§ Guide № 03 of 08 · Iron Deficiency
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Iron deficiency · H. pylori investigation

The deficiency is real. Your doctor isn't concerned. That's not a diagnosis.

The missing variable. Finally named.

64%
of refractory cases
In studies, about 64% of otherwise-unexplained iron-deficiency anemia resolved after an overlooked H. pylori infection was found and cleared.
When iron runs low for no clear reason and won't respond to supplements, an overlooked stomach infection is one of the most common things behind it — yet a standard iron workup looks at diet, blood loss, and absorption, rarely the stomach lining itself. This guide walks through four researched reasons H. pylori can keep iron low, and helps you tell whether you're one of the people it affects.
How we got this number ▼
From the standard hematology reference on unexplained, refractory iron-deficiency anemia: 64–75% of such patients are cured once H. pylori is cleared and other causes are excluded (Hershko & Camaschella, Blood 2014). We use the conservative end of that range, 64%.
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The Iron Deficiency guide · 38 pages

The Iron Deficiency guide · 38 pages

A woman standing at a window looking out toward the dawn

You were right to keep looking.

You're not imagining it. The workup just hasn't gone far enough yet.

This guide is for you if

Everything checked out. But you still don't feel like yourself.

  • Your ferritin has been low-normal and H. pylori has never been investigated as a contributing factor
  • You've been supplementing for months and your ferritin hasn't moved
  • Your GI workup hasn't mentioned H. pylori as a possible cause
  • Your doctor has ruled out celiac and bleeding but the deficiency persists
  • You want to understand the mechanism before your next appointment
  • You have never been tested for H. pylori as part of your iron workup
38 pages · 14 citations · 4 mechanisms · 14-day refund
Possible mechanisms behind your low iron
Low stomach acid The infection lowers stomach acid, and without enough acid your body can't convert the iron in food into the form it can actually absorb.
What this can look like
  • Ferritin that won't rise no matter how faithfully you supplement
  • Iron pills that move the number a little but never lift how you feel
  • Iron deficiency with no bleeding source anyone can find
Iron locked away by inflammation Low-grade, ongoing inflammation from the infection tells the body to hoard iron in storage — so blood tests read low even when your intake is fine.
What this can look like
  • An iron-deficient pattern even when your diet clearly has enough
  • Fatigue that lingers while hemoglobin still looks normal
  • hs-CRP sitting just above 1.0 mg/L alongside the low iron
Slow, hidden blood loss Irritation of the stomach lining can leak tiny amounts of blood over months — too little to notice, enough to keep draining your iron.
What this can look like
  • Iron deficiency that keeps coming back after treatment
  • A positive stool blood test with no obvious source
  • Iron that depletes faster than food can replace it
The bacteria taking its share H. pylori needs iron too, and pulls it from your gut for its own use before your body gets the chance.
What this can look like
  • Very low stores with normal hemoglobin — reserves emptied before anemia shows
  • Long-standing iron deficiency that resists standard treatment
  • Iron that responds partly but never fully resolves
A page from inside the guide
A page from Section 03 of the guide — How H. Pylori Steals Your Iron
"It quietly redirects the very doorway your gut uses to send iron into your blood — so the iron you swallow arrives, but never gets through."From Section 03 · Mechanism 01
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§ 01 · What this guide covers
What this guide covers

A workup for the iron deficiency that won't resolve.

This guide maps the clinical picture, lays out the four ways an unsuspected H. pylori infection can keep iron stores low, and gives a clear plan for what to test next.

It is not a treatment protocol. It's the investigation itself, written down — so your next move is far more specific than your last, whether you take it to a doctor or pursue it on your own.

  1. i.
    The clinical signature of iron that won't recover
    How the picture differs from period loss, poor absorption, or simply not eating enough iron — and the labs that tell them apart.
  2. ii.
    Why supplements alone keep failing
    The four pathways an infection uses to hold iron down — low stomach acid, inflammation, slow blood loss, and the bacteria's own appetite — with the evidence tier for each.
  3. iii.
    What 'normal' labs miss
    Why a result 'within normal limits' can still be wrong for you — and why H. pylori rarely makes it onto the order set.
  4. iv.
    The labs to request before testing
    A short list of secondary markers a basic panel skips — and what each one adds to the picture.
  5. v.
    Testing options for H. pylori
    Stool antigen, urea breath test, biopsy — the trade-offs, the costs, and what each one rules in or out.
  6. vi.
    What positivity changes
    The decisions that follow a positive result — eradication, re-testing, follow-up iron, and the timeline.
  7. vii.
    A script for raising it
    A practical framework for discussing testing, interpretation, and next steps — whether with your physician or as a self-directed investigation.
§ 03 · After reading

Sharper thinking. Clearer next steps.

After reading, you'll:
  • Know exactly what to investigate next — and why your iron has slipped through the standard workup so far.
  • Tell the difference between 'in range' and 'fine for you' — and which iron markers actually matter.
  • Walk away with a specific plan to act on — with a doctor or on your own — instead of another round of supplements that don't hold.
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§ 04 · Evidence base
The evidence, plainly graded

Three tiers. One rubric. No exceptions.

Every claim is tagged Strong, Moderate, or Exploratory — so you can see exactly how solid each one is. These four are the heart of why H. pylori is worth investigating in iron that won't recover.

Iron deficiency · evidence summary

Strong Moderate Exploratory
Strong
In adults whose iron deficiency has no other explanation, more than half turn out to be carrying an active H. pylori infection.
Clinical review unexplained-IDA
patient series
Strong
People carrying H. pylori are roughly twice as likely to have iron-deficiency anemia.
Pooled analysis 14+ studies
~2× more likely
Moderate
Clearing the infection alongside iron raises iron stores more reliably than iron alone — though the hemoglobin benefit is real in some adults and less consistent across trials.
Pooled trials 7–8 trials
~800 people
Moderate
H. pylori lowers stomach acid and depletes the vitamin C the gut needs to absorb iron, while its inflammation raises hepcidin — the hormone that locks iron in storage.
Mechanism studies observational
The evidence says this is worth investigating — and the guide is how you investigate it properly: which test to ask for, and what a result actually means for you.
Full references, including journal citations and DOIs, are provided within.
§ 05 · Frequently asked
Before you buy

A few honest questions.

Is this medical advice?

No. This guide is educational — written to help you understand the evidence, evaluate testing options, and identify questions worth exploring with your healthcare team or on your own.

Why isn't my doctor already testing for this?

Because iron deficiency has many possible causes, and H. pylori is classified as a gastroenterological infection — so it rarely appears on the differential for persistent iron deficiency in primary care or hematology. It's a gap between specialties, not a failing on your part. The guide shows you when investigation is warranted and exactly what to ask for — whether you raise it with a doctor or decide to pursue it yourself.

Do I need to buy the testing kit?

No — the guide is sold separately from any test or product. It covers all three testing options — stool antigen, urea breath test, biopsy — what each costs, and how to ask for it. But a test only tells you yes or no; the guide is what tells you which test to request and what to do with the result, which is where most people get stuck.

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.

Who wrote it?

Researched, written, and medically reviewed by a physician on the Welyon team. Every claim is drawn from peer-reviewed literature and graded inline — Strong, Moderate, or Exploratory — so you can weigh the evidence behind each one yourself.

§ 06 · Get the guide
Guide № 03 · Iron deficiency

Start closing the gap between 'normal' and 'explained.'

Move from ruled out to figured out.

38 pages, fourteen citations, four pathways, one clearer next step.

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The H. Pylori Investigation Series — all eight guides
01 Chronic fatigue 02 Brain fog 03 Iron deficiency 04 Thyroid / Hashimoto's 05 Metabolic 06 Nerve & energy 07 Skin 08 Immune / ITP

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