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Iron deficiency (ID) can be summarised as a shortage of iron intake or absorption within the body. If left untreated, iron deficiency can lead to iron deficiency anaemia (IDA), a condition in which the lack of iron means that we can’t produce haemoglobin (red blood cells) which are vital to helping carry oxygen around the body.
Iron deficiency and iron deficiency anaemia are among the most common nutrient deficiencies amongst women of reproductive age1.
In fact, iron deficiency is a global public health problem, with adolescence and the onset of menstruation, pregnancy and postpartum being the life stages in which we see iron deficiency most commonly reported. The World Health Organisation reported on the prevalence of iron deficiency, publishing data that highlighted a surprising statistic that 37% of pregnant women and 30% of women aged 15-49 worldwide are anaemic2.
Symptoms of Iron Deficiency in Women
As we know that iron deficiency leads to less oxygen being carried around our body via the bloodstream, fatigue and shortness of breath are two of the most commonly reported symptoms.
A lack of oxygenated blood forces the body to breathe faster to compensate and draw air in to allow more oxygen to reach our tissues, leading to a feeling that we can’t quite catch our breath.
Whilst fatigue is one of the leading tell-tale signs of iron deficiency, other common signs and symptoms are3 :
- Pica (an urge to eat non-food items such as paper and ice)
- Heart palpitations
- Headaches
- Paler than usual skin tone
- Hair loss
- Tinnitus
- Itchiness
- A sore tongue
- Restless leg syndrome
- General weakness
Causes of Iron Deficiency in Women
As outlined, life stage is one of the more common causes of iron deficiency in women. This is due to the volume of blood we lose during menstruation. Interestingly, we only lose about 1-5 tablespoons (15-50ml) of blood during our time of the month, however, if we have particularly heavy periods or our iron stores are sub-clinical it may be just enough blood loss to cause deficiency4.
Another life stage which increases the odds of iron deficiency in women is pregnancy. The body needs to produce a larger quantity of blood to supply mother and baby. Foetal red blood cell development is provided through maternal stores, meaning that the mother needs to up her iron intake to ensure that plenty is available5.
In fact, the UK government recommends expecting mothers to double their iron intake from 14.8mg daily to 27mg. Whilst generally encouraged, do ensure that you speak to a licensed health professional (such as your GP) if you’re considering iron supplementation during pregnancy6.
One of the leading factors that attribute to iron deficiency that’s unrelated to life stage is gastrointestinal dysfunction, with GI bleeding being a common contributor7.
Poor gut health will leave us vulnerable to deficiency of this key nutrient, therefore dietary and lifestyle considerations to support gut function are key to reduce risk. If you decide to carry out testing for nutritional deficiencies, a useful method to help identify whether poor gut function may be contributing to iron deficiency is to assess whether you have other nutrient deficiencies. If at least two nutrient deficiencies are highlighted through testing, then do consider that poor digestion may be a cause to address.
Dietary factors are also a key consideration. If you adopt a plant-based diet, you are at a slightly higher risk for iron deficiency. Plant-based sources of iron are not as readily absorbed by the body as animal-based foods. However, vitamin C helps to improve iron absorption therefore do eat plant sources of iron with vitamin C containing foods to help boost absorption8.
Dietary Sources of Iron
There are two types of dietary iron. Haem iron which is found in animal-based foods and non-haem iron, which is sourced from plant foods.
Sources of haem iron containing foods include9:
- Red meat (beef/lamb)
- Shellfish
- Liver
- Egg yolk
Sources of non-haem iron containing foods include:
- Dark leafy greens
- Lentils
- Tofu
- Dried fruit
- Nuts
- Soy
Iron Supplementation
As iron is one of the leading nutrient deficiencies in women globally, it is a very worthwhile addition to your supplemental toolkit. It’s particularly important to supplement if you are a ‘high risk’ group as mentioned, or if you show several signs and symptoms of iron deficiency.
Iron Complex
Public Health England’s published report on Government Dietary Recommendation guidelines recommends that all women aged between 11-50 years of age ingest 14.8mg iron daily. However, within the report it states that this may not be adequate for women with high menstrual losses and that supplementation is recommended10.
However, in order to identify whether you have an iron deficiency, testing is a great option.
Tips For Preventing Iron Deficiency
Much like with most supplementation and dietary advice surrounding nutrient deficiency, whilst upping your intake is highly recommended, the body needs to be in an optimal state to digest, absorb and utilise nutrients effectively for them to carry out their intended actions in the body.
I commonly work with women in clinic who have upped their iron supplement intake and introduced high quality sources of animal-based foods into their weekly diets without much improvement. One of the most common causes for why their stores haven’t been effectively topped up is due to poor gut health.
Working on your gut health is one of the single most important things you can do, to help improve dietary and supplemental iron absorption. Improving microbiome health by taking a probiotic, focusing on digestion and implementing a whole foods diet helps create an environment within the gut that improves the breakdown of food, regulates pH levels and supports the proliferation of good gut bacteria that helps to boost iron absorption11.
Biotic Complex
Another tip for supporting iron absorption is to focus on stress management. Whilst much easier said than done, the studies show that when the body is in a sympathetic state (fight or flight mode) digestion is impacted leaving important minerals like iron poorly absorbed. Conversely, when we are in our parasympathetic (rest and digest) our nervous system allows our body to support healthy gut function12.
