Feeling tired, hair thinning, or struggling with brain fog are symptoms of low iron. It鈥檚 true – you don鈥檛 have to be anemic to show symptoms. Iron deficiency is a common women鈥檚 health issue that is often overlooked. In Ontario, approximately 40% of women, girls, and people with reproductive capacity have iron deficiency, according to . Monthly menstrual blood loss increases the risk of iron deficiency for women. During pregnancy, increased demands for iron can also increase the risk of low iron.
But how do you know if you’re getting enough iron? Traditional blood testing practices can miss some cases of iron deficiency, but new guidelines by many health organizations, including in Canada, should help more women identify iron deficiency.
Let鈥檚 explore how the Canadian health care system is changing how it looks at iron levels in women, symptoms to watch for, and the best food sources of iron. For those looking for iron supplement recommendations, learn about ideal dosing based on emerging evidence.
Anemia is a condition where there are not enough red blood cells carrying oxygen around the body, and can cause you to have a variety of symptoms, such as feeling tired, dizzy, or having cold hands or feet. While iron deficiency won鈥檛 show up in a blood test the same way anemia does, it can cause similar symptoms. New guidelines from the suggest 50 ng/mL or less for those with heavy menstrual bleeding or other risk factors including vegan diet or long-term antacid use for reflux.
Iron may be best known for its role in producing hemoglobin, the protein in red blood cells that carries oxygen throughout the body. It also is important for brain function. Both memory and concentration can be impacted by low iron levels. Some women prone to low iron levels have reported brain fog as a common sign they need to check their iron levels. However, it鈥檚 important to be aware there are many signs of low iron to watch for, including having cold hands or feet.
Iron deficiency is usually associated with fatigue, but women need to be aware that it can cause many symptoms, including:
Women鈥檚 risk of iron deficiency can increase when blood loss is higher, or the body鈥檚 need for iron is greater.
Heavy menstrual bleeding is a significant risk factor for iron deficiency. Blood loss greater than 80 mL per menstrual cycle is considered heavy. An estimated 18%鈥�50% of females meet criteria for heavy menstrual bleeding, which is often underdiagnosed and undertreated.
Women are at greater risk of iron deficiency during reproductive stages:
It is possible to correct low iron levels or deficiency, one of the three most common nutrient deficiencies in the world, according to the .
The best way to identify iron deficiency is with blood tests. Commonly, ferritin levels are used as it is a marker of the body鈥檚 iron stores. To improve earlier detection of low iron levels, the Ontario medical system recently changed the minimum ferritin level. Ferritin levels below 30 碌g/L indicate depleted iron stores. Women with heavy menstrual bleeding should be looking to improve their ferritin levels if they fall below 50 ug/L.
The move to update testing thresholds is helping identify iron deficiency earlier, opening opportunities to support the woman in rebuilding her iron stores before major deficiencies or anemia occurs.
There鈥檚 a difference between a blood test result that comes back 鈥渘ormal鈥�, and what are optimal levels. If symptoms or risk factors are present, it is important to work with a healthcare professional to carefully analyze results to reduce the risk of developing deficiencies.
Individual factors, such as age, menstrual status, dietary restrictions, and pregnancy, can impact a woman鈥檚 daily dietary needs for iron. According to , women aged 19-50 should consume at least 18mg of iron per day. During pregnancy, the suggested daily intake increases to 27mg per day. For women who already have low iron stores or iron-deficiency anemia, they may require a different approach to restore iron levels.
Unfortunately, iron intake from food isn鈥檛 as simple as eating more of one thing or another. There are different forms of iron available in food, and factors that inhibit and support its absorption.
Foods such as tea, coffee, calcium-rich foods, and calcium supplements can also reduce iron absorption, and are best avoided close to when taking an iron supplement.
To improve the body鈥檚 ability to absorb iron from foods, pair them with foods that contain vitamin C, such as bell peppers, broccoli, or citrus fruits. For example, for optimal iron absorption from spinach in your salad, add raspberries or bell peppers. If steak is on the menu, serve with a side of broccoli.
Not every woman needs an iron supplement, as many can meet their requirements through a balanced diet. However, for women with heavy menstrual bleeding, pregnancy or other factors, they may need supplementation. Blood tests can help you better understand your needs. Women with confirmed iron deficiency should discuss the appropriate dose, duration, and follow-up testing with a healthcare professional.
If supplementation is recommended, suggests that taking oral iron on alternate days may improve iron absorption in some women. The study found women with iron-deficiency anemia had 40-50% higher iron absorption when iron supplementation was done on alternate days instead of consecutive days.
Alternate-day dosing may be worth discussing with a healthcare professional, particularly if daily iron causes gastrointestinal discomfort.
Consider the type of iron, as they differ in their elemental iron content, tolerability, and formulation.
Iron bisglycinate: An iron chelate researched in over 17 randomized clinical trials. The suggests iron bisglycinate supplementation results in higher hemoglobin concentrations in pregnant women and fewer reported GI adverse events than other forms. As such, it may be a suitable option for people who experience gastrointestinal side effects with other forms.
Ferrous sulfate: A widely used, well-studied and often cost-effective option for treating iron deficiency. However, it can cause constipation, nausea, or other gastrointestinal symptoms in some people. Of note, a study noted once daily may be as effective as twice daily dosing.
When evaluating different iron supplements, it鈥檚 helpful to compare the amount of elemental iron it offers, consider any gastrointestinal concerns, and select a dose based on your needs and your healthcare professional’s recommendations.
Where possible, improve absorption by taking iron with a vitamin C source. Some iron supplements will include vitamin C or bioflavonoids. Avoid taking an iron supplement at the same time as coffee, tea, dairy products or calcium supplements, as these can interfere with absorption.
Always read supplement labels carefully and follow product directions and professional advice. Monitor your progress and evaluate with follow-up bloodwork to determine if dose or treatment duration needs adjustment.
Turn your interest in women鈥檚 health into a rewarding career. Explore CSNN鈥檚 Natural Nutrition Program through flexible distance education today. Discover how nutrition education can open the door to a rewarding path in holistic nutrition.
.
.
