Ep. 100: Why Constipation Is Blocking Your Iron (And You Don’t Even Know It)

If you’re constipated… and your ferritin won’t improve… this episode is for you.

Constipation isn’t just uncomfortable, it's often a sign that your digestive system, minerals, and stress response are all under strain, and when that happens, iron can be one of the first things to stall.

In this episode, I connect the dots between:

• Constipation
• Fatigue
• Low ferritin
• Slow stomach acid
• Mineral depletion
• Sluggish bile flow
• Stress (both internal and external)

Because ferritin doesn’t improve just because you take iron.

Ferritin improves when the whole system improves.

If iron has made you feel worse…
If your ferritin only improves while supplementing…
If you’re bloated, sluggish, and exhausted despite “normal labs”…

This conversation will make things click.

In This Episode, We Cover:

• Why low stomach acid affects both iron and B12
• How slow motility disrupts iron recycling
• Why constipation isn’t a side effect, it’s a signal
• The connection between bile flow, SIBO, and iron storage
• How mineral depletion makes iron harder to tolerate
• Why stress shifts your body out of storage mode

🎁 Giveaway Announcement

To celebrate this being the 100th episode and our upcoming live training, I’m doing a giveaway!

One listener will win a free Lume Box! This is my favorite red light therapy device I use every day! 

Here’s how to enter:

1️⃣ Listen to this episode
2️⃣ Leave a rating and review 
3️⃣ Screenshot your review and email it to happygut@drheatherfinley.co with [100th giveaway] as the subject line

--> Bonus entries for sharing the podcast and tagging @drheatherfinley on Instagram 

The winner will be announced on next weeks podcast! 

Find the real root causes of your GI symptoms with our free, 2 minute Quiz! 

Take the quiz here!

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Transcript

Dr. Heather Finley 0:42

Welcome to the Love Your Gut Podcast. I'm your host, Dr. Heather Finley, registered dietitian and gut health specialist. I understand the frustration of dealing with GI issues because I've been there and I spent over two decades searching for answers for my own gut issues of constipation, bloating, and stomach pain. I've dedicated my life to understanding and solving my own gut issues. And now I'm here to guide you. On this podcast, I'll help you identify the true root causes of your discomfort. So you can finally ditch your symptoms for good. My goal is to empower you with the knowledge and tools you need so that you can love your gut and it will love you right back. So if you're ready to learn a lot, gain a deeper understanding of your gut and find lasting relief. You are in the right place. Welcome to the love your gut podcast.

1:34

Okay, today is a big day because I am recording the hundredth episode of the Love Regret Podcast, and I am just so grateful. So I wanted to take the opportunity. First to just thank you for being a follower of this show, and thanks for listening in whether you've been here from the beginning or whether you are a new subscriber. I am so grateful to spend any amount of time in your AirPods. On a walk or commuting or whatever you're doing when you're listening to these episodes. I have loved the podcast. I love long form content and it's just been so fun for me to be able to record these episodes and share it with you, and I know it's helped so many of you. I often hear. From so many of you on social media listening to episodes and finding them helpful. So in celebration of the hundredth episode, what I'm going to do is a huge giveaway. I'm going to give away a loom box. If you don't know what a loom box is, it is an infrared light box. It is amazing. There's research behind it. It is so good for just overall health, mitochondrial health, energy, thyroid. The lists are. Unless I use mine every day, my kids love it, my husband loves it. This thing like has to be charged at all times because we love it so much. So this felt like the perfect giveaway. All you need to do is leave a rating and review, and if you've already left one, you can just screenshot the one that you left and you're gonna. Send it to our inbox. Happy gut@drheatherfinley.co. And just in the subject line, put hundredth episode giveaway and you'll get an extra entry if you post on social media about the podcast. Maybe tag your favorite episode and tag me and I will pick a winner before next week's episode and announce it on next week's episode. So February 18th, 19th. So you have a week to. Leave a review and email it to us to be entered into the giveaway. So can't wait to see who wins and share a loom box with one of you. So now to the episode. Okay. If you are constipated and you also have fatigue. Or iron issues, or you've had low ferritin, low B12, or any walkie energy related lab markers. This episode might connect some of the dots for you because most people are told, if your ferritin is low, take iron. If it stays low, take more iron, and you might get constipated. But here's what almost no one talks about. What if constipation is the real reason that you're ironed? Isn't working, not just because constipation is annoying because it is, but because constipation signals to me that your whole system is moving too slowly and there's something else going on. And iron is just one of those first things that can stall when that happens. So today I wanna walk you through five simple layers that explain why this happens. We're not gonna get super complicated and sciency. But just go into how the body works, and if this starts to click for you, I want you to hold that thought until the end. So let's start at the very top of digestion with your stomach. It's not the the first step, but one of the first steps, I want you to think of your stomach, like a blender. When you put food into a blender, you expect it to break things down. I had a smoothie for breakfast this morning. It was. All blended up, right? But if you drink a smoothie and it had tiny chunks of pieces of food, that would not be very appetizing, right? So we expect this blender to break things down into tiny, usable pieces. Now, imagine you throw carrots, spinach, ice protein powder into the blender, which that would not be a very good smoothie, by the way, but that's just what came to mind. But maybe you barely turn it on, or the blades are dull. It kind of chops things up a little bit. And mostly there's just big chunks floating around. That is what low stomach acid is like, and your stomach is supposed to be as strong and acidic as battery acid almost, and that acid doesn't just. Sit there, it breaks food down into small pieces so your body can actually use it. Iron especially needs a strong acid bath is what we'll call it, and it has to be changed into a form that your body can absorb. So if stomach acid is low, iron doesn't get prepared properly. It's like trying to absorb a whole carrot instead of carrot juice. It just sits there half processed. And that is one of the biggest things that a lot of our clients struggle with, whether they have. Low iron or not, but if they have GI issues, and then when iron is sitting there, maybe from. Your supplements or from food it can make you nauseous. It can make you feel heavy. It can make your stomach hurt. It's not that the iron is bad, it's just not broken down completely. And so here's another thing that people don't think about is that stomach acid is not just for breaking down food, it's also for protection. You can think of stomach acid like a security guard at the front door. When your acid is strong, it kills off unwanted bacteria and parasites before they get comfortable. And when acid is weak, those things can sneak through. And this is why low stomach acid is often connected to things like h pylori, which is the most common infection in the world, parasites, other gut imbalances. This is not random. This is the front door security system not working very well. And that creates another problem because once organisms move in, they create irritation and irritation slows digestion even more. And that just becomes a cycle. Uh, there's a connection people rarely hear about, which is B12, B12, and iron often gets separated into different conversations, but in the body they can be deeply connected. B12 needs healthy stomach acid to be released from food when you eat animal or meat. Products, B12 is tightly attached to those proteins. And strong stomach acid is what breaks that bond. So B12 can be absorbed later in the small intestine. So if stomach acid is low, B12 doesn't get fully released and it just passes through. And you know what low B12 feels like? Fatigue, brain fog, low energy, sometimes tingling, mood changes. That sounds familiar, right? That's where it can get confusing because low ferritin or iron issues can also cause all of those symptoms. So I. If you feel exhausted or when one of our clients feels exhausted, we can't just assume it's just iron. It could be the whole digestive process. If stomach acid is low, you could have both low B12 and poor iron absorption happening at the same time, and that can look like that feeling of, I feel tired all the time. I can't think clearly, my workouts feel harder. I don't feel like myself. So let's just bring this back to iron. Low stomach acid doesn't just affect B12. Like I said, the interesting part is when I see low ferritin and low B12 together, you have to stop thinking about a simple deficiency and start thinking about the whole of absorption process. This is where lab work can be very helpful. Iron and B12 are absorbed in different parts of the small intestine. Iron is primarily in the upper portion. B12 is further down, but both require strong stomach acid and a healthy intestinal lining to be absorbed properly. So when they're low, it often points towards a bigger upstream issue, such as malabsorption or chronic inflammation, maybe celiac disease, h pylori, gastritis. PPI use or some form of small intestinal damage. So it's not just about iron intake, it's about how the iron and B12, et cetera, are being digested and absorbed. So to make it even more confusing, iron and B12. Deficiencies can cause anemia, but they produce different patterns. So iron deficiency typically leads to smaller red blood cells while B12 deficiency leads to larger ones. And so when those are low. Labs can look mixed or unclear, which is one of the reasons that these patterns sometimes are missed in practice because it affects everything that comes after it. If the stomach doesn't break food down well, the small intestine has to work harder. Food lingers longer. Digestion feels heavy, you maybe feel full more quickly. You may burp more. You may feel like food just sits there. And when food is lingering, movement slows. And that's where really the second piece comes in, which is motility. When movement slows, constipation becomes more likely. And when constipation sets in, iron handling becomes even more difficult. So iron struggles at the very beginning, not just because it's missing be, but because it never got broken down properly. You can think of it like an assembly line. Unassembled parts are going down this assembly line. The rest of the system is doing a good job, but it's working with incorrect parts. And iron is just one of those first nutrients to stall in that environment because. Of the need for that strong stomach acid and movement and coordination of the gut. So when somebody tells me that they're constipated and maybe they have iron issues, we don't really wanna just ask how much iron they're taking. We wanna first look at how strong is the blender, because if the blender a K, a stomach acid is doing its job. Adding in more ingredients or if the blender, sorry. If the blender is not doing its job, adding in more ingredients is not gonna fix that smoothie, right? It's still gonna be chunky. Sorry for the weird analogy. So let's talk about that second piece, which is slow motility and the movement of the gut muscles, the movement through the GI tract. I want you to picture like your kitchen trash can, right? So you went and dumped that smoothie out in the trash can. And if you take the trash out every single day, it never is a big deal. There's no smell, no overflow, no problem. But imagine if you stop taking out the trash day one. Not that bad. Day two, maybe it starts to smell. And day three, it's overflowing. So you're pushing it down, right? We all do this, like to avoid taking it out to make room, and that is what slow motility of the gut is. Like things move through at a healthy pace and waste leaves the body. It's quiet, it's normal. You don't think about it. But when movement slows down, waste will sit there. And when waste sits, bacteria will ferment. That can create gas. Gas creates bloating. Bloating creates pressure, and pressure slows things down even more. And so it becomes that loop. So one thing that I wanna connect for you here related to iron is your body wants to recycle iron. It doesn't wanna constantly pull. It in for more food or supplements. Your body is efficient. It reuses what it already has, but that recycling requires turnover. Like your laundry, right? If the washing machine is full of dirty clothes, but you never take'em out. You can't wash anything new. Even if you keep adding a detergent, it's not gonna get clean. So if nothing is moving out of your system, that recycling process is going to slow down. And now iron is harder to reuse, harder to store, which is the goal of ferritin, right? Ferritin is the stored form of iron and. It's more likely to sit in the gut and cause side effects. So this is why constipation is not just uncomfortable. It actually changes the way that things behave in the body. So when movement slows, iron is not just struggling to get in, it struggles to be used, and that's a completely different problem than, oh, you just need to take iron. Right? So let's actually zoom out a little bit more and talk about the third layer here. And this is a layer that you've heard me talk about on so many podcasts, and that is minerals. Your body runs on minerals, not in a trendy way, not in a, like you need a mega dose, all these random things way, but in a foundational electricity, muscle moving energy way, you. Have probably heard me talk about minerals as a symphony in your body. Minerals don't work alone. They work together. So one mineral that I wanna point out here is potassium. Potassium helps with muscle signaling. It's like the electrical current. In your body that tells muscles when to contract, we often associate potassium and bananas, right with muscle cramps. That's exactly what's happening. Magnesium helps to relax muscles, so movement can actually happen. Sodium helps to maintain fluid balance and supports nerve signaling, and all of them together help your digestive system to move and fire and coordinate. So how does this, why does this matter? Because your colon is a muscle. So if minerals are off, or especially if potassium is low, those signals are gonna be weak. If magnesium is low, your muscles will tighten. If sodium is low, that nerve communication gets sluggish, and if those signals are off, the colon is not going to contract properly. So that movement slows down, constipation sets in, and it doesn't really stop there because minerals. Also help your body to make stomach acid. So going up to that first layer that I talked about, they also help produce digestive enzymes, hormones, bile flow, they regulate your nervous system. So we have this chain reaction, low minerals, low stomach acid, poor breakdown of iron, slow motility, constipation, poor recycling, poor iron storage. And that's where people get stuck is because we're just focused on. Iron, but iron is not the conductor of this mineral orchestra. It's just one instrument, and if that orchestra is out of tune, adding a louder violin does not fix the music. Right. And this is why adding more iron doesn't fix low ferritin. In fact, often mineral depletion overall makes iron harder to tolerate, which is why maybe your constipation gets worse or you get cramping side effects increase because the foundation isn't there. So something important is mineral status is not. Always obvious on standard blood work, your blood is very tightly regulated. It will keep things looking normal for survival, but that doesn't always reflect deeper patterns. So one of the tools that we use clinically to assess mineral patterns is HTMA testing. Now, this would not diagnose anemia or low iron or low ferritin. But it does, and not just what's circulating in the blood at one moment. So I'm gonna go deep into that on my webinar on Sunday, but what I want you to know is that if iron hasn't worked for you. That mineral layer deserves attention because ferritin improves when your whole system improves and when your whole symphony improves, and minerals are a big piece of that. Now let's talk about layer number four, which is bile and liver load. So your liver makes bile. Bile has two big jobs. The first job is that it helps break down fats so that you can absorb nutrients, things like vitamin A, which is really important. Four iron recycling vitamin D as well. How many of you have low vitamin D? And then second, it helps to move things through your digestive track. Bile is like the dish soap, the washing machine detergent. It's when you wash a greasy pan with just water. The grease does not come off right. The grease just smears around. When you add soap, everything slides off and comes clean, and that's exactly what bile does in your body. It keeps things clean, it keeps stool from getting hard. It ke keeps things slippery. It helps waste to move out. And so here's the interesting thing that I wanna connect for you, is if bile flow is slow and your stool becomes drier, that movement is gonna slow as well. So that can be connected with slow motility and constipation. And remember constipation effects, iron handling. So let's talk just about the gallbladder for a second. Your gallbladder. Stores and, and bile releases. A, a very strong surge of bile after you eat, if you don't have a gallbladder, bile still gets made, but it just drips out slowly instead of being released in a strong pulse. So this means that bile flow matters. Whether you have a gallbladder or not, but it matters even more if you don't. And without that strong release, fat digestion can be weaker. This is where people get like intolerance to fatty meals or low vitamin D or burping bloating. Sticky stool, et cetera. So without that strong release, fat digestion, worsens and stool can be more inconsistent. And over time, that gut motility can be slower. And then if you layer in something like SIBO or small intestinal bacterial overgrowth. Bile isn't just for digesting fats, it's also keeping your bacteria in check. Remember, it's the dishwashing detergent. It has natural antimicrobial properties, so it's going to prevent bacteria from overgrowing in the small intestine. So if your bile flow is sluggish. Bacteria will have an easier time sticking around. And chronic SIBO is often tied to poor bile flow and slow motility. So here's the chain reaction that we're looking at. Sluggish bile flow, slow movement of the gut, bacterial overgrowth in the gut, inflammation, and then more sluggish bile, and it becomes a loop. So you can see where all these loops in the body really make an impact. Inflammation. Is one of the biggest signals that tells the body, do not prioritize iron storage, because when inflammation is present, the body is going to shift into defense mode and it becomes protective With iron, it hides it, it locks it down. If we zoom back to the liver, the liver is like the warehouse manager. It's gonna balance hormones, blood sugar, detox. Stress signals, inflammation, bile production, iron storage. And so if that warehouse is organized and things are moving out regularly, it can accept new inventory. But if that warehouse is backed up, if elimination is slow, inflammation is high. It's not going to storm or iron, and ferritin is your iron storage. So storage only happens when the system is organized and supported. And bile flow is not clearly just about digestion. It balances bacteria, it supports inflammation, or it helps reduce inflammation. And it helps as part of that iron storage process. So then related to constipation, you can think of that digestive tract, like a river, like I was saying. Bile helps keep things moving, keeps things slippery. When that river is flowing, everything is moving downstream. The water is clear, debris is not building up, and when that river slows, it becomes muddy. Sticky leaves start piling up. It doesn't settle proper properly, it gets caught in the mud, and that is what happens with iron. In a sluggish system, ferritin will rise when the river is flowing, not when things are stagnant and stuck and building up. Now let's zoom out one more layer to the nervous system layer number five, because you can do everything right with food and supplements and still feel stuck. And this is usually where stress enters the picture, not just emotional stress. Not just work stress, not just mom life stress. I'm talking about internal stress and external stress. External stress is what most of us think about first, right? Deadlines, kids waking up at night arguments, finances over training, et cetera. But internal stress matters just as much. So this is chronic inflammation, gut infections, blood sugar swings, mineral depletion, hormone shifts, postpartum, low thyroid function. Your body doesn't separate those things. Stress is stress. And when your brain senses. Whether it's from your inbox or from your insides your nervous system shifts into survival mode. And survival mode is not where you digest the best. So when the body thinks it needs to flight or flee, it's not going to prioritize that storage of iron. Stomach acid decreases bile flow decreases, motility slows, nutrient absorption drops. Everything that supports ferritin like we've just talked about, starts to quiet down because your body is trying to conserve energy. So the key here is that. Storage is not a survival priority. Ferritin is iron storage. And so storage happens when the body feels safe and resourced, not when it feels threatened. We can layer in the thyroid here. The thyroid is your metabolic speed dial, right? When the thyroid function slows, everything slows down as well. Digestion, motility, et cetera. We need iron for healthy thyroid function. If iron is low, thyroid function can struggle, and if thyroid function struggles, motility slows as well. So you can really see here, you're probably like, I wish I had a visual or a chart of this, which if you did, if you do, I will show you some on Sunday. But. All of this is connected, right? Stress, the nervous system, thyroid, how you're breaking down food. They all impact each other. So this is why someone can say, I'm constipated, exhausted, I'm taking iron. Nothing's working. But your system could be stuck in protection mode. And protection mode does not store. It's going to conserve. And until that stress load, both internal and external is addressed. Iron is. Trying to push against a locked door it cannot store it. So if you're constipated, your ferritin won't improve. This is why it's not just a fiber issue, and it's also not just an iron issue either. Much like maybe you've heard, constipation is a visible sign that your whole system is under functioning and that we need to address things like stomach acid, slow movement, mineral depletion, sluggish bile, nervous system stress. Iron will stall in that environment. And ferritin will improve when that system improves, not when you force it. I have a client example. Many client examples, but one in particular, she came to us with a ferritin of 14. She had been taking iron for a year and it was still 14. Every time she's. Adopt it. Her ferritin would drop again, and every time she took it, her constipation would get worse. So it was kind of a catch 22. She tried more fiber, more water, magnesium, you know, all the things, everything. And she was still only having one bowel movement every three to four days. She was bloated after meals, felt heavy after meals dragging in the afternoon. And when we zoomed out. What we could see here was her digestion was weak, her stomach acid was low, her minerals were depleted. Her stress load was really high internal and external. She had a lot of gut infections going on. She had a lot of work stress. The inflammation levels on her GI map tests were really high. So pulling her off the iron and restoring function to stomach acid, minerals, movement, bile flow, et cetera. All of a sudden she starts having bowel movements every day. Bloating decreases her energy started. Improving first minerals will do that. You can start to see improvement in energy so quick before you're gonna see ferritin jump on lab work. And then without increasing her iron dose, her ferritin slowly started rising, not because she was taking iron. But because the system finally had that capacity to store it. So that is the shift when the system works, iron will work. When the system is stuck, iron is going to stall. And that is why constipation is such an important clue. It's the signal. It's not random. And neither is your, neither are your other symptoms. Your fatigue, your low ferritin, they're all connected. So if this episode is clicking for you and you're realizing, oh wow, maybe all my symptoms are connected, they might all be part of the same story. That is clarity. Once you see that connection, you can start seeing that there's a better path forward. So. Just a reminder, I have my training on Sunday. It's called Why Iron Isn't Enough. We're gonna walk through all of this in even more depth, talking about the exact steps that you can take, the testing that could be helpful. The different patterns that we see. How to increase your ferritin without taking iron and what to do about it. So link is in the show notes. Would love to see you there, and if not, I'll see you next week on the next episode. Thanks for joining.