A&S / Map 001 · Iron · Beta v1.12

Iron Map Beta

A practical way to explore why your iron may be low — or keeps becoming low, and which parts of your story deserve attention next.

Beta test: This tool is being tested and refined with real women and real iron stories. You can skip anything you do not know; incomplete answers are okay.

Low iron is common. But the reason it stays low is not always simple.

In a population-based Australian study of women aged 18–39, around 1 in 3 had ferritin below 30 µg/L. Iron status can reflect blood loss, absorption, inflammation, reproductive history, food and nutrient interactions, medications, inherited physiology, demand, and the amount and form of iron you are actually getting.

The Iron Map helps organise those possibilities, identify the ones that appear most relevant to you, and create a clearer story to take to your healthcare provider.

Source: Iron insufficiency among young Australian women.

Important: This prototype supports self-inquiry; it does not diagnose or replace medical care. Significant anaemia, pregnancy, black/bloody stools, unexplained bleeding, fainting, chest pain, severe shortness of breath, or post-menopausal bleeding need healthcare assessment. Confirmed or persistent iron deficiency without an obvious menstrual source also deserves investigation.

1 · Your iron story

Start with the pattern over time, not just the latest ferritin.

What best describes your iron story?

This is the first time my iron/ferritin has been low My ferritin has repeatedly been low over years It improves with treatment, then falls again It barely responds to oral iron I suspect low iron but do not have recent testing My iron is currently okay; I want to prevent another deficiency

How long has low iron been part of your story?

Your age

If you have results, add your most recent blood test. Leave anything blank if you don't know it.

Approximate test date

Ferritin — stored iron (µg/L)

Haemoglobin — Hb (g/L)

Transferrin saturation — TSAT (%)

C-reactive protein — CRP (mg/L)

Mean cell volume — MCV (fL)

Vitamin B12

Folate (nmol/L)

No blood result is required to build your Map. Missing information stays unknown. Reference ranges vary between laboratories, so the Map uses these results as orientation rather than treating every number as a diagnosis.

Do you have earlier iron blood results you would like to add?

Keep it simple. For earlier tests we only need the most useful iron-context markers. Approximate dates are fine; leave anything blank that wasn't measured.

Earlier test 1

Date

Ferritin (µg/L)

Hb (g/L)

TSAT (%)

CRP (mg/L)

What was happening around this test? (optional)

Earlier test 2

Date

Ferritin (µg/L)

Hb (g/L)

TSAT (%)

CRP (mg/L)

What was happening around this test? (optional)

If useful results above are blank, which best describes why?

When your most recent bloods were taken, were you acutely unwell or recovering from an infection?

Why this matters: ferritin can rise during inflammation, so the circumstances around a blood test can change how confidently we interpret it.

How is this showing up in you right now?

I feel generally well / I don't notice symptoms I connect to iron Fatigue / unusually low energy Reduced exercise capacity / I tire much sooner than expected Breathlessness on exertion Dizziness / light-headedness Palpitations / racing heart Restless legs Increased hair shedding Feeling unusually cold Pica / unusual cravings such as ice Something else / hard to classify

2 · Are you currently menstruating?

Not bleeding is not synonymous with menopause. The reason changes the interpretation.

Are you currently having menstrual bleeding?

Yes No / effectively no bleeding Very irregular / hard to say

What best explains why you are not currently bleeding?

About how long?

Other context

Pregnancy pathway: iron requirements, thresholds and treatment decisions are different in pregnancy. This Map can still identify background contributors, but it will not generate a DIY iron dosing plan.

No current menstrual loss: if iron deficiency or iron-deficiency anaemia is new or persistent after menopause, the Map will prioritise looking for non-menstrual sources rather than attributing it to historical periods.

Since menopause, have you had any new vaginal bleeding or spotting?

3 · Current menstrual loss

If you bleed, how hard is your body working to replace what leaves each cycle?

Typical cycle length

Bleeding days

Genuinely heavy days

On your heaviest day, which comes closest?

Which are part of your usual period?

Repeated larger clots Overnight changes or flooding Bleeding changes exercise, sleep, work, travel or what I wear Bleeding/spotting between periods or after sex Periods have become noticeably heavier Periods have become noticeably lighter None of these

Current uterine / reproductive context

Fibroids Adenomyosis Endometriosis Polyps Copper IUD Perimenopausal / increasingly irregular cycles None known / never investigated

3 · Recalling your period history

You are not currently having periods, so we will not ask about “current cycles”. Thinking back to the years when you did menstruate helps us understand the bleeding pattern that may have contributed historically.

When you were having periods, they were usually…

Typical number of bleeding days

Thinking back, which best describes your usual heaviest bleeding?

Were any of these commonly part of your periods?

Repeated larger clots Overnight changes or flooding Bleeding affected sleep, work, exercise, travel or clothing choices None / don't remember

4 · Reproductive + menstrual history

We are reconstructing your lifetime exposure to menstrual blood loss — not just what your periods look like now.

Why are we asking this?

Humans conserve iron tightly. We do not have an active pathway for deliberately excreting large amounts of it, so repeated blood loss matters.

One hypothesis worth exploring is lifetime menstrual exposure. Some contemporary reproductive lives involve many more menstrual cycles than those observed in natural-fertility populations, where pregnancy and long stretches without periods after birth created substantial breaks from menstrual blood loss.

This does not mean anyone should reproduce differently, breastfeed longer or suppress their cycle. Pregnancy also increases iron demand and birth can involve blood loss. We are simply adding up one part of your personal iron arithmetic: how much of your reproductive life has involved menstrual bleeding — and how much has not?

Context source: Strassmann · menstrual cycling in a natural-fertility population. We use this as one population-level evolutionary lens, not as a universal model of ancestral women.

Age at first period

Have you ever been pregnant?

Approximately how many months have you been pregnant in total across all pregnancies?

Across all pregnancies, approximately how many months in total did you go without periods after pregnancy?

Don't include pregnancy months here — we'll add them separately.

Have you ever used hormonal contraception?

Which hormonal contraception have you used?

Pill Hormonal IUD Implant Injection Ring / patch Other

Approximate total time using hormonal contraception

Before your first hormonal contraception, your natural periods were…

While using hormonal contraception, bleeding was usually…

If you later stopped hormonal contraception, what happened to your natural bleeding?

Other reproductive / menstrual history

Current or previous copper IUD Long periods of frequent cycles (<25 days) Other long periods without menstruation (not pregnancy/hormonal contraception)

Anything important about when your iron was best or worst?

5 · Family + inherited clues

We are interested in the family phenotype, not just whether someone was labelled “anaemic”.

In close relatives, are any of these common?

Recurrent low ferritin / anaemia / iron infusions Very heavy or prolonged periods Fibroids / hysterectomy for bleeding Endometriosis / adenomyosis Easy bruising, frequent nosebleeds, unusual dental/surgical bleeding or postpartum haemorrhage von Willebrand disease / known clotting disorder Thalassaemia / haemoglobin disorder Pernicious anaemia / B12 deficiency / autoimmune gastritis Coeliac disease / significant autoimmune disease Haemochromatosis / iron overload None of these that I know of I don’t know enough about my family history

Your blood group (optional)

Your own bleeding clues outside periods

Frequent/prolonged nosebleeds Easy or unexplained bruising Excessive gum bleeding Excessive bleeding after dental work Excessive surgical bleeding Significant postpartum haemorrhage None of these

Have you ever had a bleeding / haemostasis work-up because of heavy periods, easy bruising or other bleeding?

If you know, what did that work-up include?

Full blood count / platelet count Routine clotting screen — PT/INR, aPTT ± fibrinogen von Willebrand factor antigen/activity Factor VIII or other specific clotting-factor assays Platelet-function testing Haematology review I don't know

6 · Are you eating the iron system?

“I eat well” doesn't tell us whether iron, copper, retinol, B12, riboflavin, B6, folate and vitamin C are actually represented. This is a broad food-pattern screen, not a nutrient-intake calculation — portions, fortified foods and supplements can change the picture.

Red meat

Haem iron · B12 · B6 · zinc

Liver / organ meats

Iron · copper · retinol · B12 · B2 · folate

Oysters / mussels / shellfish

Iron · copper · zinc · B12

Fish

B12 · B6 · protein · variable iron

Poultry / chicken / turkey

B6 · B12 · protein · some haem iron

Eggs

B12 · B2 · retinol · protein

Dairy

B12 · B2 · iodine · calcium

Legumes

Non-haem iron · folate · copper

Nuts / seeds

Copper · zinc · non-haem iron

Leafy greens / folate-rich vegetables

Folate · carotenoids · non-haem iron

Vitamin-C-rich fruit / vegetables

Capsicum · kiwi · citrus · berries · broccoli

7 · What are you using to support iron or Blood?

“Taking something for iron” can mean direct iron replacement, a food concentrate, a TCM Blood formula, or a broader naturopathic tonic. We want to know what job each intervention is actually doing.

Do you currently take anything intended to improve iron, Blood or blood production?

Iron supplement with a stated iron ingredient Multivitamin / prenatal containing iron Desiccated liver / organ supplement TCM herbal formula for Blood / Blood deficiency Western herbal / naturopathic “blood-building” formula Food-based / mineral tonic Something else None

Iron form

How often?

On a day you take it, how much elemental iron do you get?

This records what you are taking; it is not a dosing recommendation. The Map uses dose, frequency, tolerance and biochemical response together rather than assuming “one capsule” means a therapeutic trial.

When do you usually take your iron?

Do you usually take it with food?

Why timing can matter
Hepcidin is one of the body's main iron gatekeepers. It rises across the day, can rise after an oral iron dose, and can also rise for several hours after exercise. The Map uses these signals as small, modifiable context — never as proof that timing alone explains low iron.

For your liver / organ supplement, does the label state an actual iron amount per serve?

Stated elemental iron per daily serve

Was the TCM formula prescribed by a practitioner?

Formula name, if known

What were you told it was addressing?

Blood deficiency Qi + Blood deficiency Heavy menstrual bleeding / holding Blood Digestion / Spleen function Postpartum / recovery / convalescence I don't know

Does the naturopathic / herbal formula state an elemental iron amount?

Elemental iron per daily serve

What else is in it, if you know?

B12 Folate B6 Vitamin C Copper Zinc Liver / organ powder Herbs Don't know

Zinc dose (mg/day, if used)

Calcium supplement?

Around your iron supplement or most iron-rich meal, what is typical?

Coffee within ~1–2 hours Tea within ~1–2 hours Large calcium supplement / very high-calcium load at the same time My iron-rich meal is often built around whole grains/bran/oats, legumes (beans, lentils, chickpeas), soy foods, nuts or seeds Usually includes vitamin-C-rich food None of these / not usually

A useful distinction
Known iron replacement = the elemental iron dose is actually stated. Supportive / amount unknown = liver, food concentrate, TCM or herbal support where the iron exposure cannot be quantified. Both can belong in your plan; they just should not be confused with each other.

8 · Can you absorb and use it?

Recurrent iron plus B12/gastric problems, poor response to oral iron, or chronic gut disease can change the whole strategy.

Have you been diagnosed with any of these?

Coeliac disease Inflammatory bowel disease Bariatric / gastric surgery Atrophic / autoimmune gastritis Pernicious anaemia / recurrent B12 deficiency H. pylori (current or previous) None of these / none known

Current digestive pattern

Frequent upper-abdominal bloating/fullness Frequent reflux Chronic/recurrent diarrhoea Significant constipation Significant food-triggered digestive symptoms None of these

If atrophic/autoimmune gastritis or pernicious anaemia is part of your history

That is more than a generic “gut issue”. Loss of acid-producing stomach cells can make non-haem iron harder to absorb, while autoimmune loss of intrinsic factor impairs B12 absorption. We ask a few extra questions so this pathway can give you practical next steps rather than simply saying “consider absorption”.

Do you know what is thought to be driving the gastritis?

How is B12 currently managed?

Has ongoing gastric follow-up / surveillance ever been discussed with you?

Acid-suppressing medication

How has oral iron worked?

Broader-system lens
Digestive capacity is also a meaningful theme in traditional systems such as Chinese medicine and Ayurveda. This Map does not translate digestive symptoms into a traditional diagnosis; it simply keeps the question open: are nutrients entering a system that can comfortably digest and assimilate them?

9 · Chronic illness, inflammation + thyroid context

We care about patterns across months and years. Conditions already captured in the digestive or reproductive sections are carried forward automatically, so you do not need to enter them twice.

Infections/illness episodes in the last 12 months that altered normal activity for ≥2 days

Typical time to feel fully recovered

Between episodes, are you genuinely well?

Known or persistent inflammatory / endocrine context

Thyroid condition — underactive, overactive, Hashimoto's, Graves' or other Rheumatoid / inflammatory arthritis Lupus or another autoimmune condition Chronic kidney disease Persistent dental / sinus / other inflammatory focus Prolonged post-infectious symptoms CRP/ESR has repeatedly been elevated when I was not acutely sick None known / don't know

Which thyroid condition, if known?

Most recent thyroid-stimulating hormone — TSH (mIU/L), if known

10 · Demand + other losses

Additional iron demand or non-menstrual loss can matter even when the rest of the system is working well. Current pregnancy is already captured earlier and is carried forward automatically.

Which apply now or recently?

Pregnancy/birth within the last 2 years High-volume endurance training None of these

If you take oral iron, when is it usually taken relative to a harder training session?

Whole-blood donations in the last 12 months

Possible non-menstrual blood loss

Black/tarry or visibly bloody stools Unexplained weight loss Frequent NSAID use None of these

11 · What has your body already taught you?

Past responses are useful natural experiments. They can show whether your iron can be restored — and what happens next.

Have your ferritin or iron stores ever clearly improved?

Once it improved, what happened?

What would you most like this Map to help you understand or decide?

Why my iron keeps becoming low My ferritin is low, but I feel well — does it matter? What further testing or questions might actually be useful Why iron supplements haven't worked as well as expected What I could reasonably explore next Something else

Tell us what you're trying to work out.

Your pattern · beta interpretation

Your Iron Map

Your priorities

Take this to your healthcare provider

A quick snapshot of what you reported

Questions / issues worth discussing

Re-measure, don't guess

Where iron deficiency is confirmed and a repletion strategy is started, a defined follow-up matters. Australian guidance commonly repeats iron studies after roughly 60–90 days; if iron stores have not corrected, the next move is to revisit the cause rather than simply escalating indefinitely.

Evidence anchors used in v1.12

This prototype intentionally separates well-established physiology from exploratory hypotheses. Key anchors include the Royal College of Pathologists of Australasia (adult ferritin <30 µg/L as diagnostic of iron deficiency in the absence of confounding inflammation); WHO guidance on ferritin interpretation during infection/inflammation; the Australian Heavy Menstrual Bleeding Clinical Care Standard; Australian Red Cross Lifeblood guidance on causes and treatment of iron deficiency; AGA guidance on atrophic gastritis and iron/B12 deficiency and on using IV iron when oral iron is not tolerated, fails to improve ferritin, or is unlikely to be absorbed; ASH/ISTH/NHF/WFH guidance on specific von Willebrand testing; Australian guidance on persistent iron deficiency; and TGA guidance used to distinguish a listed product ingredient amount from a quantified nutrient amount within food/organ concentrates.

RCPA · Ferritin · WHO · ferritin guideline · ACSQHC · Heavy Menstrual Bleeding · Lifeblood · underlying causes · Lifeblood · oral iron treatment · NIH ODS · iron absorption · Oral iron · time of day, coffee & vitamin C · Oral iron · hepcidin response to dosing · Exercise · hepcidin & iron absorption · Health Victoria · persistent iron deficiency · AGA · atrophic gastritis · AGA · iron-deficiency management · ASH · von Willebrand disease · TGA · listed medicine labelling

Iron Map v1.12 · beta test · exploratory educational tool · The Iron Map itself does not send your answers to a server; your interpretation is generated in your browser.