How Inflammation Can Lead to Low Iron and Anemia

If you’ve ever been told your iron is low but you don’t understand why, inflammation may be part of the answer. When your body experiences inflammation—whether from infection, chronic illness, or even stress—it can change the way your body handles iron. Over time, this can lead to low iron levels and a condition called anemia of inflammation, also known as anemia of chronic disease.

How Inflammation Affects Iron in Your Body

Your body needs iron to make red blood cells, which carry oxygen to all your tissues. But when inflammation is present, your immune system shifts how iron is used and stored. Here’s how that happens:

1. The Hormone Hepcidin Blocks Iron

When your immune system is active, inflammatory molecules—especially one called interleukin-6 (IL-6)—signal your liver to make more of a hormone called hepcidin.
Hepcidin acts like a gatekeeper: it blocks iron absorption from food and traps iron inside storage cells in your liver and immune system. This means even if you eat enough iron, your body can’t use it effectively (Lanser et al., 2021; Rosenblum, 2023; Wessling-Resnick, 2010; Cappellini et al., 2023).

2. Iron Gets “Locked Away”

During inflammation, your body increases storage iron (measured as ferritin), but circulating iron in the blood drops. This creates what’s called functional iron deficiency—you have iron, but it’s stuck in storage and unavailable to make new red blood cells (Lanser et al., 2021; Ueda & Takasawa, 2018; Rosenblum, 2023; Cappellini et al., 2023).

3. Red Blood Cell Production Slows Down

Inflammation doesn’t just affect iron—it also interferes with erythropoietin, the hormone that tells your bone marrow to make new red blood cells. This means your body produces fewer red blood cells, worsening anemia (Lanser et al., 2021; Rosenblum, 2023; Cappellini et al., 2023).

4. Iron Absorption from Food Decreases

Inflammation can also make your intestines less able to absorb dietary iron, which adds to the problem (Suchdev et al., 2017; Cappellini et al., 2023).

Summary: How Inflammation Affects Iron

Why This Matters for Your Health

Anemia of Inflammation Is Common

This type of anemia is common in people with chronic conditions such as kidney disease, heart failure, obesity, autoimmune disorders, and ongoing infections. You may notice fatigue, weakness, or pale skin, even though your diet seems adequate (Lanser et al., 2021; Ueda & Takasawa, 2018; Rosenblum, 2023; Berton & Gambero, 2023; Cappellini et al., 2023).

It Can Be Hard to Diagnose

Doctors often check ferritin to measure iron stores, but ferritin rises during inflammation even if your actual iron levels are low. This means it can be tricky to tell whether you have simple iron deficiency or anemia of inflammation (Ueda & Takasawa, 2018; Suchdev et al., 2017; Berton & Gambero, 2023). This is why if there are symptoms of low iron, not just ferritin should be checked. The most common symptoms include fatigue, low energy, pale skin, shortness of breath, dizziness, and feeling unusually cold. Some people notice headaches, heart palpitations, brittle nails, hair loss, or restless legs. Others experience unusual cravings for non-food items like ice or clay (a condition called pica), or find it harder to concentrate and think clearly due to reduced oxygen supply to the brain. Because iron also supports the immune system, low levels can increase your susceptibility to infections. Additional blood work includes serum iron, transferrin saturation, and hemoglobin.

Treatment Focuses on Reducing Inflammation

Because inflammation blocks your body’s ability to use iron, the best approach is to address the underlying cause of inflammation—such as infection, poor gut health, or chronic stress.
In some cases, as a necessary short term ‘bandaid’, intravenous iron may be used instead of oral supplements, since inflammation can prevent iron from being absorbed properly through the gut (Ueda & Takasawa, 2018; Cappellini et al., 2023).

Key Takeaway

Inflammation and iron are deeply connected. When inflammation is ongoing, your body holds onto iron instead of using it, leading to low blood iron and sometimes anemia. Managing inflammation through nutrition, lifestyle, and medical care can help your body restore balance and improve energy levels.

For a deeper understanding of inflammation, including its root causes and effective natural strategies, visit my free Inflammation Playlist on YouTube.