Nutrients for women – Iron

Nutrients for women – Iron

Are you “just tired” or are you low in iron?

Iron is the number one nutrient deficiency experienced by women, especially premenopausal women, causing many symptoms we often attribute to just living a busy life.

Fortunately, low or deficient iron levels are relatively easily diagnosed, and once they are addressed, can make a big difference to how you feel physically.

Let’s look into the what and why of iron for female hormonal and general health.

Firstly, why do we need Iron?

Optimal iron levels (not too little, not too much) are important for women of all life stages, particularly from teenage years up until perimenopause. This is because the body uses iron to make the red blood cells that transport oxygen around your whole body via the bloodstream. 

Iron is also needed for cellular energy production, a strong immune system, the metabolism of carbohydrates and protein, protection against free radical damage, and gastrointestinal motility.

Low or deficient iron levels mean your body doesn’t have enough for its needs which can bring on many symptoms and health issues. 

It’s pretty important, right?

What are the signs and symptoms of low iron?

  • Chronic, constant tiredness
  • Weakness
  • Poor work performance
  • Negative mood states
  • Reduced resistance to infection
  • Irritability
  • Feeling cold/intolerance to cold
  • Poor concentration
  • Dizziness
  • Headache
  • Exercise-induced heavy/laboured breathing (dyspnoea)
  • Pale skin, inside the lower eye, mouth, nail beds
  • Ridged, spoon-shaped, thin flat nails
  • Brittle hair
  • Reduced thyroid function and capacity to make thyroid hormones
  • Cracking at mouth corners
  • Preterm birth
  • Restless leg syndrome

The symptoms above can be varied and multiple as Iron depletion occurs progressively if it isn’t diagnosed and addressed. The stages are as follows: 

  • Stage 1 – iron deficiency: iron stores in the bone, liver and spleen are depleted.
  • Stage 2 – iron deficient non-anaemia: red blood cell production diminishes as iron supply is reduced.
  • Stage 3 – iron deficient anaemia: haemoglobin production falls resulting in anaemia.

What causes low iron levels?

Insufficient dietary intake

  • Vegan
  • Vegetarian
  • Low carbohydrate intake
  • Low energy/calorie diets

Increased demand

  • Growth periods (adolescence, pregnancy)
  • Physical activity (particularly frequent high-intensity endurance exercise).

Increased losses

  • Blood losses (heavy menstrual bleeding, haemorrhoids, parasites, peptic ulcers, Helicobacter pylori infection, NSAID-induced, hookworm, postpartum haemorrhage)
  • Sweating.

Poor absorption

  • Caused by conditions including coeliac disease, atrophic gastritis, Helicobacter pylori, peptic ulcer, inflammatory bowel disease
  • Other micronutrient deficiencies (vitamin B12, folate, riboflavin)


  • Hypothyroidism
  • Hashimoto’s thyroiditis (due to autoimmune gastritis that is common in this condition impairing iron absorption)
  • Uterine fibroids
  • Infections (HIV, cancer)
  • Obesity (due to inflammation reducing absorption)


  • Proton pump inhibitors, 
  • NSAIDs
  • Salicylates
  • Glucocorticoids
  • Anticoagulants

Can I get my levels tested?

To get an accurate diagnosis of current iron status, the following measurements should be taken and the results need to be accurately assessed:

  • Serum ferritin
  • Serum iron
  • Transferrin saturation
  • Total iron-binding capacity
  • Haemoglobin

How often you get tested is dependent on several factors, but a general guide is below:

Yearly: if there is no history of the following:

  • iron deficiency
  • low dietary iron intake
  • irregular menstrual cycles
  • absence of iron-deficient symptoms
  • underlying pathologies

Biannually: if in the last 2 years there has been:

  • stage 1 iron deficiency
  • irregular menstrual cycles
  • high training loads

Quarterly: if in the last 2 years there has been:

  • stage 1, 2 or 3 iron deficiency
  • high training loads
  • presence of irregular menstrual cycles
  • ongoing fatigue (or other symptoms associated with low iron levels),
  • low dietary iron or energy intake.

Who can benefit from Iron?

It’s easy to conclude that anyone who has been diagnosed with low or deficient levels of iron needs to increase their intake and address the underlying factors.

Individuals at particularly high risk of low or deficient levels include;

  • Young children
  • Adolescents
  • Women during child-bearing years
  • Pregnant women

Where can I get iron from?

Haem iron sources

Non-haem iron sources

  • Red meat
  • Chicken
  • Fish
  • Oysters
  • Clams
  • Shellfish
  • Egg yolks
  • Nuts
  • Legumes
  • Beetroot
  • Tofu

*Food substances that can enhance the absorption of iron include

  • Vitamin C-rich foods (citrus, capsicum, leafy greens, tomatoes)
  • Meat (when eaten with non-haem food sources)

For individuals diagnosed with low or deficient iron levels, appropriate forms and doses of oral supplementation or blood iron infusions may be appropriate.  

Are there any side effects or interactions with supplemental iron?

Too much iron in the body can be toxic so it is vital that supplemental iron is only taken if iron deficiency is diagnosed.

Signs of iron overload include vomiting, bloody diarrhoea, liver toxicity, shock, and impaired consciousness.

If iron supplements are prescribed, they tend to be tolerated better when taken with food, must be taken at the recommended dose and two hours away from substances that can interfere with its absorption including;

  • Medications (ACE inhibitors, antacids, cimetidine, erythropoietin, anti-ulcer drugs, L-dopa, omeprazole, penicillamine, quinolone or tetracyclic antibiotics, sulfasalazine, thyroxine)
  • Dairy products
  • Eggs
  • High-tannin tea (green, raspberry leaf, bilberry – adding milk to tea may reduce this iron-binding effect)
  • Phytates (found in whole grains and legumes)
  • Oxalic acid (spinach, chard, chocolate, berries, tea)
  • Zinc supplements.

If you’re unsure if it is your busy life making you tired or you ticked off some of the other symptoms listed above, click here to book an appointment with me. 

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