For iron deficiency (low ferritin), an iron-rich diet is the first step. Heme iron from animal sources (red meat, liver, poultry) is absorbed much better than non-heme iron from plants (lentils, spinach, pumpkin seeds, whole grains). Vitamin C (citrus, bell peppers) significantly enhances non-heme iron absorption. Inhibitors like phytates (grains, legumes), tannins (tea, coffee), and calcium (dairy) should be consumed separately. However, diet alone is often insufficient to correct manifest iron deficiency, especially with blood loss or chronic inflammation. Identifying the root cause (e.g., GI bleeding, celiac disease) is critical. Iron supplements (e.g., ferrous sulfate) are usually required, but only under medical supervision due to toxicity risk. Evidence for dietary interventions is strong, but individual response varies. Caveat: Ferritin is an acute-phase reactant; inflammation can falsely elevate levels. Always measure CRP before supplementation.
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