We have birth control that lets us plan our lives on our terms. We have life-saving interventions for high-risk pregnancies. We have medications that can stop a hemorrhage in seconds.

Modern medicine has come so far. So why is iron deficiency still so common?

For years, I thought iron deficiency was just a nutrition issue. Something I could fix with the right foods, the right supplements, the right habits.

But here’s what we never talk about.

Most of us start birth control in our late teens or early 20s, without a second thought. Some of us take medications for acne, heartburn, or period pain for years. These things become routine, normal, just part of life.

What if these very same advancements—the ones meant to make life easier, advance gender equity, and improve our health—are quietly working against our iron levels?

That’s what I’m covering in this issue: how some of the most widely used medical treatments may be interfering with iron in ways we never expected, and what you can do about it.

🔬 Medical Advancements That Impact Iron Absorption and Loss

Modern medicine has transformed women’s health, from safer childbirth to better pain management and hormonal control. But in ways we rarely consider, some of these advancements have unknowingly altered how much iron women absorb, retain, and lose.

Here’s how some of the most common medical interventions could be affecting your iron levels:

🩸 Birth Control & Menstrual Regulation: The Unexpected Iron Trade-Off

Birth control has become one of the greatest tools in family planning, women’s careers, and gender equity. But beyond contraception, doctors prescribe it for irregular, painful, or heavy periods, migraines, and even acne.

Some forms of birth control drastically reduce or eliminate periods, lowering the amount of iron lost each month.

🚨 Other forms, like the copper IUD, do the opposite, leading to heavier periods and higher iron loss.

🤰🏻 C-Sections & Postpartum Blood Loss: A Safer Birth, But Overlooked Recovery

Before modern medicine, childbirth was one of the biggest causes of death for women, largely due to postpartum hemorrhage. C-sections have revolutionized maternal survival, making childbirth safer than ever.

🚨 But C-sections cause greater blood loss than vaginal births, leading to significant iron depletion. Postpartum iron checks aren’t routine, meaning many women go undiagnosed with postnatal iron deficiency.

💊 PPIs & Antacids: Stomach Acid Relief at the Cost of Iron Absorption

Proton pump inhibitors (PPIs), like omeprazole and pantoprazole, and antacids provide relief from GERD, acid reflux, and ulcers. They protect the esophagus from long-term damage by reducing stomach acid.

🚨 But stomach acid is essential for breaking down iron (especially non-heme iron from plant-based foods). By lowering stomach acid, long-term use of PPIs and antacids decreases iron absorption and can contribute to iron deficiency over time.

🍪 Doxycycline for Acne & Rosacea: A Skin Fix That Blocks Iron

Doxycycline is a go-to antibiotic for long-term acne and rosacea treatment. It reduces inflammation and bacterial overgrowth, helping to clear stubborn breakouts.

🚨 But doxycycline (and other tetracyclines) bind to iron in the gut, blocking absorption for both the antibiotic and iron—making them both less effective.

🪡 Bariatric Surgery & Weight Loss Medications: A Metabolic Shift That Alters Iron Uptake

Bariatric surgery (like gastric bypass and sleeve gastrectomy) helps with severe obesity and metabolic disease, while GLP-1 receptor agonists (like Ozempic, Wegovy) are changing weight loss treatment.

🚨 Gastric bypass removes parts of the stomach responsible for iron absorption, making deficiency very common post-surgery. GLP-1 medications slow digestion, which may impact nutrient uptake, including iron (though research is still emerging).

💊 NSAIDs & Iron Loss: The Hidden Risk of Everyday Pain Relief

Nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen and naproxen, are staples for period pain, migraines, and inflammation as they’re widely available and non-hormonal.

🚨 But long-term, regular NSAID use can cause microscopic gut bleeding, leading to slow, unnoticed iron loss over time. Women who rely on NSAIDs for period pain, especially if they already have heavy periods, may be at higher risk of depletion.

Modern medicine has given us incredible tools, but some come with hidden trade-offs for iron levels. If any of these treatments apply to you, here’s how to minimize their impact on your iron stores:

1. Boost iron intake if you have a copper IUD. If your periods are heavier on birth control, increase iron-rich foods or consider supplementation to prevent depletion.

2. Optimize iron before childbirth. Building up your iron stores before delivery can support postpartum recovery and reduce the risk of deficiency.

3. Separate iron from PPIs, antacids, and antibiotics. Take iron supplements at least 2–4 hours apart from these medications to avoid absorption issues.

4. Monitor iron levels after bariatric surgery or weight loss medications. If you've had gastric bypass, sleeve gastrectomy, or take GLP-1 medications, regular iron checks and supplementation may be necessary.

5. Reconsider frequent NSAID use. If you rely on ibuprofen or naproxen for period pain, be mindful of slow iron loss over time—and consider getting your levels tested.

Small, intentional changes can help you maintain healthy iron levels while still benefiting from modern medical advancements.

We’ve come so far in modern medicine. We’ve gained control, security, and life-saving interventions. But with every advancement, there are trade-offs. Some are more obvious than others.

Today, iron deficiency isn’t just a nutrition issue. It’s not just about eating more spinach or taking the right supplement. It’s built into the way we manage our health, often without realizing it.

Birth control, acid reducers, antibiotics, weight loss medications, pain relievers—all tools designed to help us, but with unintended consequences for our iron levels.

That’s why awareness matters. Because when you understand what’s working against you, you can make better decisions for your health.

See you in the next issue. 💌

🩺 Common medical treatments like birth control, acid reducers, and pain relievers can impact iron levels, but awareness is the first step to making informed choices that support your health.

💬 What’s one thing you wish doctors told you about when you started birth control, acid reducers, or other long-term medications?