Running Out of Steam? 2 Reasons Why Your Doctor Didn’t Tell You to Take More Iron

If you’ve ever made an appointment with your doctor to discuss fatigue, brain fog, heavy periods or a loss of your healthy stamina, she probably checked you for anemia, and for good reason. Women lose blood and iron with every period, and as many as 90% of us don’t consume enough iron to meet our daily needs. A host of other factors can further deplete our iron stores, including pregnancy and breastfeeding, gluten or other food intolerances, intense athletics, irritable bowel syndrome, or giving blood frequently. Iron deficiency can bring on irritability, painful periods, poor memory, brittle or pitted nails and a pale complexion. Low iron can decrease your chances of getting pregnant. It also makes your hair fall out, which is iron deficiency’s #1 most unpopular symptom!

“Your Blood Tests Came Back Normal”

It’s often helpful to have your blood work interpreted through a second set of eyes, especially when it concerns nutrients such as iron. On a regular basis, I see results that support a diagnosis of iron deficiency in symptomatic women who have been reassured that all was well within normal range. You can request a copy of your lab work and look for the following two important but different measures of iron status:

1. Hemoglobin (Hb): this value determines whether or not you have anemia, or can donate blood. In non-pregnant women, a normal hemoglobin level is between 120 g/L and 160 g/L. During pregnancy, hemoglobin may decrease slightly. Anemia in pregnancy is diagnosed if hemoglobin is below 110 g/L in the first and third trimesters, or 104 g/L in the second trimester.

2. Ferritin: this is the best measure of your iron stores. It may or may not have been included in your blood work. If it was, it’s still possible that your iron deficiency was missed. That’s because not all medical labs are reporting updated ranges, and not all health practitioners are looking for optimal wellness. Conventional practitioners are trained to identify and treat disease (and that’s great, because we do need them to do this!) while your naturopathic doctor is trained to help you find your best health. In my experience, most women feel their best when their iron stores (ferritin) falls in the range of 70-100 mcg/L. In fact, as some lab reports are currently indicating, if your ferritin is less than 50 mcg/L, you probably have iron deficiency. However, you may not have been encouraged to take iron supplements unless your ferritin level fell to below 11 mcg/L.

You can have iron deficiency without anemia. 

Iron deficiency can hold you back from feeling your best, and can progress to anemia. Your body tries to conserve iron efficiently, but any condition that either:

  • decreases your ability to absorb iron;
  • increases your body’s need for iron; or
  • increases your loss of iron

…can easily lead to iron deficiency. Pay special attention to your iron status if you:

  • Are pregnant, breastfeeding, or are considering becoming pregnant
  • Follow a vegetarian or vegan diet
  • Have heavy periods
  • Have low stomach acid
  • Donate blood frequently
  • Have had a chronic illness
  • Have celiac disease, food sensitivities, ulcers, have had surgery, or any other source of bleeding or inflammation in your gastrointestinal tract

Do You Need More Iron?

To find out how much iron you need, how to get the most out of your iron supplements, and how to spot iron deficiency symptoms in your children, download my article, Iron: the nuts & bolts of it.