EP.280/ signs you’re low in iron and what to look for on blood tests
I am seeing a bit of a growing trend with my clients and students – and that’s low iron levels.
But they’re not alone. Iron deficiency or low iron levels are extremely common, in fact, iron deficiency anaemia is the most common nutritional deficiency in the world, with menstruators being one of the most affected groups.
The problem with this, is that low iron levels are often disregarded as not a big deal, because the problem is so pervasive, yet low iron levels can significantly affect our quality of life and reproductive health.
Iron is a mineral that helps to produce haemoglobin. Hemoglobulin takes all that lovely oxygen you’re breathing in and delivers it to your cells via your red blood cells. Clearly, we can all see the importance of oxygen for functioning, but iron is also heavily involved in healthy egg development and ovarian function, which is important for all of us, whether we want to conceive or not, as the ovaries are the source of healthy and stable female sex hormones – and when they struggle, we struggle.
So, now we know why good iron levels are essential, let’s look at some of the most common signs of iron deficiency:
You have heavy menstrual bleeding
Whilst it’s understandable to think that low iron levels would result in lighter periods, this isn’t always the case. In fact, iron deficiency or low levels, can worsen periods and cause more blood loss, but then we get stuck in a vicious cycle, because heavy menstrual bleeding is one of the leading causes of iron deficiency and anaemia in menstruators.
One of the ways to lessen your heavy flow, is to increase iron levels, and one way to increase your iron levels, is to lessen your heavy flow – so it can put people in a very tricky situation.
You have a period ‘hang over’
Another very common symptom is that people will report period ‘hang overs’, where they are left feeling fatigued, depleted and brain fogged after their period, often for a few days afterwards, or for the entirety of their menstrual phase.
Whilst there are other causes, like pushing yourself too hard during your period, it is most commonly caused by the loss of iron and also essential minerals and nutrients, that are depleted during this process.
Many people also tend to believe the tiredness and feeling run down after their period is due to the pain and trauma they experienced from their endo symptoms during menstruation, and whilst this may be a contributing factor, I think I am yet to see a case where low iron levels were not the key cause.
You have severe endo fatigue and weakness
Often people put their fatigue and weakness down to just having endo, and so they don’t often look into it or push for further testing. However, some of the classic symptoms of low iron levels include feeling tired all the time and physically weak. And this can vary, from person to person, and depending on how bad your iron levels are.
For some, they just feel tired all the time; for others, they notice they are more exhausted after physical exertion or exercise, and when my iron deficiency was at its worst, I felt as if my body was made from lead in the mornings, and it would take me forever to wake up. I just felt incredibly heavy and as if my body had no strength. When I would try to exercise, it wasn’t like the exercise was hard – it felt like I physically couldn’t do it, I kept having to stop, and I just felt tanked of any fuel inside me.
You suffer from strange symptoms
Many people with low iron levels or anaemia suffer from what may seem like random symptoms and for our community, if you also have a diagnosis of dysautonomia or POTS, you may put these symptoms down to that because they look very similar.
But some classic low iron symptoms include dizziness, rushing in ears or tinnitus, chest pain and/or palpitations, breathlessness, and restless leg syndrome.
Don’t be fooled by the idea that you must look pale, have light pink veins on the inside of your eyes or dark circles. This is absolutely not the case for everyone, and I remember as a teenager, my nan kept telling me I couldn’t be low in iron because the insides of my eyes look red, and so I didn’t go to the doctors for a long time and lo and behold, I was actually anaemic.
You’re depressed and anxious
Low ferritin levels (which are your iron stores) or iron deficiency are associated with depression, anxiety and other mental health disorders. I have noticed a continued theme that those clients and students with low iron levels often suffer with low moods, hopelessness, negative thinking, etc.
So, how do you test your iron levels and what should you be looking for in a test?
The first stage of iron deficiency is that your iron stores, known as ferritin, drops and so ideally, we want to catch your iron levels here because symptoms are absolutely felt during this stage and can still be severe. Don’t be fooled into thinking that ferritin is just a backup storage of iron and it doesn’t matter if it drops, it really does – ferritin releases iron into your blood stream whenever iron is required. In fact, ferritin is the go-to marker and test for doctors when they are looking for iron deficiency, though there are other markers too.
So, if your ferritin is low, it’s time to take action.
Now, your GP will work with conventional ranges, and conventional ranges are based on averages of healthy people and people with deficiencies, so these ranges do not give you optimal levels you should be aiming for, and symptoms are often felt on the low end of normal.
Within functional medicine, we typically want ferritin levels to be at least between 30-100 ng/ml but for optimum health, above 70. I tend to see people around 50-ish are doing okay, though they do feel better when we increase iron a little. When we get below 30, I am seeing symptoms, and I cannot tell you the amount of times a client has been told their iron levels are normal, when they are literally one digit away from deficiency, even based on conventional ranges – they’re not given any warning, any advice, etc. It’s really shocking, especially because these people are going to their doctors with classic signs of low iron, and yet because they’re not actually deficient, they’re just at the low end of normal, it’s apparently not a problem.
Remember, the conventional ranges are based on averages. You are not an average. You are an individual with individual bodily responses, if you have low iron levels and symptoms of low iron, you should work on improving those. As long as you iron levels don’t go over safe levels in terms of getting too high, you should be able to supplement with iron, unless you have a condition where it’s advised not to, like thalassemia. However, remember, this is just a podcast providing general education and information and is not tailored advice, so you should check your iron levels and then consult your doctor before taking any supplements.
In the show notes, I have provided you with the other optimal reference ranges in case you also want to get these tested.
Show Notes
Optimal ref. ranges:
Serum iron: 40–135 μg/dL
Total iron-binding capacity: 275–425 μg/dL
Unsaturated iron-binding capacity: 175–350 μg/dL
Iron saturation: 17%-45%
Ferritin: 30-100 ng/mL, but above 70 ng/mL is optimal
Need more help or want to learn how to work with me?
Free resources:
This podcast!
Ways to work with me:
This EndoLife, It Starts with Breakfast digital cookbook
Masterclasses in endo nutrition, surgery prep and recovery and pain relief
Live and Thrive with Endo: The Foundations DIY course
One to one coaching info and application
Can you help me save Jelly the kitten? We are currently travelling, working remotely, and within 24 hours of arriving in Montenegro, we met Jelly. He was extremely thin, with a distended stomach and a little lollypop head and bulging eyes. We took him to the vets where he was put on an IV drip for dehydration, and treated with antibiotics and anti-inflammatories for a bacterial infection that has spread into his bloodstream from his intestines. His intestines are damaged due to excessive worms, which has caused him to become malnourished.
The vets have given us a very stark picture of the reality. If Jelly goes back on the streets, his condition will deteriorate and he will suffer until he eventually passes away. We have been told to find him a home where he can continue getting care or put him to sleep.
We have found him a foster home and a forever home in the UK, but the total cost is over £1200. We have already spent hundreds on vet visits getting him to this point, and need your help, if you can.
If you are able to and want to support, you can donate and read Jelly’s full story on our Go Fund Me page. I truly cannot express how much your support means to me, thank you from the bottom of my heart.
This episode is sponsored by Semaine. Semaine is a plant-based supplement for reducing period pain and inflammation, that you take for 7 days of your cycle, during your period. Semaine is made up of 9 super-powered plant extracts and minerals that are all vegan and sourced for maximum quality and bioavailability and selected based on the latest clinical research. If you want to try Semaine, they are currently offering 20% off your first order with code: THEENDOBELLYCOACH and they deliver worldwide! Head to: www.semainehealth.com
This episode is sponsored by BeYou Cramp Relief Patches. Soothe period cramps the natural way with these 100% natural and discreet menthol and eucalyptus oil stick on patches. Click here to find out more and to shop: https://beyouonline.co.uk/pages/how-it-works
Produced by Chris Robson