting 20-50% of women.
Iron is stored in Ferritin and Ferritin is the best marker of iron stores: -
> Ferritin above 50 is normal
> Ferritin less than 30 is iron deficiency
> Ferritin less than 15 is empty!
Note - Lab reference ranges are not for diagnosing - they just calibrate the machines! (mean and 2 s.d.).

Iron Deficiency causes symptoms that can be disabling impacting mental and physical health, a common cause of disability in women (similar to diabetes!)

WHY?? - because iron is vital for aerobic metabolism that makes energy for your cells. Iron is the core component of the enzymes and proteins in the nuclear power house of your cell - the mitochondria.

If you steel IRON out of your muscles, you feel fatigued and tired, whilst you can walk comfortably on the flat, if you walk up two flights of stairs, you suddenly feel short of breath, air hunger' feel dizzy can develop chest pain or palpitations.

if you steel IRON out of the brain, you can't make neurotransmitters (the chemicals that enable your brain cells to talk to one another) and women describe a brain fog of forgetfulness, an inability to think clearly, failure to cope and often misdiagnosed as ADHD or anxiety or depression (this is real!)

Severe symptoms of iron deficiency include pica, commonly eating ice, restless leg syndrome, or itchy skin.

Yet there is no charity, no central place to get good advice, no recognised source for information, nowhere for women to get help advice and direction!

We will soon be transitioning to the SHINE foundation, a Charity headed by Prof Toby Richards to raise awareness for women about heavy menstrual bleeding and iron deficiency. To offer the correct medical advice to empower women to get the correct information in order to get the correct treatment and to stop the suffering of many. Please watch this space over the next few weeks.