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Iron deficiency anemia in women

Fatigue, weakness, shortness of breath, dizziness, poor concentration, headaches, pale skin, and a decrease in the ability to do exercise can be an indicator that you are iron deficient. Iron is a necessary component to hemoglobin, the protein portion of red blood cells that functions as an oxygen carrier. Hemoglobin has the fun job of transporting oxygen to the tissues, and removing carbon dioxide from these same tissues back to the lungs. When your body is low in iron and unable to create enough hemoglobin, symptoms may arise from this oxygen deficit.

So, how might you become iron deficient?

1. Menstruation: Iron is lost with every menstrual period, making iron deficiency a common concern of all menstruating woman. Women with heavy periods, long periods, short cycles (frequent periods), or spotting may be at an increased risk of iron loss.

2. Pregnancy: Pregnant woman can be at risk of iron deficiency due to an increased need to support additional red blood cells.

3. Vegans/vegetarians: Iron is a mineral found primarily in animal protein sources (meat, fish, poultry). For vegan or vegetarian woman, this puts them at an increased risk of deficiency due to lower accessibility of iron rich foods. These groups are also at an increased risk of B12 deficiency.

4. Decreased absorption: Digestive concerns (Ex. Celiac disease, gastrectomy etc.) and certain medications can lead to decreased absorption in the small intestine.

5. Inadequate intake: Picky eaters, eating disorders, and diets low in animal protein can lead to low iron intake.

6. Blood loss: This can include blood lost in digestive disorders, internal bleeding and frequent blood donation.

7. Exercise: For the female athlete, exercise-induced haemolysis is an additional cause of iron deficiency. This is especially seen in marathoners due to the constant pounding on pavement.

8. Inflammation: Research suggests that acute inflammation caused by intense exercise stimulates the expression of hepcidin. Hepcidin is a hormone regulator of iron homeostasis that has been associated with iron deficits.

If you are curious whether you’re deficient in iron, have your doctor run a blood test. Iron deficiency anemia is indicated on blood work by decreased hemoglobin, decreased hematocrit, decreased ferritin (stored iron), and smaller, paler red blood cells. The degree of deficiency can help you determine whether it’s worth taking an iron supplement or if food sources will suffice.

Tips for improving iron status:

-Take a heme (animal source) or non-heme (non-animal source) iron supplement

-Improve the absorption of non-heme iron by consuming it with citrus

-Cook your food in a cast-iron pan or use an iron fish (

-Eat foods high in heme iron: oysters, red meat, chicken

-Eat foods high in non-heme iron: leafy greens, soybeans, kidney beans, lentils, blackstrap molasses

-Avoid consuming iron with things that decrease iron absorption: black tea, coffee, mint, chocolate, chili, milk thistle, antacids, and proton pump inhibitors

Other medical conditions and anemias can present similarly to iron deficiency anemia, so it is important to talk to your doctor and get the required testing done before supplementing on your own.

Dr. Michelle Hislop ND


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