Iron deficiency is a common nutrient deficiency that is thought to affect approximately 5% of the entire Australian population. Now there is a main diagnostic difference between iron deficiency and iron-deficiency anaemia. In iron deficiency, you will see a ferritin (stored iron protein) level of under 30 and normal haemoglobin (oxygen transport protein) levels. Whereas in iron deficiency anaemia you will see a ferritin level of under 15 and decreased haemoglobin levels. This diagnostic difference usually explains the symptomatic differences where the common symptoms associated with iron deficiency translate to those that are anaemic (decreased blood oxygenation = fatigue etc.). However, I have also experienced personally and in clinical practice that even iron deficiency on its own, with normal haemoglobin levels, can produce these same symptoms.
So what are the most common symptoms associated with iron deficiency?
Fatigue (feeling extremely tired).
Headache, dizziness or light-headedness.
Cold hands and feet.
Chest pain, fast heartbeat or shortness of breath.
Tongue inflammation or soreness.
poor memory and concentration
poor performance at school or work
frequent or chronic infections
Something that must be noted is that although these symptoms are commonly associated with iron deficiency, they can also be symptoms of other deficiencies, conditions, and/or the complete opposite which is haemochromatosis (iron toxicity) – hence why I never recommend beginning supplementing UNLESS you have had blood tests confirm you are iron deficient.
Why is iron deficiency so common and what are the main causes? Although dietary intake is one, I can tell you there are many other causes that are often overlooked.
Common causes of iron deficiency:
Absorption issues (coeliac disease, inflammatory bowel disease, history of gastric surgeries, etc.)
Excessive blood loss (heavy menstrual bleeds, injury, ulcers, giving blood too often, etc.)
Increased iron usage (chronic or significant infection, over-exercising, etc.)
These are the most common causes of iron deficiency and can be extremely hard to uncover on your own – which is why I also recommend enlisting the help of your health care team to get down to the bottom of it.
So, as a summary here are my generalized top tips for supporting yourself if you are iron deficient:
1. Get down to the bottom of it and address the cause.
Why are you iron deficient? Is it just not enough dietary iron or is there more going on?
2. Support your gut health regardless of the cause. As I’ve explained previously, prebiotics have the ability to modulate gut bacteria (i.e. increase the growth of beneficial ones and suppress the growth of opportunistic ones) and the byproducts produced from the fermentation are short-chain fatty acids (SCFAs). Now SCFAs alone have several mechanisms of action in the gut that increase iron absorption through lowering luminal pH, increasing the absorptive area of the gut, improving iron solubility, and anti-inflammatory effects that can reduce hepcidin levels (a protein that binds to iron). So by increasing your fiber and prebiotic intake, you will be supporting your gut health and therefore your iron absorption (& other nutrients!).
3. Take your iron supplement consistently! Current recommendations for increased absorption include a double dose, every 2nd day – 2 hrs away from coffee and tea. (Always check with your practitioner regarding individual dosages).
4. If you’ve been prescribed a transfusion due to chronic deficiency – consider doing it. Sometimes it can be extremely hard (also dependent on the cause) to increase iron levels from significantly low to optimal just through supplements or it may take months – years to begin seeing the effects take place. So, in some cases, transfusions are a great option to increase levels quickly and then instead, work with your health practitioner to maintain those levels long-term (and address the original cause of deficiency) to reduce your potential need for another transfusion in the future.
5. Get blood work done every 6 months to monitor the efficacy of your treatments. And if you continue to have the same symptoms, speak to your health practitioner as something else might be going on.
I hope you found this helpful and let me know below if you have any personal journeys with iron deficiency. And as always, if you need 1:1 support, please reach out as I would love to support you in getting down to the root of what's going on.