Could the bacteria in your gut be the key to your anemia?


Could the Bacteria in Your Gut be the Key to Your Anemia?An essential part to healthy living and Paleo is making sure that you are getting the right amount of key nutrients. One such element is iron.1 Maintaining a proper balance of iron in the body is crucial to ensure the body can make red blood cells.1 Red blood cells act as oxygen carriers taking oxygen from the lungs to your body’s tissues. In cases where a shortage of iron exists, an anemia occurs. Extreme fatigue due to decreased ATP energy production from the insufficient amount of red blood cells,2 is a key symptom. Ward anemia away by including Paleo friendly food options rich in iron, such as meat, poultry, fish, spinach, and almonds.1

Healthy people naturally lose about 0.5 to 2 mg of iron daily.2 So how does the body regulate iron? Hepcidin, a hormone produced in the liver, serves as the main regulator of iron homeostasis.3 When a person consumes food rich in iron, it enters the body via the intestine. When there is iron supply depletion, the body has a symbiotic mechanism, through the release of hepcidin, which encourages iron absorption.3 The same is also seen with infections or inflammation in the body. On the other hand when iron concentration increases, the liver releases hepcidin, which inhibits absorption.3

The Research Study

Earlier research studies focused upon the mechanism of uptake through the intestinal epithelial cells. Recent research from France shows that the actual intestinal microbiota, the bacteria within the gut, may play a more meaningful role in the process.4

In a controlled study, researchers removed the intestinal microbiota from mice. In another group, the mice were later colonized with a controlled microbiota. In the germ free group, the mice had low iron supplies whereas the mice with microbiota present in the intestine exhibited high levels of iron supply, with the presence of ferritin, the iron storage protein and increased levels of ferroportin, the iron transporter protein, which distributes iron in the body.

Researches also saw that certain commensal organisms (Bacteroides thetaiotaomicron VPI-5482 and Faecalibacterium prausnitzii A2-165) and a probiotic strain (Streptococcus thermophilus LMD-9) resulted in an increase of 12-fold induction of ferritin in the colon.

Based on these results, the researchers concluded that microbiota in the intestine leads to transformation of the intestinal cells. This encourages them to allocate iron around the body and store it.

Paleo, Anemia, and Crohn’s Disease: What’s the Connection?

The study’s findings seem to suggest that the microbiota serves as part of the regulatory control process. This guides our understanding of certain iron overload diseases in addition to the iron levels in people diagnosed with gastrointestinal conditions such as inflammatory bowel diseases like Crohn’s disease and Ulcerative Colitis.

It is also important to connect these findings with those from a study published in Nature5 where researchers studied fecal samples from the Matses in the Amazon, one of the last hunter-gatherers communities in the world. Their samples were compared to those of a group of residents from Oklahoma, and showed the Matses’ microbiota was much more diverse. Notably present was a strain of bacteria known as Treponema which is not normally seen in civilized western populations. This bacteria is also found in other Paleolithic communities such as the Hadzas in Tanzania. Researchers further stated that this high level of microbial diversity appears to have real benefit to host populations.


Anemia is a prevalent problem seen in individuals diagnosed with Crohn’s disease due to excess gastrointestinal blood loss.6 The antibiotics that are often prescribed to combat symptoms remove microbes and impact the gut flora.6One can speculate that this could further cause iron deficiency and anemia, given the results of the earlier study on the role of microbial flora in supporting the uptake of iron. Because microbiota diversity may play a role in preventing conditions like Crohn’s diseases, what do you have to lose? Keep your gut in check by following a risk free Paleo diet – you only have your health to gain.


1. University of Illinois At Urbana Champaign. (2010). Dietary Sources of Iron. Retrieved Sep 29, 2015, from McKinley Health Center: //

2. Sharp, P., & Srai, S. (2007). Molecular mechanisms involved in intestinal iron absorption. World Journal of Gastroenterology, 13(35), 4716-4724. Retrieved Sep 29, 2015, from //

3. Nemeth, E., & Ganz, T. (2006, Aug). Regulation of Iron Metabolism by Hepcidin. Annual Review of Nutrition, 26, 323-342. doi:10.1146/annurev.nutr.26.061505.111303

4. Deschemin, J., Noordine, M., Remot, A., Willemetz, A., Afif, C., Canonne-Hergaux, F., . . . Nicolas, G. (2015, Sep 14). The microbiota shifts the iron sensing of intestinal cells. The FASEB Journal. doi:10.1096/fj.15-276840

5. Obregon-Tito, A., Tito, R., Metcalf, J., Sankaranarayanan, K., Clemente, J., Ursell, L., . . . Marin-Reyes, L. (2015, March 25). Subsistence strategies in traditional societies distinguish gut microbiomes. Nature communications. doi:10.1038/ncomms7505

6. National Hematologic Diseases Information Service. (2013, August 26). Anemia of Inflammation and Chronic Disease. Retrieved Sep 30, 2015, from National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

About O. H. Okoye, MD, MBA, MSEpi

O. H. Okoye, MD, MBA, MSEpiDr. Obianuju Helen Okoye is a US Health Care Consultant with a Medical Degree (MD), an MBA in Healthcare Management, and a Masters in Epidemiology/Public Health. Her background includes being a National Institutes of Health (NIH) Clinical and Research Fellow, and State of Michigan HIV/AIDS Epidemiologist.

She has a plethora of clinical research experience and has presented at US and International Medical Conferences. Dr. Okoye has authored some publications, such as the impact of the implementation of the Affordable Care Act on medical tourism in the USA, the Market Analysis on US Health Reform (Impact on Supply and Demand for Health Care Services), and on lessons learned from the Ebola epidemic. Dr. Okoye’s interests include disease prevention, empowering under-served communities globally, bridging access (to) and streamlining the delivery of healthcare services.

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“2” Comments

  1. I was interested in this research and in the diversity of gut biota, so just googled Treponema bacteria. It seems this bacteria gives us Syphillis and other quite nasty skin deseases; Pinta, Bejel and Yaws prevalent in South America so it is not really surprising to find these bacteria present in the Matses people. So I’m not sure we can equate Treponema with good health simply by their merely being present – it seems they actually cause disease!

  2. This article does a disservice to people who follow Dr. Cordain’s advice fairly closely. Meat, poultry, spinach and other leafy greens like kale are indeed great sources of iron. If you follow the Paleo diet you are more likely to have HIGH iron levels, not anemia. People discussing iron and a Paleo diet would better serve their readers by noting they may also want to watch for high iron levels when they get their blood panel work done. Fortunately if you can regularly donate blood you can address the issue. It is safe, drug free and will keep the iron levels of a male on the Paleo diet in a normal range.

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