Around a third of women under 50 are iron-deficient, yet most of us have no clue what that actually means or what to do about it.
So we tapped functional medicine and nutrition specialist Leona West Fox to explain iron deficiency, including the common symptoms, misconceptions, and tips for people with low iron.
“It means a person does not have enough iron to produce hemoglobin, a protein in red blood cells that is responsible for bringing oxygen to the tissues and organs throughout the body.”
Why is it so common in women? And what causes it?
“It’s common in women because of menstruation, which results in monthly blood loss, as well as during pregnancy, when there is an exponential demand for iron week by week to support the growth of the baby,” Leona says.
Those are the two main causes, although Leona notes that things like genetic predispositions, gut-related issues, or other underlying health issues can also impact iron levels.
What are some common symptoms?
“The number one symptom is usually fatigue or just overall low energy levels,” Leona says. “I have also seen low iron impact a person’s overall mood, well-being, and motivation. Over time, it can cause weak hair, weak nails, and pale skin. With extreme anemia, a person can also feel dizzy, very weak, and short of breath.”
If you think you may have low iron, ask your doctor to run these labs: CBC panel, total iron, and ferritin.
“It’s always worth erring on the side of working with your doctor or a nutritionist, as the faster iron levels are supported, the better,” Leona says. “When anemia has gone on for a long time it can take longer to treat. If any of these symptoms are present in pregnancy, a woman should reach out to her doctor immediately.”
Common misconceptions about iron deficiency:
Below, Leona sets the record straight.
Misconception: A poor diet is always the culprit.
Truth: “While poor diet is a leading cause, many people become iron deficient due to other factors such as genetic predispositions, gut-related issues, heavy menstrual periods, or underlying conditions,” Leona explains. “Nutritional deficiencies, like low B12, can also impact iron metabolism and its delivery to cells.”
Misconception: Low iron or anemia is not a serious concern.
Truth: “In reality, it can significantly affect a person’s physical, mental, and emotional health and should be treated as a priority,” Leona says. “Women who are trying to become pregnant should also check their iron levels, as anemia can reduce the chances of conception (an often overlooked fact).”
Tips for People with Low Iron Levels
1. Eat iron-rich foods.
But first, know that there are two types of iron sources—and one has a much higher absorption rate and bioavailability.
“Heme iron comes from animal sources and has an absorption rate of 20% to 30%,” Leona says. “Non-heme iron is from plant sources, and the absorption rate can be as little as 5% and up to 20%. Ideally, we need to be getting iron from both heme and non-heme sources.”
Good sources of heme iron:
Red meat
Liver
Chicken
Turkey
Fish
Eggs
Good sources of non-heme iron:
Leafy greens
Beans
Some nuts and seeds
“If a person does not consume heme iron foods, such as in a vegan diet, they will need to consume more non-heme iron sources to meet their iron needs,” Leona says. “It’s important to understand that raising iron levels may take longer, and supplementation will likely be necessary and may need to be continued for an extended period.”
2. Pair iron with vitamin C.
“Just to reiterate, vitamin C enhances iron absorption, so pairing vitamin C-rich foods with iron-rich foods and iron supplements is ideal,” Leona says. “B vitamins also support iron absorption, but iron-rich foods are often also rich in B vitamins, so they’re naturally paired together.”
3. Take care of your gut.
“Overall, our absorption and utilization of iron is only as good as our gut health, no matter our diet or supplements. So improving gut health will also be an important, although sometimes overlooked, factor in optimizing iron levels,” Leona says.
4. Don’t take it with calcium.
“High doses of calcium should be taken separately from iron supplementation, as calcium can slow down iron absorption,” Leona explains.
5. Follow dosage instructions very carefully.
“Never take more than the recommended dose daily. This is very important,” Leona says. If you take too much, iron can build up in your body and cause health problems.
Along with this, Leona recommends retesting iron levels every one to three months during supplementing to monitor your progress and see when you can reduce or stop supplementation.
“Generally, though, if a woman is menstruating monthly, I have rarely—if ever—seen iron levels get too high through supplementation,” she says. “Conversely, high iron levels in men and non-cycling and post-menopausal women can be more common.”
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