Why your iron won't budge.
A clinical investigation guide for adults with refractory iron deficiency — what the standard workup is missing, the four mechanisms by which H. pylori blocks iron absorption and storage, and the questions to bring to a physician next.
A workup for the iron deficiency that won't resolve.
This guide is written for the patient who has done it right — taken the supplement, eaten the spinach, repeated the labs — and whose ferritin still won't move. It maps the clinical picture, lays out the four mechanisms by which an unsuspected H. pylori infection can keep iron stores low, and gives a sequenced plan for what to ask next.
It is not a treatment protocol. It is the diagnostic conversation, written down, so the next appointment is shorter and sharper than the last one.
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i.
The clinical signature of refractory IDAHow the picture differs from menstrual loss, malabsorption, or pure dietary deficiency — and the labs that distinguish them.
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ii.
Why supplementation alone keeps failingHepcidin, hypochlorhydria, occult bleeding, bacterial competition — the four pathways, with the evidence tier for each.
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iii.
The standard workup's blind spotWhat a CBC, ferritin, and iron panel can and can't see — and why H. pylori rarely makes it onto the order set.
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iv.
The labs to request before testingA short list of secondary markers — TSAT, transferrin, sTfR, CRP — and what each adds to the picture.
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v.
Testing options for H. pyloriStool antigen, urea breath test, biopsy — the trade-offs, the costs, and what each one rules in or out.
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vi.
What positivity changesThe clinical decisions that follow a positive result — eradication, re-testing, follow-up iron, and the timeline.
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vii.
A conversation script for the next appointmentThree questions, phrased clinically, that route the workup toward the gastric pathway without overstating the case.
How an unsuspected infection holds iron down.
Iron deficiency in the presence of H. pylori isn't a single mechanism — it's a small family of them, often acting at once. The guide treats each as testable. Below is the short version.
Hypochlorhydria
Chronic gastritis from H. pylori reduces gastric acid output. Dietary iron — particularly non-heme — relies on stomach acid to convert from ferric to absorbable ferrous form.
Hepcidin elevation
Persistent low-grade inflammation drives hepcidin up. Hepcidin blocks iron release from enterocytes and macrophages — labs read deficient, body stores stay sequestered.
Occult mucosal blood loss
Erosive gastritis and ulceration leak small volumes of blood over long stretches — the classic chronic, low-grade, fecal-occult-blood-positive picture.
Bacterial competition
H. pylori itself sequesters iron via outer-membrane uptake proteins for its own metabolism — a contributing pathway, less dominant than the first three.
Sharper questions. Better appointments.
The guide doesn't replace a clinician. It gives you the language, the labs, and the literature — so the visit is a clinical conversation, not a search.
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Recognise the clinical signature of refractory IDA and how it differs from dietary, menstrual, and malabsorptive presentations.
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Name the four mechanisms — and the evidence tier on each — by which an unsuspected H. pylori infection can keep iron stores low.
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Request the right secondary labs — TSAT, transferrin, soluble transferrin receptor, CRP — and read them in combination, not in isolation.
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Decide between testing options — stool antigen, urea breath test, biopsy — based on cost, accuracy, and your specific clinical context.
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Bring a structured conversation to your physician — three concrete questions that route the workup toward the gastric pathway without overstating the case.
Three tiers. One rubric. No exceptions.
Every claim in this guide is tagged with one of three evidence tiers. The summary below previews the four claims central to the case for investigating H. pylori in refractory iron deficiency. The full reference list — fourteen citations — sits at the back of the PDF.
Iron deficiency · evidence summary
A few honest questions.
Is this medical advice?
No. It is an investigation guide — written to inform the conversation with a clinician. Diagnosis and treatment decisions belong to your physician.
Do I need to buy the testing kit?
No. The guide is content, sold separately from any Welyon product. It covers all three standard testing options — stool antigen, urea breath test, biopsy — and tells you what each costs and how to ask for it through your existing physician or insurer.
What if my labs are 'in range'?
The guide spends a section on this exact situation — what 'in range' obscures, what to look at in combination, and the secondary markers that frequently shift the picture without changing the headline numbers.
Refund policy?
14 days, no questions. If the guide isn't useful, the Lemon Squeezy receipt has a one-click refund link. We track this to keep the guides accountable.
Who wrote it?
The investigation series is authored by Welyon's editorial team and is being reviewed by the scientific advisory board currently in formation. Reviewer names will appear in the front matter of each guide upon confirmation.
Stop fighting the same lab result. Investigate the cause.
38 pages, fourteen citations, four mechanisms, one clear path to a sharper appointment. PDF, instant download.
FDA disclaimer · Commercial interest
These statements have not been evaluated by the Food and Drug Administration. This guide is for informational purposes only and is not intended to diagnose, treat, cure, or prevent any disease. Consult your physician before acting on any information presented here.
Commercial interest disclosure. Welyon produces an at-home H. pylori testing kit and a physician-supervised Foundation Protocol referenced in this guide. The presence of these products is disclosed throughout — including on this page, the guide cover, and in the front matter of the PDF — and does not change the content of the guide. The investigation steps described would apply equally if neither product existed.
Editorial independence. Evidence grading in this guide follows the same three-tier rubric used across the H. Pylori Investigation Series, applied identically regardless of whether the resulting investigation routes a reader toward — or away from — Welyon's products.