How IBS Can Cause Iron Deficiency and Anemia

Wondering if IBS could be causing other symptoms? You're not alone.

Dr. Steven Wangen shares how Irritable Bowel Syndrome (IBS) can cause iron deficiency and anemia, along with steps to take. Learn more about what can cause IBS, including gluten intolerance, here.

Many patients who have digestive problems are also anemic due to low iron or low vitamin B12 levels. This problem causes fatigue, so it should be of interest to many people. Being anemic and having IBS is not unusual and there is a logical reason for it. First we’ll discuss anemia and then how it relates to IBS and digestive problems.

What is anemia?

Anemia is a common blood disorder that is a decrease in the number of red blood cells (RBCs) and/or poorly formed red blood cells. These are the cells in your blood that carry oxygen. If you are anemic, then you will be tired because you are not delivering as much oxygen to your body as someone who is not anemic.

There are many different types of anemia, but the most common are due to iron deficiency or vitamin B12 deficiency. Iron deficiency anemia will show up on your complete blood count (CBC) as a low RBC count, low hematocrit (Htc), and/or low hemoglobin (Hgb). Vitamin B12 deficiency anemia typically shows up as an increase in the size of the red blood cells. On your CBC it is noted as the MCV.

How to catch low iron before you become anemic:

Iron is stored in the body in a protein form called ferritin. Ferritin levels can be measured with a simple blood test. Ferritin decreases long before iron deficiency anemia is apparent on a complete blood count. Therefore you can often prevent iron deficiency anemia by monitoring your ferritin level.

It can take several months of iron supplementation to rebuild iron stores. If you are anemic and you take iron only long enough to correct the anemia, you likely have not built up your iron stores enough to last for very long. Then you are much more likely to become anemic again in the near future, which of course will cause you to be tired. This is another good reason to check your ferritin level.

What is borderline anemia?

It is not unusual for people to report that they have been told that they are borderline anemic. In most cases, they were not told to take iron. What you should know is that borderline anemia is not a technical term. You either are anemic or you are not anemic. If you have been told that you are borderline anemic, then you are probably anemic.

Correcting this problem will help you to feel much better. If you are borderline anemic and it is due to an iron deficiency, then your iron stores will be very low. So have your ferritin checked.

What about vitamin B12?

If your anemia is due to a B12 deficiency, then taking B12 will solve your problem. Your doctor may prescribe B12 injections, which will improve the treatment and vastly increase the amount of B12 getting into your body. Vitamin B12 is also stored in the body, but its stores are unfortunately not so easy to measure.

What does this have to do with IBS?

The important question underlying anemia is “Why do you have low iron or B12 levels?” The answer may be that you don’t absorb them well. People with IBS and related digestive problems often have a problem absorbing nutrients. This is particularly obvious with diarrhea, which is clearly a malabsorption issue.

Dr. Steven Wangen

Article Courtesy:  Dr. Stephen Wangen
Founder of the Center for Food Allergies and the IBS Treatment Center

photos courtesy of IBS Treatment Center

4 thoughts on “How IBS Can Cause Iron Deficiency and Anemia

  1. I'm disappointed that the article seems to suggest that IBS causes anemia. If anemia is present, further testing is required. It's a symptom, not a diagnosis.

    It seems very likely that the patient's "IBS" is something else entirely, like celiac disease.

  2. I have iBS and i have lost weight. I have also been told i have low iron levels and my doctor prescribed iron tablets, but i had a baad reaction to the iron talbets before.. I don’t seem to be getting an straight answer from the doctor as to what is causing my weight loss or why i have low iron levels. all my other blood test are normal. I am so frustrated

    1. Hi Tracy my boyfriend is in the same boat we’ve been dealing with this for 2 years and no one can give us any answers. If you have any updates please let us know.

    2. Hi Jess
      Has anyone suggested to you about having a colonoscopy?
      I have ibs and now low iron levels and the 1st thing my Dr asked was have I had a recent colonoscopy
      Hope you get some answers

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