While prepping a class on iron deficiency for the Menstrual Health Intensive that Liane Moccia and I are currently teaching, I stumbled into a rabbit hole: a 1963 BMJ paper linking beeturia - pink or red urine after eating beets - to iron deficiency. Physiology nerds, check out this episode for a quick overview of why iron deficiency might cause red or pink urine in some cases, and why it's more of a clue and less of a clear diagnostic sign. What I Cover Beeturia basics A 1963 study in BMJ that identified the relationship between beeturia and iron deficiency The working theory about why iron deficiency might cause red or pink urine Why beeturia isn't diagnostic on its own, but might be worth noticing alongside other signs and symptoms Key Takeaways Red or pink urine after eating beets does not mean you (or your client) have iron deficiency - it shows up in roughly 2-15% of "normal" people without ID/IDA Beeturia is more common in iron deficiency, especially when untreated The likely mechanism is an "iron hunger": the gut absorbs iron faster, so less is left in the lumen to oxidize and decolorize betanin before it's absorbed Links and Resources Mentioned Oski, F. A. (1993). Iron deficiency in infancy and childhood. New England Journal of Medicine, 329(3), 190–193. https://doi.org/10.1056/NEJM199307153290308 Wang, Y., Adekolurejo, O. O., Wang, B., McDermott, K., Do, T., Marshall, L. J., & Boesch, C. (2024). Bioavailability and excretion profile of betacyanins - Variability and correlations between different excretion routes. Food Chemistry, 437(Pt 1), 137663. https://doi.org/10.1016/j.foodchem.2023.137663 Watson, W. C., Luke, R. G., & Inall, J. A. (1963). Beeturia: Its incidence and a clue to its mechanism. British Medical Journal, 2(5363), 971–973. https://doi.org/10.1136/bmj.2.5363.971 Wiczkowski, W., Romaszko, E., Szawara-Nowak, D., & Piskula, M. K. (2018). The impact of the matrix of red beet products and interindividual variability on betacyanins bioavailability in humans. Food Research International, 108, 530–538. https://doi.org/10.1016/j.foodres.2018.04.004 Menstrual Health Intensive - my class with Liane Moccia, in case you're interested! The 1963 paper is open access; the others may take some scouting to find full text. Stay in Touch If you're not already on my Practitioner Notes newsletter, I send it out every Thursday with things we don't cover here on the podcast. You can sign up at camillefreeman.com or intheclinic.com. Thanks so much for the work that you do!