IRON DEFICIENCY IN PERIMENOPAUSE – HERE'S HOW TO TACKLE IT.Oct 10, 2023
Have you been diagnosed with iron deficiency by your GP? Or perhaps you suspect you have it because you’re exhausted, pale and mentally foggy?
Iron deficiency is one of the most common nutrient deficiencies world-wide. There are a lot of factors that increase your risk of it, and not much in our modern lifestyles that support healthy iron levels.
So let’s take a look at what this can look like and what you can do about it.
WHO IS AT RISK OF IRON DEFICIENCY?
There are quite a few risk factors for low iron levels! Here are some of the most common ones I see in my clients:
- Pregnancy (it can take 12 months to replenish stores, or longer if you’re not getting enough for other reasons/have pregnancies close together)
- Heavy periods (which is vicious cycle, as low iron can also cause heavy bleeding)
- Vegetarian & vegan diets
- High stress levels
- Coeliacs – particularly if undiagnosed – and non-Coeliac gluten sensitivity
- Going on restrictive diets frequently
- Gut health concerns including an imbalance in the microbiome, parasitic infections or bacterial overgrowths
- Intestinal blood loss (always look at your poo, friends!)
As you can see, there are a lot of factors that women in their 40s have experienced!
WHY IS IRON SO IMPORTANT, ANYWAY?
Like all nutrients, iron wears many hats in the body. Think:
- Energy production
- Cognition, focus & concentration
- Oxygenation of cells
- Supporting immune function & inflammatory processes
- Production of neurotransmitters (brain chemicals)
- Thyroid hormone levels
And these explain why there are so many symptoms that come with iron deficiency. We’re talking:
- Fatigue, lethargy, reduced stamina
- Feeling short of breath
- Muscle fatigue and heaviness
- Restless legs
- Low mood and depression
- Poor digestion – slowed, sits like a brick in the chest, struggling to digest meat
- Hair loss
- Falling sick more frequently and/or lingering infections
- Compulsive eating of ice (pica)
- Sores around the mouths
- Red, sore tongue
- Pale face, tongue and conjunctiva (check the underside of your lower eyelid)
- Concave fingernails
HOW DO I GET A DIAGNOSIS OF IRON DEFICIENCY?
This is a moment for Soapbox Sarah:
The lab ranges for assessing iron deficiency leave a lot to be desired. It’s incredibly common for women to be symptomatic for weeks or even months before they reach the definition of ‘deficient’. But because they were told that their bloods were ‘fine’, they thought nothing was going on!
So what are my favourite labs to assess your blood quality, or rule out iron deficiency?
- Full blood count
- Iron studies – including ferritin. A decrease in ferritin often comes before other signs of deficiency!
- B vitamins, particularly 9 & 12
- Inflammatory markers – because we know that inflammation can make your iron levels look higher than they actually are!
For some cases, we may also want to look at other bloods such as zinc and copper.
And yes, if your doctor is not interested in getting these tests done, you can get them via your naturopath or nutritionist.
It won’t be bulk-billed like bloods via a GP. But we can get so much information about what’s going on for you just from these cheap blood tests – especially when we look at them from a functional perspective, and using optimal ranges for women.
HOW TO INCREASE YOUR IRON LEVELS
So now that you know why iron deficiency can be a big deal for your symptoms, what can you do?
First up, what we are not going to do is just take a doctor-prescribed supplement like Ferrograd. Why? Because they don’t work for the majority of people!
So many women have tried iron supplements before and complained that the constipation, the bloating, the black stools were making them feel even worse. That’s because the iron is not absorbing into their system. The doses are too high and in a form that isn’t great for the body. And in fact, iron running wild in the digestive tract can actually cause damage (not what you want!)
So with that in mind, let’s talk what WILL help.
TAKE YOUR SUPPLEMENT EVERY SECOND DAY
Now assuming that you’ve spoken to your friendly nutritionist or naturopath about an effective iron supplement that won’t constipate you? The research shows that you will absorb more iron if you take a supplement every second day.
Why does this happen? Without getting too deep into the science of it, there is a gatekeeper that prevents too much iron from entering your system. When you take an iron supplement, that gatekeeper is increased for 24 hours – even if your body is desperate for more iron. So taking it every second day ensure that you get optimal absorption.
SUPPORT YOUR GUT HEALTH
Would it really be an article by yours truly if this didn’t come up somehow? But when it comes to iron, we know that it’s not just how much you consume – it’s also how much you absorb. And where does it absorb? Through the gut!
We also know that some probiotic strains increase absorption. Since probiotics never go anywhere BUT the digestive tract, that means there are mechanisms in your gut that control how much iron makes it into the bloodstream.
BE CAREFUL WITH COFFEE
Now don’t worry, I’m not here to tell you to stop drinking coffee. But this is more about the timing of when you have your coffee around meals and supplements.
Coffee has been shown to inhibit absorption of iron by up to 90%. And tea drinkers, sorry but you’re not off the hook either – it has a similar effect.
But the important thing to note here is that this is when coffee or tea is consumed alongside a meal or an iron supplement. So what you want to do is have your coffee at least 60 minutes after an iron supplement or meal.
And before you start thinking you can have coffee an hour before your breakfast? Don’t do it! This is a perfect storm for increasing your cortisol levels – leaving you more stressed, hangry and shaky for the day. A 10am coffee also works much better with your body’s internal rhythms than a 7am cup.
IDENTIFY UNDERLYING INFLAMMATION
Another massive driver of iron deficiency in perimenopause is our old buddy inflammation.
Remember that iron gatekeeper we mentioned earlier? Well that guy also gets excited and increases activity when there’s inflammation going on in the body. Too much iron can contribute to inflammatory processes, so he doesn’t let anyone pass until the inflammation dies down.
So when you’re inflamed, your body will absorb less iron. And if you’re chronically inflamed, well, it’s a recipe for iron deficiency.
SICK OF STRUGGLING WITH LOW IRON SYMPTOMS & SIDE EFFECTS?
Don’t settle for feeling crummy 24/7 – let’s uncover the drivers underlying your iron issues and get you feeling amazing again! Book in for a free discovery call today. Together, we can explore how I can help you to support a healthy hormone balance and smooth the transition through perimenopause.
Is it perimenopause hormone changes or something else making you cranky, exhausted, overwhelmed, and gaining weight in your 40s?
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