Iron Supplements for Anemia: Know When You Need Them and When an Alternative Treatment May be Better


Iron supplements have always been the standard treatment for iron-deficiency anemia. It makes logical sense: if you’re low in iron, then take iron supplements for anemia. But new research in nutrient absorption has revealed that iron-deficiency may not always be the issue.

For those who have systemic inflammation (or inflammation throughout the body), then your body won’t properly absorb the iron. If your body is holding onto iron and not properly absorbing it, then it doesn’t matter how many iron supplements you take. If you are experiencing symptoms of anemia and also have inflammation, then it’s likely you have Anemia of Inflammation.

Different Types of Anemia and How to Treat Them 

Anemia can occur for many reasons, including serious diseases that absolutely require management by a physician. There are three common types of anemia that require different treatments: vitamin deficiency anemia, anemia of chronic disease, and iron deficiency anemia. 


Vitamin Deficiency Anemia

If you diet lacks vitamin B-12 or other vital nutrients that help produce red blood cells, that you could develop vitamin deficiency anemia. In some cases, you may be consuming plenty vitamin B-12, but your body has a hard time processing it. A doctor can help you develop a proper treatment plan to assist with nutrient absorption and processing.


Iron Deficiency Anemia 

Iron deficiency anemia is the most common type of anemia and develops when there isn’t sufficient iron in the body to make hemoglobin. Iron deficiency anemia is common in pregnant women as well as children and the aging.

You can treat iron deficiency anemia with high quality iron supplements, which are usually prescribed by your doctor. However, some people are misdiagnosed with iron deficiency anemia when they really have plenty of iron that isn’t being processed properly.

So if the problem isn’t typically with iron deficiency, then what is the problem? Anemia is defined quite simply as “low hemoglobin”, meaning values of <12 mg/dl in men and <11 mg/dl in women. Hemoglobin (Hb) is the vital component of red blood cells which carries oxygen throughout the body. It is produced in bone marrow in a process known as erythropoiesis and is vitally dependent upon the presence of iron.

Anemia of Chronic Disease (Anemia of Inflammation)

With Anemia of Inflammation, there is plenty of iron present in the body, but the bone marrow is not sharing it with the red blood cells. Anemia of Inflammation is commonly associated with chronic infections, chronic inflammatory conditions, and other chronic diseases. The condition (frequently referred to as Anemia of Chronic Disease) is the second most common form of anemia worldwide (1). Anemia of Inflammation becomes increasingly common for women and men as we age.

Proper function of the bone marrow can be suppressed if someone is taking certain medications where this is a side effect. This is quite common, as 40% of older adults use about 5 medications weekly, with 12% using 10 weekly (2). There are some commonly prescribed medications with this side effect, including ACE receptor blockers, ACE inhibitors, certain antibiotics as well as anticonvulsants (3).

Who is at Risk of Developing Anemia of Inflammation?

Anemia of Inflammation is a major contributor to the loss of vitality, wellbeing and ultimately independent living for aging adults (65+). The New England Journal of Medicine estimates that 17% of this population is anemic, an estimate that we think is certainly on the low end.

Why Should We Focus on Anemia As We Age?

Keeping your hemoglobin levels up as you age can have a dramatically positive effect on your vitality. When your vitality is up, you stay out of the medical system and you can continue living independently.

Brenda Phennix PhD of Wake Forest University was a leader in the study of the consequences of anemia in the aging for the National Institute on Aging. In her publication she clearly stated, “anemia is a major risk factor for age-related loss of physical function” and that resolving it could “…{sic} keep older people out of nursing homes and hospitals.”  The evidence linking hemoglobin levels and vitality is undeniable:

  • The Cleveland Clinic has written that anemia in the aging population constitutes a 150% greater risk of hospitalization and 200% greater risk of a move to a nursing home.
  • The New England Journal of Medicine (source of the 17% estimate mentioned above) says that anemia in the elderly hastens cognitive decline, contributes to cardiovascular and other diseases, and impairs quality of life.


At Epiphany Therapeutics, we believe that a very strong case is made for the importance of anemia in the elderly. So what actions can you take to prevent anemia as you age?

  1. Always speak with your physician about anemia. The cause could be something more difficult than simply Anemia of Inflammation.
  2. We believe that highly purified bovine lactoferrin is a logical and natural supplement alternative to maintaining your ability to get and keep hemoglobin in a normal range.  (Note: just weeks shy of my 65th birthday, your author here has taken between 250mg and 1,000mg of highly purified bovine lactoferrin daily for about the last 9 years and hemoglobin has stayed consistently between 14.5 mg/dl and 15.0 mg/dl).

The Best Supplements for Anemia of Inflammation

There are a few ways to treat Anemia of Inflammation once the cause is identified. However, the cause can be difficult to pinpoint. Doctors often prescribe erythropoietin (EPO), which is an expensive medicine administered via injection. This medicine is typically not covered by insurance and it can be hard on your heart and kidneys and is known to have some major side effects for those who suffer from chronic disease.

For many, there is no way around taking necessary medications, but there is an alternative for treating Anemia of Inflammation that don’t involve expensive injections and major side effects. That alternative is purified bovine lactoferrin. 

Bovine lactoferrin is a side-effect free alternative to iron supplements and EPO treatment. But before you buy the generic brand of lactoferrin at your local drug store, know that the quality of lactoferrin is crucial for the best results.

The Research: Lactoferrin For Anemia and Iron Regulation

Valenti et al made an enormous contribution to the field of Anemia of Inflammation when they studied >1,200 pregnant women with anemia (4). They viewed Pregnancy Associated Anemia as an Anemia of Inflammation, and in their studies used iron supplements as their control arm. The treatment arm for their studies was purified bovine lactoferrin supplement taken orally, either 200 mg per day or 400 mg per day.

Their results were both conclusive and stunning: At 30 days of treatment hemoglobin increased broadly (by ~2 grams per dl) and pro-inflammatory cytokine values (IL-6) dropped. In the iron supplement control arm, hemoglobin was flat to slightly higher, accompanied by significant increases in IL-6 and the unpleasant side effects that come with iron, including constipation and abdominal pain.

These are the largest studies conducted by anyone anywhere to date, and they did an enormous service to the understanding of anemia in general, and shined a bright light on anemia in the elderly. They also served to support the premise that daily consumption of highly purified bovine lactoferrin is an important supplement for us each and every day.

What is Bovine Lactoferrin?

Lactoferrin is an iron binding and iron regulating protein found in human and bovine milk (it can also be found in human saliva, tears, and mucus–but don’t worry, supplements are not derived from these sources). Lactoferrin also has antimicrobial properties and can protect our bodies from pathogens that lead to illness and disease.

Lactoferrin binds to bacteria that feed on iron to grow. This keeps harmful bacteria from multiplying. This is not the case for helpful bacteria. Luckily, the good bacteria in our GI tract are resistant to this process simply because they are less dependent on outside sources of iron.

Bovine lactoferrin is extracted from cow’s milk, and if the proper precautions are not taken, the quality and effectiveness of the lactoferrin can be compromised. If you buy a product like this, then might as well be taking a placebo pill.

Purity is critical when selecting a lactoferrin supplement. The vast majority of lactoferrin supplements are produced from cheese whey, a vast soup of mold, fungi, bacteria and their toxins. This is not an acceptable source.

Our Acacia Highly Purified Bovine Lactoferrin is virtually endotoxin free which helps to assure that it will not contribute to inflammation as cheese whey does. Quality matters, purity matters and we are committed to giving you only the best products for your supplement needs.

Ready to boost your gut health and treat anemia naturally? Get your bottle of Acacia now.




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About the Authors

Bill Goolsbee

William Goolsbee has spent his career in Life Sciences including leading roles in drug development in immunology and genetic medicine. Recent senior positions include Chairman of the Board at Sarepta Therapeutics and Founder and CEO at Metrodora Therapeutics.

Dr. Gil Price

Gil Price M.D. is the Chief Medical Officer at the Propharma Group, where he provides medical supervision for all clinical trials. He previously served as the Chief Executive Officer of Drug Safety Solutions, where he oversaw safety monitoring for drugs in clinical development. Dr. Price also served as the Director of Clinical Development at Medimmune Oncology and Director of Medical Affairs at Glaxo.

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By and | September 18, 2018 | Diverticulitis & Lactoferrin | 0 comments

Ceasing to offer products effective May 26. Monday May 25 will be the last day that you can purchase any product from Epiphany Therapeutics.  We appreciate the loyalty and support of those of you who have purchased our products over the years.  This is a necessary, but not easy decision.