Anemia of Chronic Disease: Is Your Iron Supplement Hurting You?

PREMIUM CONTENT

Anemia of Chronic Disease presents with symptoms similar to Iron Deficiency Anemia:

• Weakness
• Fatigue
• Headaches
• Paleness
• Shortness of breath
• Air hunger

But how can we distinguish the two?

IDA VS ACD

It's important to determine whether you are dealing with Iron Deficiency Anemia or Anemia of Chronic Disease (ACD) before supplementing with iron. Iron is the double-edged sword of the nutrient world. Anemia of Chronic Disease does not require iron; in fact, iron can cause more inflammation in the long run in this case.

This table demonstrates what we would typically (but not always) observe in each scenario. Looking at iron levels alone is unreliable when determining whether you are dealing with IDA or ACD. On another note, high testosterone and dehydration can mask RBC, hemoglobin, and hematocrit levels, making them appear normal or elevated.

How to Determine

• First, consider the markers in the table above.
• Test Soluble Transferrin Receptors and Ferritin.
• Calculate the ratio of soluble transferrin receptor and (log) ferritin.
  • If it is 1.7 or higher, this indicates iron deficiency anemia.
  • If it is lower than 1.7, this indicates anemia of chronic disease.

Exploring the Root Causes of ACD

• Stealth Infections including bacterial, fungal, and parasitic  
• Dormant Infections
• High Toxic Load

Next Steps

If dealing with Anemia of Chronic Disease, consider the root causes listed in this protocol. Consider removing iron from the body and reducing inflammation if you have been supplementing.

If you suspect that you are dealing with Iron Deficiency Anemia, consider testing the following markers to determine if you have an issue with iron recycling before supplementing iron:

• Ceruloplasmin (serum)
• Copper (serum)
• Ferritin
• Hemoglobin (Hgb)
• Iron and Total Iron Binding Capacity (TIBC)
• Magnesium RBC
• QuestAssureD 25-Hydroxyvitamin D (D2, D3), LC/MS/MS
• Transferrin
• Vitamin A
• Zinc

A panel that includes all of these markers: Full Monty Panel