Insufficient iron intake and absorption problems are common and well-known, but new studies suggest these issues are more widespread than previously thought. 

In an analysis of 8,000 participants of the National Health and Nutrition Examination Survey (NHANES), about 14% of adults had an absolute iron deficiency (JAMA Network Open, 2024). An additional 15% had functional iron deficiency, characterized by normal iron levels but impaired utilization.

Taken together, one in four Americans has some form of iron deficiency, and the biggest underestimations from previous studies were among people without anemia, chronic disease, or pregnancy. Prevalence was particularly high in women under age 50, reaching up to 34% in certain groups.

Certain dietary restrictions can elevate the risk of iron deficiency, noted Jennifer Toomey, North America vice president of product at TopGum. “Vegan and vegetarian lifestyles, often lower in bioavailable [non-heme] iron, have increased both the risk of insufficient intake and public awareness around the importance of iron.”

Older adults are also particularly vulnerable to iron deficiency. “These factors have significantly raised consumer awareness, highlighting iron as a critical nutrient that still requires better solutions and education,” Toomey said.

Iron is often overlooked despite its profound impact on everyday measures of health and quality of life. “Iron is no longer only about fatigue, but rather also greatly impacts anxiety, brain fog, poor sleep, palpitations, hair thinning, and hormonal symptoms that were historically blamed on stress or just getting older,” said Vincent Hackel, president and CEO of Sloiron Inc. “Gentle correction can significantly improve energy, mood, and cognitive function.”

Modern diets and lifestyle factors can all contribute to iron insufficiency, Hackel noted, including plant-based or vegetarian diets, frequent blood donation, chronic use of acid-suppressing medications, and highly-processed, low-fiber diets.

Isabel Gómez, global marketing manager at Lubrizol Nutraceuticals, noted additional factors, like tea or coffee with meals, post-bariatric surgery, and celiac disease, which can also reduce iron absorption, driving sustained iron loss well before a formal diagnosis.

Women’s Health

Women are overall more susceptible to iron deficiency and experience drastic fluctuations in daily iron requirements.

“We see womanhood as an ongoing journey, with the body constantly evolving,” said Toomey. “Too much of the supplement industry still takes a ‘one size fits all’ approach … We believe the industry must evolve alongside women’s changing physiology.”

Pregnancy raises demand meaningfully, and poor iron status is linked with adverse maternal-fetal outcomes. Gestational anemia recovery often requires 6-12 weeks of iron supplementation, so tolerable options are essential, said Gómez. “Aligning delivery technology, timing, and format with each life stage is the next step forward … Women have historically faced lagging outcomes in iron status, strengthening the case for women-focused innovation,” she said.

Recommendations from health authorities often align with women’s real needs, noted Oliver Riemann, senior marketing and business development manager of Albion Minerals at Balchem. For adult women, the baseline recommendation is 18 mg per day, which is 125% more than for adult men. In pregnancy, the U.S. Centers for Disease Control (CDC) recommends starting at 30 mg per day from the first prenatal visit. However, these recommendations alone aren’t effective.

“Nearly 20% of adult women aged 19-50 years do not get enough iron from foods and beverages alone,” Riemann noted, “and that figure skyrockets in pregnancy, to as much as 85% of pregnant women in the U.S. … As an industry, we can do more to educate female consumers on this.”

“Heavy or prolonged menstrual bleeding, high training loads in active women, postpartum depletion, and perimenopausal changes can all dramatically increase iron losses, yet many of these women are never thoroughly assessed beyond a basic hemoglobin test. Normal hemoglobin with low ferritin can still leave people exhausted, anxious, and tired while also feeling tense and ‘keyed up,’ and this gap in testing keeps risk hidden,” said Hackel. Iron depletion is often misdiagnosed as PMS and stress, and during postpartum, it is rarely investigated unless anemia is obvious, he added.

Sports Nutrition

Iron shouldn’t be overlooked in sports nutrition, especially for runners and endurance athletes. 

“Athletes need about 70% more iron than the RDI because they lose lots of iron through foot strike hemolysis, where red blood cells burst open during running, and also through losses in the urinary and digestive system during endurance training,” said Libby Weaver, PhD, nutritional biochemist and partner with Sloiron, Inc. Further, low-grade inflammation from exercise can interfere with iron absorption, so timing supplementation before workouts is important, she noted.

Cognitive Development and Mental Wellness 

Research suggests that early childhood iron deficiency significantly affects neurodevelopmental outcomes, with an estimated 7.1% of U.S. children suffering from absolute iron deficiency.

A 2025 review of 17 cohort studies linked iron deficiency during the first 1,000 days of life to lasting cognitive, motor, behavioral, and neuroendocrine impairments into adulthood.

Recent studies have shown that iron deficiency is linked to depressive symptoms. An analysis of NHANES data from 2017-2020 found a significant correlation between three measures of iron deficiency (ferritin, serum iron, and transferrin saturation levels) and depressive symptoms.

Weaver referenced a 2023 literature review, which found that iron deficiency is linked to psychiatric symptoms such as anhedonia, anxiety, and depression. Addressing deficiencies is associated with symptom improvement or complete resolution.

Overcoming Formulation Challenges

Conventional iron forms cause stomach upset and are absorbed in a complex manner with interference from other minerals and anti-nutrients.

Ferrous sulfate, a common form, nearly doubles the risk of GI upset in the general population, and more than triples the risk in pregnant women, compared to placebo, noted Riemann.

“GI tolerability is one of the most significant barriers to compliance with conventional iron supplements,” said Toomey. Constipation, nausea, abdominal discomfort, and bloating are widely reported, and for many consumers these side effects are severe enough to cause discontinuation, even among people who clinically need iron supplementation.”

Sophisticated delivery technologies trump higher dosages, said Toomey. TopGum’s iron gummies feature a fiber-based matrix for improved taste and organoleptic performance, masking iron’s strong, earthy, and metallic taste. “Our confectionery heritage plays a key role,” said Toomey. “We bring deep expertise in flavor development, texture, and mouthfeel, allowing us to apply decades of candy-making know-how to nutraceutical formulations.”

Chelation, meanwhile, “creates a strong and stable bond between iron and two molecules of glycine,” said Riemann, enhancing absorption and reducing GI distress compared to ferrous sulfate. One meta-analysis (Nutrition Reviews, 2023) found that ferrous bisglycinate improved hemoglobin status in pregnant women more efficiently than iron salts, while reducing relative GI events by 64%.

Balchem also launched Taste-Free Iron, a ferric trisglycinate that offers even lower reactivity for enhanced sensory performance in chewables, gummies, and functional foods/beverages.

“Women often report that their senses, including taste, are heightened during pregnancy,” making it all the more important during this critical juncture, noted Riemann. Chelated structures also limit the ability of anti-nutrients, such as phytates, to interfere with iron absorption. “This form was selected by the World Health Organization as a ‘fortificant of choice’ for specific applications.” For each of its chelated minerals, Balchem introduced TRAACS (The Real Amino Acid Chelate System), a process to ensure all minerals are fully reacted and truly chelated.

Lubrizol Nutraceuticals has a specialized microencapsulation technology to support iron fortification in gummies. “By protecting iron and controlling its release, we can deliver performance with a gentler experience that supports long-term adherence … Microencapsulated iron paired with vitamin C in formats such as gummies and orosoluble sticks helps consumers absorb iron despite common inhibitors,” Gómez said. In a preclinical study, the ingredient reversed deficiency while leaving gut barrier integrity markers unchanged in an animal model.

Sloiron utilizes ferritin iron, which is extracted from legumes. In this food matrix, iron is double-encapsulated by protein and absorbed by gut cells through a specific pathway called receptor-mediated endocytosis. This prevents the distribution of unbound, reactive iron in the gut, which can cause oxidative stress. By contrast, ferritin is taken up intact or its iron core is released from a protein “cage” under controlled conditions, reducing oxidative stress and improving tolerability, Hackel said.

It’s also important to consider the impact of iron on the finished formulation, Hackel added. Iron can cause emulsions, dairy-style products, and omega-3-enriched systems to become rancid and can degrade vitamins, phytates, and polyphenols to the point that products fail to meet the dosages claimed by shelf life.

Poor choices in processing, heat, and pH can worsen these issues. “In multi-ingredient or multi-mineral formulas, the strategy has typically been to ‘out-dose’ the inhibitors: push iron high enough, add vitamin C, and hope that net absorption is adequate despite competitive interactions,” at the expense of tolerability and taste for the consumer.

Microencapsulation techniques can also help minimize iron’s effects on flavor, color, stability, and nutrient interactions. “For ready-to-drink beverages and dairy systems, this means better flavor stability and a more enjoyable experience that supports repeat use,” Gómez said.

Looking Ahead

According to Hackel, the defining features of iron ingredients today should include: physiologic, regulated absorption rather than sheer solubility; minimal GI effects or oxidative stress; compatibility in real-world diets and multi-ingredient products; and clinical validation in women, plant-based eaters, and other high-risk groups.

In the future, “expect to see more ferritin- and postbiotic-inspired iron systems, better personalization based on ferritin and hepcidin dynamics, and combinations that reflect the systems biology perspective where iron status is addressed alongside inflammation, hormones, and gut integrity rather than in isolation,” Hackel said.

“Dosing rhythm matters too,” said Gómez. “Hepcidin-aware schedules, including alternate-day dosing, can sustain fractional absorption with better comfort, ideal for products intended for daily use … Looking ahead, expect microbiome-friendlier designs, personalization guided by hepcidin dynamics and digital tools that help consumers time doses for optimal absorption and comfort.”