Updated June 2026 · Ireland Health Shop · The Honey Pot, Clonmel
Iron is the central atom in haemoglobin — the protein in red blood cells that carries oxygen from the lungs to every tissue in the body. It's also a component of myoglobin (stores oxygen in muscle), cytochromes (essential for mitochondrial energy production), and hundreds of enzymes. Without adequate iron, the body simply cannot function at full capacity.
These are two distinct stages on the same spectrum, and understanding the difference matters:
Ferritin (iron stores in the liver and other tissues) falls, but haemoglobin remains normal. The person may already feel tired, have reduced exercise capacity, and experience cognitive difficulties — but a standard full blood count (FBC) will appear normal. Many GPs overlook this stage because they only check haemoglobin. A ferritin test specifically is needed to detect early iron depletion.
Ferritin is low, and iron transport markers (transferrin saturation, serum iron) are affected, but haemoglobin is still normal or borderline. Symptoms become more noticeable — persistent fatigue, cold hands and feet, difficulty concentrating, reduced immunity.
Ferritin is very low, and haemoglobin has fallen below normal. Red blood cells become small and pale (microcytic hypochromic anaemia). Symptoms are more severe — extreme fatigue, pallor, breathlessness on exertion, palpitations. This is what most people think of as "anaemia."
Ask your GP for a ferritin test specifically, not just a full blood count. Optimal ferritin for women is generally considered to be above 50–70 ng/mL, and above 100 ng/mL for athletes. Many Irish GPs use lower reference ranges (ferritin above 12–20 ng/mL) as "normal," meaning that functionally deficient levels may be reported as acceptable.
Menstruation is the dominant risk factor for iron deficiency in women — monthly blood loss increases iron requirements substantially. Women with heavy periods (menorrhagia) are at particularly high risk. The FSAI recommendation for premenopausal women is 14mg elemental iron per day — nearly double the 8mg recommended for men and postmenopausal women. Many Irish women don't come close to this through diet alone.
Iron requirements nearly double during pregnancy — the growing fetus and placenta need substantial iron, and blood volume expands by 40–50%. The HSE recommends routine ferritin screening in early pregnancy. Iron supplementation is prescribed for pregnant women who are deficient, and many obstetricians recommend low-dose iron maintenance supplementation throughout pregnancy regardless of initial status.
Breast milk is low in iron (though bioavailability is high), and the body stores laid down in pregnancy deplete around 4–6 months after birth. Iron-rich solid foods should be introduced from 6 months. The HSE recommends iron-fortified infant formula for bottle-fed babies and that first solid foods include iron-rich options (meat, fish, legumes, iron-fortified cereals).
Athletes — particularly distance runners — have higher iron requirements due to: increased red blood cell production, iron loss through sweat, mechanical haemolysis (rupture of red blood cells from the impact of foot strikes), and increased GI tract losses. Female athletes are at highest risk. Low ferritin significantly impairs athletic performance even before anaemia develops.
Plant foods contain non-haem iron, which is substantially less bioavailable than haem iron from meat and fish. Absorption of non-haem iron is also inhibited by phytates (in cereals and legumes), tannins (in tea and coffee), and calcium (in dairy). Vegans and vegetarians need to consume approximately 1.8 times the recommended iron intake to achieve the same absorption.
This is the most important practical piece of advice for anyone trying to increase iron intake from plant foods: vitamin C dramatically increases non-haem iron absorption. A single glass of orange juice or a fresh tomato taken with an iron-rich meal can increase absorption by 2–3 fold. Conversely, tea and coffee (tannins), dairy (calcium), and wholegrain cereals (phytates) reduce non-haem iron absorption. The golden rule: have your tea or coffee 1 hour before or after your iron-containing meal, not with it.
Iron supplements come in several forms, with very different tolerability profiles:
The standard prescription form — cheap and effective, but notoriously hard on the gut. Side effects include constipation, dark stools, nausea, stomach pain, and cramping. Many people stop taking iron supplements because of these effects. Take on an empty stomach for maximum absorption, but with food if tolerated issues arise.
Chelated iron bound to glycine — significantly better tolerated than ferrous sulphate with substantially fewer gastrointestinal side effects, while maintaining good absorption. This is the form recommended by most natural health practitioners in Ireland, including Pat Coffey at The Honey Pot. Brands such as Floradix (liquid) and specific bisglycinate capsules are popular and well-evidenced.
Better tolerated than sulphate, intermediate between sulphate and bisglycinate for both efficacy and tolerability.
Products such as Floradix and Spatone (natural iron-rich water from Welsh springs) offer iron in forms that are gentler on the stomach. Particularly popular for women during pregnancy and for children. Lower elemental iron per dose than capsules but absorbed efficiently.
Take iron with vitamin C if possible. Allow 2 hours between iron and any dairy, tea/coffee, or other mineral supplements (particularly zinc and calcium, which compete for absorption). Take iron at a different time from thyroid medications (levothyroxine), antibiotics, and antacids.
Find gentle iron supplements — Floradix, bisglycinate and more — at The Honey Pot, Clonmel
Shop The Honey Pot → 📞 052-612 1457