Ep. 114: How Jessica Increased Her Ferritin by 20 Points in 2 Months [Part 3: Iron & Ferritin Series]

This is part 3 of the iron/ferritin series! 

Three episodes, three clients, three different breakdowns in the same system:

Part 1: Ashley's body couldn't absorb iron because of active gut infections and a system in defense mode.

Part 2: Danielle's body couldn't transport iron because of low ceruloplasmin, copper utilization impaired by long-term zinc, and microbial activity driving inflammatory sequestration.

Part 3: Jessica's body couldn't store iron because the terrain was depleted, the nervous system wasn't in a building state, and the downstream conditions for storage weren't in place.

Same symptom. Three completely different root causes and interventions. 

If you've been listening to this series and you see yourself in one or all three, of these cases, and you want to actually understand which step is the issue for you, that is exactly what our May 31st webinar is built to help you figure out. We'll go through all three steps, the testing that shows you where your system is breaking down, and what to actually do about it. Link to register is in the show notes.

And if you're ready to work through this with our team directly, gutTogether is where we do this work together: GI Map, HTMA, Full Monty iron panel, and a plan built around your specific picture. No generic protocols. No "just take more iron." Just the real answer to why your body isn't doing what you've been trying to get it to do. The link is in the show notes.

Thank you for spending this series with me. I don't take it lightly that you trust me with your time and your health. I'll see you next week.

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Transcript

Dr. Heather Finley 0:03

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.

0:55

I wanna start this episode with an email that I received a couple weeks ago. And this was from a client who said, "Since working with you in February, my ferritin has increased by almost 20 points. I'm so excited about the progress. I'm finally starting to feel human again." So this was basically over the course of two months, she was able to increase her ferritin by 20 points, which is honestly amazing. And the part that I love about this is this is our client, Jessica, who actually is a health professional. She knows about gut health. She has done SIBO testing. She had had an endoscopy, colonoscopy, CT scan, tried herbal protocols. She had done the work. And when she came to us with a ferritin of 27 and infrequent bowel movements, foul sulfur-smelling gas, food sitting in her stomach like a brick, waking up two to four times a night, it was not because she hadn't done anything. She- It's wasn't because she wasn't smart enough or wasn't trying hard enough. It was because she hadn't answered the question of why is everything not working together? This is what this episode is about. It's storage, the final step in this iron series. If you haven't listened to part one or part two, you might wanna go back and listen to those pieces. And Jessica's case is one that just shows why getting this step right requires understanding the whole system underneath it. So if you've been following the series, part one was Ashley. We talked about why her body could not absorb iron because of gut infections and a system that was in full-on defense mode. We had to address her terrain before iron had anywhere to go. Part two was Danielle. Her ferritin was actually high, but her iron saturation was low, and her ceruloplasmin was low. Her iron was getting absorbed, but it couldn't be transported. The body had locked it away because of active infections and a copper transport breakdown. And then part three is Jessica. So iron is coming in. She has no catastrophic infection picture. Her ferritin was stuck, but because the body didn't feel safe enough or supported enough to actually regulate and store it. So- Like I said, Jessica was a health professional. She was working kind of a lot of hours in work. She referred herself to the program because she had known about Gut Together through some colleagues. And when a clinician who also helps people with health-related challenges reaches a point where they need help themselves, you know that it is to the point where they are really ready to make a change. And I love working with other health professionals because they really wanna get into the weeds, and they really wanna dig into all the different pieces. So Jessica came to us with bloating, constipation, foul-smelling gas, the low ferritin, and just that perpetual feeling of food sitting in your stomach and never moving. She also was feeling constantly cold. Another interesting thing, like I said earlier, she was waking up two to four times a night and never felt rested. Her anxiety would go up when her symptoms were bad, naturally. She had food anxiety that was building quietly, and her story really starts as a teen. So when she got her first period, her GI symptoms somewhat started. She didn't have a natural cycle until midway through her teens. At eighteen, she went on hormonal birth control to try to regulate things. Her doctor had suggested possible PCOS, and her gut never really recovered after that. She said she had a kind of chaotic diet through high school and college. She had mono in college. And then in twenty eighteen, she came off birth control and got severely constipated almost immediately. She developed cystic acne. She tested positive for intestinal methanogen overgrowth or methane-dominant SIBO, and she didn't treat it at the time. She had a baby in twenty twenty-one, and she said that her mo- her hormonal symptoms improved after the pregnancy, which is really interesting, but the GI issues remained. So by twenty twenty-five, she was still positive for intestinal methanogen overgrowth and diagnosed with SIBO. She tried various SIBO protocols, things like oregano, berberine. She did an endoscopy, a colonoscopy that showed diverticulitis, no H. pylori, no celiac. And then in January, when she reached out to me, she had a CT scan after, after five or seven days of really severe pain. And basically, the CT scan came back with inflammation of the GI tract. She had elevated white blood cells, elevated bilirubin. So she came to us that same month. I remember talking to her, and her intake form said, "I'm really hoping to find the one missing piece of my GI issues. I feel like for the most part, I'm doing everything right. I think it's a liver and stomach acid issue." So she was definitely right about the liver piece, and more on that in a moment. So just to backtrack a little bit, we spent two episodes talking about what happens before iron reaches storage. But I wanna take a few minutes to talk about what storage actually means and why it's the step that determines whether all the other work pays off. So ferritin is your body's iron savings account. You can think about what a savings account actually does. It's not the money that you are spending right now, it's the reserve you're building so that when your body needs to draw on it, it actually has something to give. A lot of women are depositing iron into their checking account. They're absorbing it, they're circulating it, but nothing is ever getting transferred into savings, so their ferritin is staying low. That reserve is never building, and the body just runs on that feeling of, like, a phone battery stuck at 3%, which that is literally story of my life. My phone battery is always less than 10%. It drives my husband nuts. But you can technically function, right? But you're just kinda always living on the edge over there. But every single thing is draining you. You're always closing out apps, right? That's what it's like when ferritin stays low, and it's never converting to storage. So when your ferritin is low, it's not just the fatigue, it's hair thinning, it's being perpetually cold. It's that second wind at night that keeps you up because your cortisol is compensating for your depleted reserves. It's waking up at 2:00 AM just lying there with your mind racing. It's the anxiety that spikes when your digestion is off. That sense of, like, your body is working harder than it should have to for normal daily life. So for iron to actually be stored, several things have to be true. Inflammation, number one, has to be low enough that the body isn't hoarding iron defensively. The gut environment has to be healthy enough that iron can be properly regulated. The nervous system has to be calm enough that the body is in a state of building and repair rather than survival. And motility has to be working because a slow or sluggish gut creates conditions for overgrowth or fermentation that keep the immune system on alert and iron out of storage. So Jessica had issues in all of these areas. Not dramatically, not like this horribly catastrophic picture, just like persistent enough that her ferritin stayed low despite her doing a lot of right things. So like I mentioned, Jessica's GI map results were not full on dramatic red flags. There was no raging H. pylori levels, no C. diff, no significant pathogen load. And that is actually the educational point I wanna make here, because it's easy to write that off. You don't need a catastrophic infection for iron absorption or storage to be disrupted. So the terrain matters even when nothing looks that bad. Her GI map did show H. pylori that was present at a very low level. It doesn't h- take a high load to impact the stomach lining and stomach acid. Even low level H. pylori can quietly impair the environment. She did have some mild dysbiotic bacteria, nothing crazy. She did have a parasite that was present, just flagged just below the threshold level. And that matters particularly for iron, because this type of parasite is a known iron scavenger. Also known-- this parasite that she had was Blasto. Her secretory IgA, which is her gut immune system, was low. And across the board, her beneficial bacteria were pretty depleted And this was the thing that stuck out to our team the most, just that poor or low microbial diversity. Because that affected her gut immune system. The lower diversity you have in your gut, the more depleted your gut immune system is going to be. Her gut immune system was not well-equipped to hold the line. It's the bouncer that's supposed to be managing the door, and there weren't enough bouncers. Her microbiome was depleted to the point where the foundation wasn't there to support healthy immune regulation, motility, or iron management. So this is a terrain problem. No single infection that's, like, glaringly obvious, just a gut environment that was gradually depleted by birth control, years of a suboptimal diet, mono stress, the intestinal methanogen overgrowth that went untreated. And then now her soil is just no longer fertile enough to support any of those downstream systems that storage depends on. So I wanna spend some time on the, on this piece and I talked about this in part one, and that is the nervous system. So Jessica had a history of high stress and trauma, including just a recent really stressful life situation. She noted that her anxiety consistently worsened when her GI symptoms were bad, so it was a two-way street. She was waking two to four times a night. She rated her health stress an eight out of ten. She was working a ton. Her stress recovery, um, is just notable in itself. It shows that even though she was walking and cooking and doing some enjoyable things, that she just needed more, like, restorative time for her nervous system. Her HTMA was pretty significant as well. Sh- it showed a slow metabolic type, a slow one pattern. This is by far the most common pattern that we see, and this just basically reflects a body that is running in conservation mode. Her minerals were depleted across the board. Calcium, magnesium, sodium, potassium, copper was low, iron tissue was low. Cobalt, which reflects B12 status and stomach acid, was essentially depleted So the pattern on HTMA was a body that had been running on empty for a long time and had just shifted into this slow, protective metabolic state. So the connection that I want you to make is the body stores resources when it feels safe. It builds reserves when the nervous system is in a state that says, "We're okay." Like, "We have enough. We can invest in the future." When the nervous system is chronically in a low-grade stress state, not necessarily like this dramatic, you know, acute stress, but just this quiet background hum of stress, it, the body doesn't prioritize storage. It's prioritizing survival. So low ferritin is not always just a nutrition problem. It's a safety problem as well, like I mentioned in part one. And that word safe is not soft or, like, woo woo. This is pure physiology. When the stress response is chronically activated, cortisol is high, adrenaline is high, adrenal function is taxed, the body allocates its resources toward immediate needs versus long-term reserves, which is what ferritin is. So ferritin cannot build. So fer- Jessica's cortisol pattern was showing up at night in the form of those 2:00 AM wake-ups. Her body was revving when it should have been restoring, and that pattern was both a symptom of depleted minerals and also just continued depletion. Now, one more piece that I wanna connect here, because I think it's easy to think that constipation is a separate issue, and I talked about this in part one and two. Jessica came with infrequent, incomplete rabbit pebble bowel movements. She wasn't going at all. On two of the days she was working at the office, she had thin, sticky stools. She said it seemed like peanut butter. This is a sign of poor fat digestion and poor bile flow, which connected back to the liver findings her doctors were also looking at. Her elevated bilirubin, the sign on the liver scan, the gallbladder-like symptoms. All of it was pointing to a liver and bile story underneath this GI picture. So slow motility is creating this cascade. Food is sitting longer. It's fermenting more. It's feeding dysbiosis. It increases the bacterial load in the gut. It keeps the immune system on alert, raises that inflammation signal, and just tells the body to stay in protective mode. So iron doesn't get stored when the body is in a protect mode. And every one of those steps connects back to why ferritin is stuck. Her potassium was really low on her HTMA, and potassium is essential for smooth muscle contraction, including the muscles of the intestinal wall that drive motility. So when potassium is depleted, the gut does not move well. She was craving salt and carbs, which are classic signs of adrenal depletion, electrolyte insufficiency. Her body was telling her something through those cravings, and we just needed to tune into that. Now, I want to introduce something in this episode that I think is one of my favorite tools for iron, and when I posted about this on Instagram a few weeks ago, I had so many comments and questions about that, and that is lactoferrin. Most people have never heard of it or they've seen it mentioned without really understanding what it does. So I wanna explain it. Lactoferrin is an iron-binding protein that your body naturally produces. It's found in breast milk, it's found in saliva, in tears, gut lining. And what it does is it binds to iron, but not to supplement it. It binds to regulate it. It helps to direct it appropriately to keep it away from pathogens that would use it as fuel and to support the mucosal immunity of the gut lining in the process. So you can think of it as like luggage at an airport. Lactoferrin is like the airport worker that makes sure the luggage gets directed to the right gate. Without that direction, the bags are ending up in the wrong place, which we definitely don't want. There's nothing worse than getting to your destination and realizing that your bags aren't there, right? So this matters for Jessica's picture in a specific way because when her gut immune system was depleted with that low secretory IGA, poor microbial diversity, the Blasto is present, that low level H. pylori, her body's own regulation of iron in the gut lining was compromised. Laf- lactoferrin is also bifidogenic, meaning that it supports the growth of beneficial bacteria. It's anti-inflammatory to the gut. It helps keep iron out of the hands of the pathogens that compete for it. So it's not just adding more iron, and it's not just a supplement you take because your ferritin's low. It's more of like a regulatory tool, and one thing that made sense for Jessica's case in directing iron appropriately, not just like dumping more iron into her system. So what actually moved the needle for Jessica? The answer was not more iron. In fact, at the point that Jessica came to us, she wasn't supplementing iron. She had only been doing, like, some just basic supports like some ginger, turmeric teas, et cetera. We had to work on getting her bowel movements regular. That sounds basic, but it was foundational. We had to really support her minerals because they were so depleted. Magnesium alone was not going to cut it. Like I said, her potassium was so low. Her sodium was so low. We had to support all the cofactors that help with magnesium absorption. We had to also support fiber intake and diversity because her beneficial bacteria were low, and that's going to affect bowel regularity and also just help overall her nervous system regulation. She noted that when she started having daily bowel movements, her mood improved. That is not a coincidence. Next thing was mineral support, just to dig in a little bit more. Like I said, she was so depleted. We had to build her minerals back gradually. We had to use targeted minerals. We also had to really prioritize vitamin A, which is essential for iron recycling. We had to support her liver and bile flow, which was a clear part of her picture, given some of the labs and the scan findings. Bile is how the body clears and recycles many of its metabolic processes, and a backed up liver means the whole recycling system runs inefficiently. We needed to address her microbiome terrain, not with antimicrobials necessarily out of the gate, but we actually had to increase her beneficial bacteria. Now, lactoferrin can do that, and other specific probiotics can do that. We had to support her nervous system regulation. Jessica had already been working on this. She knew this was a piece of her picture, and we just built onto what she was already doing to help her sleep through the night, to support her blood sugar, to, and as we built up her mineral reserves, her nervous system regulation became easier and easier because we need minerals for stress resilience. So as I stated in the beginning of the episode, within two months of starting this, Jessica emailed us her ferritin had increased by almost 20 points, which is amazing. She was putting in the work, and like what I want to say here is like this was not overly complicated. It's not like she was on some crazy plan. It was just strategic and specific to her. This was not by taking more iron. It was not from loading up on random supplements. It was giving her body the conditions that it needed to finally do what it had been trying to do all along. So before I close out this series, here are the things that I want to leave you with just so that you can kind of wrap this in a bow. Number one is low ferritin is not always an intake problem. Storage is that final step, and it depends fa- on far more than how much iron you are consuming. Next is the body stores iron when it feels safe, when it feels nourished, when it feels regulated. So chronic stress and nervous system regulation in a depleted mineral picture are physiological blockers of storage, not psychological ones. Next is you don't need a dramatic infection for iron regulation to be disrupted. A depleted microbiome, like we saw with Jessica, low secretory IgA, and a gut terrain that's been slowly worn down over years can be enough to do it. Next is that constipation and slow motility are not separate from your iron issues. They keep the body in this low-grade inflammatory state, a protective state that directly impairs storage. Next is that lactoferrin is a regulatory tool for iron. It can be so helpful for the right person at the right time. Next, and this might be kinda obvious, but minerals are not optional. They are the infrastructure. Sodium, potassium, magnesium, copper, cobalt, they all run motility, stomach acid production, adrenal function, thyroid conversion, and the entire nervous system response that determines whether the body saves or spends the resources. And then the most important thing I want you to take from this series is that iron metabolism is never just about iron, and that's probably obvious by this point. It is about absorption, transport, and storage. It's about the gut, the liver, minerals, nervous system, microbiome. It's about whether your body feels safe enough to build a reserve. And when you find the right lever, and you can through specific testing and proper just searching, ferritin is going to move. So that is the end of this iron series, three episodes, three different clients. I hope it's helpful to see it through the lens of an actual case. Ashley's body couldn't absorb iron because of active gut infections and a system in defense mode. Danielle's body couldn't transport iron because of low ceruloplasmin and copper utilization. Jessica's body couldn't store iron because her terrain was depleted, and nervous system wasn't in a building state, and the downstream storage conditions weren't in place. So same symptom, completely different root causes. So if you've been listening to the series and you see yourself in one or all three of these cases, and you wanna actually understand which step is the issue for you and exactly where to start, join me on May 31st in my live webinar, Why Iron Isn't Enough. We're gonna go through all three steps in more detail, the testing that shows you where your system is breaking down, and actually what to do about it. So I look forward to seeing you there. You will also get our low ferritin troubleshooting guide. The link to register is in the show notes, and I can't wait.