Feeling constantly tired and lacking energy can significantly impact your daily life and overall well-being. MANY factors can lead to fatigue, but one common culprit, especially among women, is low iron levels.
Iron is a mineral found in every cell of the body, vital for producing red blood cells and energy. In this blog post, we will explore the connection between iron deficiency and fatigue, the importance of testing your iron levels, and effective ways to boost your iron intake to regain your energy and vitality.
Understanding Iron and Its Role in the Body
Iron plays a crucial role in energy production and metabolism. It is a key component of haemoglobin, a protein in red blood cells that transports oxygen to tissues for ATP (adenosine triphosphate) production, the body’s energy currency. Iron also serves as a vital co-factor in the electron transport chain within the mitochondria of our cells, where most energy (ATP) is generated.
Without adequate iron, these processes are impaired, leading to decreased energy production and metabolic efficiency, which can result in fatigue and weakness. Furthermore, it plays a role in growth and development, immune function, wound healing, and can impact the production of hormones.
Causes of Iron Deficiency
Anemia and non-anemic iron deficiency are still prevalent in the developed world. Iron deficiency is especially common among children, women of childbearing age, and during pregnancy.
According to a 2016 World Bank Development Indicator for Singapore, 22% of non-pregnant women aged 15-49 experienced anemia, while 31% of pregnant women were affected. Rates are similar in the USA depending on race. A 2023 US national survey revealed that up to 40% of females aged 12 to 21 may be iron deficient with a criterion of ≥25 μg/L, while 17% were ≥15 μg/L.
Factors that can contribute to low iron levels may include:
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- Poor dietary intake
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- Increased iron needs (e.g., pregnancy, growth spurts)
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- Blood loss (menstruation, uterine fibroids surgery, injury)
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- Medical conditions affecting iron absorption (e.g., celiac disease, Crohn’s disease)
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- Obesity
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- Intense athletic training
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- Frequent non-steroidal anti-inflammatory drugs (NSAIDS) use
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- Frequent blood donor
Symptoms of Iron Deficiency and Fatigue
Iron deficiency can manifest in various symptoms. Common indicators of low iron levels include persistent tiredness, weakness, dizziness, and pale skin. Fatigue resulting from iron deficiency can impair both physical and mental performance, making everyday tasks challenging and affecting overall quality of life.
It’s essential to address these symptoms promptly by investigating if there is an iron deficiency before taking a supplement. Based on my personal experience with anemia (≥12 μg/L), I encountered extreme dizzy spells and low energy, which were not pleasant. Therefore, it’s vital to advocate for yourself and not allow anyone to dismiss your symptoms.
Diagnosing Iron Deficiency
If you experience symptoms suggestive of iron deficiency, it’s advisable to consult a healthcare professional. Additionally, individuals that have any of the above-mentioned risk factors or follow a vegan or vegetarian diet should have their iron levels checked.
Healthcare providers can order various iron tests to better understand the results. These tests include:
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- Serum iron test, which measures the amount of iron in the blood
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- Transferrin test, which measures transferrin, a protein that moves iron throughout the body
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- Total iron-binding capacity (TIBC), which measures how well iron attaches to transferrin and other proteins in the blood
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- Ferritin test, which measures how much iron is stored in the body
It highly recommended to ensure that a ferritin test is included. The healthcare practitioner may also include folate and B12 since they are essential nutrients for healthy red blood cell production. For example, low iron can be due to a folate deficiency.
Ferritin levels ≤12 μg/L are considered as anaemic. However, does that mean anything above 12 μg/L is all good? The answer is no! Levels ≤30 μg/L are considered insufficient while levels ≥50 μg/L are optimal. Symptoms of low ferritin can vary between individuals with some experiencing little to none while others may feel tired or unfocused. A study found that levels below 50 μg/L may impact energy levels but women with levels ≤30 μg/L were most affected.
Preventing and Managing Iron Deficiency Fatigue
It is vital to consume enough iron to prevent low iron levels. Dietary iron is present in the form of heme iron from animal foods and non-heme iron from plant and animal foods. Heme iron is more bioavailable than non-heme iron. The absorption rate of heme iron is approx. 25% while the absorption rate from non-heme iron is approx.17%.
Heme iron is not affected by factors that inhibit absorption like phytates. Despite the differences between plant and animal iron, vegetarians and vegans can meet their iron needs. The body also increases iron absorption when stores are low and reduced absorption when stores are high.
| Heme Iron | Non Heme Iron |
| Occurs in oysters, red meat, poultry, beef liver, and fish | Occurs in beans, nuts, lentils, and green leafy vegetables |
| Absorption rate is high | Not well absorbed |
| EXCESS heme iron can cause health risks | Does not cause health risks |
Here are a few tips to meet your iron needs:
1. Eat an adequate number of calories
2. Achieve a healthy body weight
3. Consume coffee or tea 1 hour before a meal or 2 hours after a meal (consuming vitamin C can help to offset the effects).
4. Do not take a calcium supplement with meals
5. Consume fortified foods like breakfast cereals if diet is inadequate
6. Consume iron enhancers with meals
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- Vitamin C from citrus fruits, red pepper, watermelon, broccoli, tomato juice, brussels sprouts etc.
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- Citric acid from lemon or lime
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- Sulphur-rich allium species like onion and garlic
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- Cooke with amchur (mango powder)
7. Consume Iron rich plant foods:
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- Legumes (lentils, chickpeas, beans)
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- Tofu and tempeh
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- Dark leafy greens (spinach, kale, Swiss chard)
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- Whole grains (quinoa, brown rice, oats)
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- Dark chocolate
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- Canned tomatoes
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- Sweet potato
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- Almonds and cashews
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- Mint, iron, cilantro (coriander)
8. Go easy on the wine and alcohol consumption
9. Get enough sleep! (yes, sleep impacts EVERYTHING even iron levels)
10. Eat a varied plant-based diet or lean unprocessed meats
11. Consume lean meat or other animal foods if they are part of your diet
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- Chicken, sardines, or any other lean meat
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- Organ meats
Iron in Foods Chart
| Food | Portion Size (approx.) | Amount of Iron |
| Haem sources | ||
| Beef liver | 85 g | 5.2 mg |
| Beef-ground | 85 g | 2.2 mg |
| Canned clams | 85 g | 23.8 mg |
| Chicken breast | 85 g | 1.1 mg |
| Chicken liver | 85 g | 10.8 mg |
| Fish, tuna canned | 85 g | 1.3 mg |
| Lamb | 85 g | 3.0 mg |
| Large egg | 1 | 1.0 mg |
| Oysters | 85 g | 13.2 mg |
| Pork | 85 g | 2.7 mg |
| Sirloin steak | 250 g | 1.6 mg |
| Shrimp | 85 g | 2.6 mg |
| Salmon | 100 g | 1.28 mg |
| Tofu | 100 g | 8 mg |
| Turkey, dark meat | 85 g | 2.0 mg |
| Turkey, light meat | 85 g | 1.1 mg |
| Non-haem sources | ||
| Greens/veggies: | ||
| Beets, canned | 64 g | 1.5 mg |
| Brussels sprouts | 64 g | 2.0 mg |
| Collards or beet | 64 g | 1.2 mg |
| Dried thyme | 5 g | 1.2 mg |
| Greens | 125 g | 2.2 mg |
| Mushrooms | 64 g | 1.4 mg |
| Peas, frozen | 64 g | 1.2 mg |
| Potato, baked with skin on | Medium size | 1.9 mg |
| Swiss chard | 64 g | 2.0 mg |
| Spinach, cooked/raw | 64 g/128 g | 3.0 mg |
| Sweet potato, baked with skin on | Medium size | 1.1 mg |
| Sauerkraut, canned | 64 g | 1.7 mg |
| Tomato Sauce | 64 g | 1.3 mg |
| Nuts | ||
| Almonds or pistachios | 32 g | 1.3 mg |
| Walnuts | 85 g | 1.0 mg |
| Dried peaches | 64 g | 1.6 mg |
| Dried raisins | 64 g | 1.4 mg |
| Dried plums | 64 g | 1.3 mg |
| Dried apricots | 64 g | 1.2 mg |
| Pine or cashews | 85 g | 1.6 mg |
| Prune juice | 125 g | 3.2 mg |
| Strawberries | 1 pint | 1.5 mg |
| Beans: | ||
| White | 100 g | 5.8 mg |
| (Black, pinto) | 64 g | 1.6–1.8 mg |
| (Kidney, lima) | 64 g | 2.6–3.9 mg |
| Soybeans | 64 g | 4.4 mg |
| Tofu, firm | 64 g | 3.4 mg |
| Chickpeas | 100 g | 2.4 mg |
| Double beans (cooked) | 125 g | 4.5 mg |
| Tomato (sun-dried) | 125 g | 4.9 mg |
| Soy milk | 300 ml | 2.7 mg |
| Quinoa | 125 g | 2.8 mg |
| Kale | 125 g | 1.1 mg |
| Grains: | ||
| Lentils | 64 g | 3.5 mg |
| Pumpkin seeds | 28 g | 4.2 mg |
| Cereal | 64 g | 2–12 mg |
| Oatmeal | 64 g | 1.7 mg |
| Oatmeal, instant fortified with iron | 64 g | 5.0 mg |
Plant Food Combinations
*Lemon juice in sauteed leafy greens, in bean soup or dip, squeezed over a curry, or in cashew sour cream
Iron Supplements
Do not take an iron supplement without checking your iron levels. Iron metabolism differs from other metals in that there is no physiologic mechanism for iron excretion. Women tend to have lower levels than men due to having periods.
Supplementation without knowing your levels can easily create an imbalance, so make sure to take supplements as directed by a healthcare provider to determine the correct dosage and duration.
Furthermore, iron is a pro-oxidant, and high iron stores have been linked to chronic diseases such as heart disease. Additionally, supplementing with an excessive amount of one nutrient can cause a deficiency of another, like copper.
Vegan and Vegetarian Blood Donation
Yes! Vegans and vegetarians CAN donate blood. Check out this great article on blood donation to learn more- https://healthfulforu.com/health/nutrition-optimisation/
Conclusion
Iron deficiency is a common but often overlooked cause of fatigue that can significantly impact your daily life and overall well-being. Understanding the role of iron in the body, recognizing the symptoms of deficiency, and knowing when to seek medical advice are crucial steps in managing your energy levels.
By incorporating iron-rich foods into your diet and following strategies to enhance iron absorption, you can effectively prevent and combat iron deficiency. Always consult with a healthcare professional before starting any supplementation to ensure it’s necessary and safe for your specific health needs. Prioritizing your iron levels can lead to better energy, improved focus, and a higher quality of life.
