Vital Grace: Why Are So Many Women Low in Iron?

DR.vegan

Feeling tired has almost become part of everyday life. While juggling work, school, relationships, and workouts, it is easy to think that feeling tired is simply the result of a hectic schedule. Many women often dismiss symptoms like fatigue, low energy, poor concentration, and brain fog. But sometimes, feeling constantly drained may have another explanation: low iron. 

Iron deficiency is one of the most common nutritional deficiencies worldwide, and women are particularly vulnerable. Many causes of iron deficiency include menstruation, pregnancy, eating habits, and certain health problems. But because many early symptoms mirror the appearance of stress and tiredness, iron deficiency can easily go unnoticed.

According to Yale Medicine hematologist Dr. Layla Van Doren, women of childbearing age bear much of the burden of iron deficiency. This is mainly because menstruation results in regular blood and iron loss. These studies have noted that nearly a third of women of childbearing age in America are iron deficient.

Why Iron Matters:

Iron may be a micronutrient, but it plays a significant role in the body.

One of the main roles of iron is the creation of hemoglobin. This is the substance in blood cells that enables blood to transport oxygen throughout the body. Additionally, iron supports proper muscle function, immunity, DNA production, and other activities needed to ensure normal body function. 

Iron deficiency develops when iron intake falls short of iron loss. However, iron deficiency and iron-deficiency anemia differ. A person can have reduced amounts of iron before their hemoglobin level falls to the level associated with anemia.

As Dr. Van Doren states, most symptoms connected with iron deficiency, not anemia, are "nonspecific and vague." For instance, fatigue, foggy thinking, depression, restless legs, hair thinning, and brittle nails can all be observed.

The ambiguity is part of what makes this condition so difficult to diagnose. A woman who finds it difficult to work may think that she is stressed. A person who wakes up tired may think it is necessary to sleep more. Someone who notices that workouts suddenly feel harder may simply assume they are out of shape.

Nevertheless, after some time, symptoms may call for a more careful investigation.

Why Women Are Especially Vulnerable: 

The difference in iron requirements between men and women is mainly due to menstruation. 

Women lose blood with each menstrual period, and blood is a source of iron. Under normal circumstances, a woman gets the iron she needs from her diet, but heavy or prolonged menstrual cycles can make it harder.

"The degree of iron deficiency depends on the amount of blood lost each month from menstruation," Dr. Van Doren explains.

Women with heavy menstrual bleeding therefore have a significantly higher risk of iron deficiency. One of the causes of excessive bleeding is uterine fibroids, so it is crucial to not only restore iron but also determine the cause of this blood loss.

However, the risk is not limited to menstruation. Iron needs change considerably at different ages of a woman’s life. Women aged 19-50 are recommended to consume approximately 18mg of iron daily. During pregnancy, this number rises to 27mg due to the growing fetus's need for iron and changes in the mother's blood volume.

Thus, the time before a woman becomes pregnant is essential.  

“If a woman begins pregnancy iron deficient, then it's going to be very difficult for her to make that up throughout her pregnancy," said Dr. Van Doren to Yale Medicine.

After childbirth, blood loss during delivery and the demands of postpartum recovery can create additional challenges, especially for those women whose iron stocks were low before pregnancy.

Diet Matters, But It Is Not the Whole Story:

We get most iron from our diet; however, that doesn't mean absorption is equally effective regardless of how we get it.

Heme iron, which can be found in animal food products such as meat and seafood, is absorbed more successfully than non-heme iron, which can be found in food sources such as lentils, beans, spinach, nuts, and fortified grains.

This does not mean that women following vegetarian or vegan diets will automatically become iron deficient, but they may need to pay closer attention to meeting their iron needs.

Nonetheless, many factors can affect iron absorption. Iron-rich foods combined with vitamin C increase its absorption. At the same time, some compounds in foods can interfere with iron absorption, which means dietary patterns can matter as much as the amount of iron listed on a nutrition label.

However, diet is only one way to get iron; other causes of iron deficiency include heavy menstruation, digestive disorders, regular blood donations, or pregnancy.

When Fatigue Is Worth Mentioning:

Occasional tiredness is normal. However, chronic fatigue that doesn't improve after rest or a change in routine is different.

If tiredness occurs along with symptoms like weakness, dizziness, inability to concentrate, breathlessness, palpitations, restless legs, or unusual changes in hair/nails/very heavy periods, see a physician.

A blood test can help determine whether iron levels are low. Ferritin, the protein that has the function of storing iron, is one of the most commonly used methods of checking how much iron is in a person’s system. Hemoglobin levels can help determine if anemia has occurred.

Treatment should be chosen based on the severity of the deficiency and its cause. While some people may improve simply by eating the right foods and taking oral supplements, those who have suffered significant blood loss or have problems absorbing iron may need intravenous iron. Moreover, oral forms of iron are often accompanied by side effects like nausea and constipation, which is another argument against the idea that supplements can solve all the problems.

Most importantly, persistent fatigue should not automatically be accepted as a normal part of being busy.

According to Dr. Van Doren, women often refrain from mentioning their health complaints to their doctors because they believe that their problems are part of normal life. They might believe that excessive bleeding is a trait that runs in the family, while chronic tiredness is a common characteristic among friends, colleagues, and other women of a similar age. However, common doesn't mean it's something to ignore.

Iron deficiency is especially common among women because several factors can overlap throughout different stages of life. These include continuous blood loss from menstruation, increased iron demand during pregnancy, dietary habits, and diseases that affect iron absorption. These factors can overlap and make iron deficiency even more common among certain women. Because symptoms like exhaustion and concentration problems are easily mistaken for a busy life, this condition may go unrecognized for a long time. 

Understanding iron deficiency is not about assuming that every tired day is caused by low iron. Rather, it is about recognizing the factors that make women particularly vulnerable and knowing when persistent symptoms deserve more attention. Menstruation, pregnancy, and diet are normal parts of many women's lives, but their effects on iron levels should not be overlooked. Paying attention to these changes and speaking with a healthcare professional when fatigue or other symptoms persist can help women better understand what their bodies may need.