Oh, the many things we’ve gotten wrong about health. And iron is a big one! So many people don’t realize that what appears to be “iron deficiency” is actually iron dysfunction.

Your ability to utilize oxygen properly in your body and make energy in your cells is the ultimate predictor of health. That’s why it’s so important to understand how iron and oxygen interact in the body.

When we talk about anemia, what that means is the body has a low amount of healthy red blood cells to carry oxygen through the body. Yes, that is a big problem. BUT, instead of asking WHY red blood cells are low or WHY serum iron is low, we just usher in iron supplements.

It’s really hard to be truly “iron deficient”

Iron has been heavily added to our food system for 70+ years, it’s in tap water, pharmaceuticals, birth control, and cosmetics. HOW could we be truly deficient?

Many people are consuming massive quantities of iron every day, yet still have low RBC and low serum iron. It doesn’t add up! (unless, of course, you are literally bleeding out).

Morley Robbins equates using iron to try to stimulate red blood cells as the equivalent of “using cocaine to stay awake and alcohol to stay asleep.” On the surface, it gets the job done, but also while causing serious damage to your health and body and doesn’t address any underlying issues.

Iron is the metal that ages us. It reacts with oxygen to create rust (without the presence of copper). It triggers magnesium loss that leads to chronic inflammation. Iron is at the root of chronic illness.

There is a difference between iron deficiency and iron dysregulation. There is also a difference between iron in the blood and iron in the tissue. We are actually struggling with iron overload in the tissues.

What is iron overload?

Iron overload is an excess of iron that accumulates in the tissues, liver, endocrine glands, joints, and other organs.

This can manifest as hormone imbalances, PCOS, arthritis, diabetes, hypothyroidism, infertility, chronic infection, bacterial/yeast overgrowth, depression and many other chronic illnesses.

Excessive amounts of iron, combined with lack of bioavailable copper and retinol are the biggest contributing factors to iron overload. Iron overload is one of the biggest contributing factors to inflammation and chronic illness.

unbound iron leads to oxidative stress and inflammation

How does iron get unbound?

Due to nutrient deficiencies and modern living, we are not able to metabolize or process iron the way we were designed. When iron can’t maintain homeostasis, it results in chronic unbound iron that reacts badly with oxygen (oxidation!).

So how does iron get unbound? There are many factors at play, but some of the biggest contributors are:


  • Fortified foods (grains, wheat, bread, cereals)
  • Birth control
  • Tap water
  • Pharmaceuticals
  • Prenatal and multivitamins
  • Baby formula
  • Even makeup and cosmetics!


  • Bioavailable copper
  • Retinol (preformed vitamin A from animal foods)
  • Ceruloplasmin (copper-activated protein)

Unbound iron = chronic inflammation

“When you introduce too much iron into the mitochondria, medical literature wants you to think it’s very tightly regulated. It simply is not, certainly NOT in the modern era of low bioavailable copper and high iron fortification. ATP production can vary by at least 40% and as much as 96% if there’s too much iron in the cell and/or in the mitochondria. This “stuck” iron is the metabolic stimulus for inflammation.”

“[Cu]re: Your Fatigue” by Morley Robbins

The Iron Recycling System (RES)

Your body has an iron recycling system, the reticuloendothelial system (RES) that can recycle about 24 mg of iron per day, when working properly. We only need about 1 mg of iron per day and we can easily get that from foods like grass-fed meat and liver.

Without sufficient amounts of bioavailable copper and pre-formed vitamin A (retinol), the RES doesn’t function properly and iron gets stuck in the tissues, where it doesn’t belong. Iron stored in the tissues will not show up in a blood test.

iron gets unbound from too much iron and not enough bioavailable copper and retinol

Iron low on a blood test?

If you only look at a nutrient in isolation and ignore its antagonists and agonists, that’s reductionist thinking. Testing iron or ferritin alone does not give the full picture of iron status.

On a blood test, it’s important to also look at the markers below to fully understand how iron is stored and working in the body.

  • Ceruloplasmin
  • Copper
  • Ferritin
  • Hemoglobin (Hgb)
  • Iron
  • TIBC
  • Magnesium, RBC
  • 25-Hydroxy Vitamin D
  • Transferrin
  • Vitamin A (Retinol)
  • Zinc

An HTMA also provides useful insight into what iron and other minerals are doing in the body, as well as indicators of stress, thyroid, and adrenal function.

What about ferritin?

Ferritin is often seen as a great marker for iron status in the body. However, there are several reasons why that’s not an accurate way of thinking. Ferritin is a storage protein made inside the cell. It is responsible for storing iron. It is an INTRA-cellular storage protein, meaning it stores iron IN the cell.

As iron researcher, Morley Robbins, puts it, ferritin in the blood is an “empty shotgun shell” once it’s in the blood, it’s no longer holding the iron.

What serum ferritin really means

High ferritin in the blood means iron has been dumped in your cells, where it shouldn’t be, and where it can cause all kinds of oxidation and damage. This is why high serum ferritin is linked to chronic illness because high ferritin equals inflammation.

Ferritin belongs in the cell, not the blood. Serum ferritin should be low.

Blood is a transport medium. Blood tests are not the end-all-be-all. They are a tool, but only show part of the picture. Blood has to maintain a very specific pH and in order to do so, moves minerals in and out of the blood. Blood work doesn’t show us what is happening at the cellular level and how the body is using iron and other minerals.

“A ferritin level is not a sign of iron vitality. It is a sign of tissue pathophysiology. The only time ferritin shows up in the serum is when organ cells are breaking down. By the time that ferritin protein shows up in the blood, the iron inside it is likely already released. Note: each molecule of ferritin can hold 4,500 atoms of iron. The ferritin showing up in the blood is most likely the protein, without the iron.”

-Sir Douglas B. Kell, PhDde

There are three types of ferritin:

What many people don’t realize is there are actually three different types of ferritin and that really matters.

  1. Heavy chain ferritin: Requires ferroxidase enzyme (dependent on bioavailable copper) in order for iron to load into it.
  2. Light chain ferritin: Operates independently of ferroxidase. Increases in times of inflammation.
  3. Serum ferritin: Empty of iron, as the iron has been discharged into the cell before it enters the blood.

When inflammation is present, light chain ferritin becomes more prominent and dumps iron inside the cell and then the empty ferritin protein is excreted into the blood.

This process disrupts the RES (iron recycling system).

Too much iron and lack of bioavailable copper leads to inflammation

As we age, we lose copper and iron accumulates. Iron is the mineral of aging while copper is key to harnessing oxygen and iron. Without copper, iron cannot be mobilized from the tissues into the blood. Iron in the tissues reacts with oxygen, creating oxidation and inflammation.

When the body is inflamed due to decreased energy production, it releases pro-inflammatory cytokines. Inflammation drives up iron storage and that will result in lower iron values on blood tests.

What this really comes down to is the inability for iron to move from the tissues, into the blood, due to lack of ferroxidase activity at the ferroportin doorway. Ferroxidase is dependent on bioavailable copper.

iron deficiency vs iron dysfunction

What to do about iron overload?

Iron metabolism is a complex subject and this post is only beginning to scratch the surface. Morley Robbins is an expert on ironology so I encourage you to explore his research if you’re interested in learning more.

Thankfully, there are solutions:

  • Get more bioavailable copper
    • 🍊 Copper sources: beef liver, citrus fruits, bee pollen, shellfish, oysters
  • Get more retinol:
    • 🧈 Retinol sources: egg yolk, beef liver, raw dairy, butter, cod liver oil
  • Add in a daily adrenal cocktail or two.
  • Add mineral drops to your water.
  • Make sure you’re getting enough of the right magnesium (and that it’s in balance with potassium and sodium)

With all protocols, the stops are just as important as the starts. If it’s listed as a “stop” it means it interferes with your body’s ability to make ceruloplasmin and interferes with the RES.

You can find a full list of the stops and starts here. I’ll be covering them in more detail in future posts.

I’ll be talking more and more about how to address iron overload in future posts. Without copper keeping the iron recycling system functioning, iron gets stored in the tissues causing all kinds of oxidative stress at the cellular level. I also encourage you to check out Morley Robbins’ research and the Root Cause Protocol (I happen to be a Certified Root Cause Protocol Practitioner).

Important Notes:

I am not a doctor, and I don’t claim to be one. I can’t prevent, treat, cure or diagnose illness or disease. The information presented on this website is not meant to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice, treatment or diagnosis. The purpose of this website is to share knowledge from my research and experience. I encourage you to make your own decisions regarding your health care based on your own research and relationship with your health care professional.

Some of the links on this page are affiliate links, which means I earn a small commission if you purchase through that link, at no additional cost to you. Thank you for supporting my work!

Iron Resources:

Serum ferritin is an important inflammatory disease marker, as it is mainly a leakage product from damaged cells

Expression and loading of recombinant heavy and light chain homopolymers of rat liver ferritin

Studies on the interaction between ferritin and ceruloplasmin

Metabolic crossroads of iron and copper

Modification of ferritin during iron loading

Iron behaving badly: inappropriate iron chelation as a major contributor to the aetiology of vascular and other progressive inflammatory and degenerative diseases

Ferric citrate and ferric EDTA but not ferrous sulfate drive amphiregulin-mediated activation of the MAP kinase ERK in gut epithelial cancer cells

Vitamin A deficiency aggravates iron deficiency by upregulating the expression of iron regulatory protein-2

Iron loading is a prominent feature of activated microglia in Alzheimer’s disease patients

Iron Metabolism in Cancer

Increased levels of transition metals in breast cancer tissue

Iron, Oxidative Stress, and Cancer

Iron Toxicity in Diseases of Aging: Alzheimer’s Disease, Parkinson’s Disease and Atherosclerosis

Iron and neurodegenerative disorders

Regulation of iron acquisition and storage: consequences for iron-linked disorders