Tired? Have you had your iron level checked lately?
Any of this sound familiar?
I’m. So. Tired. I can barely get out of bed in the morning. My anxiety has gone through the roof and I feel like I’m on edge all the time - every little thing is stressful! I know I should exercise but I find it makes everything worse and then I want to nap for a couple hours afterward. I have kids but I’ve never been tired like this. My brain is foggy, I’m struggling to perform at work and feel like a lousy partner. This isn’t who I want to be. I need help. Something has to be wrong because I’ve never felt this awful before.
No, it’s not all in your head. It’s not necessarily just because you have kiddos and are working.
You may have low iron levels.
Now, there’s more than a few things you need to know about iron and it can get confusing! The goal of this writing is to help lay the foundation and give you some background knowledge that we can build on later!
Let’s begin!
THE IRON STORY
CHAPTER 1: Iron deficiency - what does it look like?
Iron deficiency means your levels or iron are lower than optimal. And yes, both men and women can have low iron levels!
Signs and symptoms of iron deficiency include::
New or worsening fatigue* (this is the most common symptom)
Paleness (also known as pallor) of the face
Worsened pre-existing anxiety or depression
Shortness of breath or easily winded after exercise / less exercise tolerance
Elevated heart rate or experiencing heart palpitations
Difficulty concentrating / brain fog
Dizziness
Hair loss
May be impacting sleep
May experience pica (cravings for non-food items such as ice / dirt etc)
Do you need to be experiencing all of these symptoms to get your iron looked at?
Nope.
Showing some of these symptoms is enough to warrant an iron investigation!
CHAPTER 2: Do I have iron deficiency or iron deficiency anemia? What’s the difference?
The difference basically has to do with the length of time you’ve been iron deficient.
If you haven’t had low iron levels for long, your red blood cells won’t be “crying for help / sounding the alarm”, but that doesn’t mean you’re not feeling the effects!
If you’ve had low iron levels for a while (note: “a while” seems to vary from person to person based on what’s going on / causing their low iron as to when this shift occurs), it means that your red blood cells have been impacted and now, due to the lack of iron available to them, they aren’t able to bind (or stick) as well to oxygen and carry it around your body to various organs and tissues that need it.
This is why you get symptoms - because you don’t have enough oxygen circulating in your system and your body doesn’t like this. Your body is trying to do all the things you’re asking it to do with way less oxygen than it needs to be able to do these things well!
CHAPTER 3: Iron issues & labs - how do I know if I have an iron issue?!
To know if someone has iron issues, we (regulated healthcare practitioners who are able to order blood work) have to run blood work, we can’t simply guess by looking at someone that they are iron deficient (though that doesn't mean we don’t strongly suspect it!).
When running labs, we’re typically looking at a CBC (complete blood count) & ferritin levels. Ferritin is a protein that stores iron. Checking this determines how much iron your body is storing. Depending on what your ferritin level is, this is what tells us if you are iron deficient (meaning your levels are low) or if your levels are adequate!
Iron deficiency:
According to the World Health Organization, iron deficiency has been classified as having a ferritin level of < 15ug/L (World Health Organization, 2020). That means that if your ferritin level is under 15, you are considered to be iron deficient.
In 2024, there was an exciting update.
Lifelabs updated what they consider to be “ok” levels for ferritin. As of 2024, a ferritin result of <30 ug/L is considered to be “low iron” or “iron deficiency”.
What does this mean? It means if your ferritin is under 30, it is now considered to be low (before this, your number had to be under 15 to be considered low).
Iron deficiency anemia:
If you have iron deficiency anemia, your ferritin level will also be low + you will notice that you’ll have some other markers that will be flagged as abnormal. One of the key markers is your hemoglobin level. Hemoglobin is a protein which binds (or sticks to) oxygen to allow the oxygen to be carried around the body. Iron is needed to make hemoglobin.
The definition of iron deficiency anemia is when your hemoglobin levels fall below what is considered normal based on your age & gender (Warner & Kamran, 2023).
This is why I tell my patients to get a copy of any recent lab work they have had done or we work to get a copy from their doctor’s office to see where their numbers are at if their iron has already been investigated.
CHAPTER 4: Fixing iron issues
The treatment for iron deficiency is supplementing iron, regardless of whether you are iron deficient or if you have iron deficiency anemia.
The dose, type/brand & dosing frequency is all something to be discussed individually with your healthcare practitioner!
PLEASE DON’T DO THIS ALONE AS TOO MUCH IRON IS ALSO HARMFUL AND CAN CAUSE MEDICAL PROBLEMS!
YOUR TAKE HOME NOTE: low iron won’t go away on its own. It needs to be dealt with or things will get worse!
Concerned about your iron levels and want to get to investigating? Reach out to book a meet & greet to learn more about working together!
Dr. Stacy Burke, ND
References:
World Health Organization, 2020. WHO Guideline: Use of ferritin concentration to assess iron status in individuals and populations. https://www.who.int/publications/i/item/9789240000124
Warner & Kamran, 2023. Iron Deficiency Anemia. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK448065/
