Low Iron Matters!

Is it worth checking your iron levels? For many of us, especially women, and vegetarians, the answer is yes. 

In North America,~10-15% of pre-menopausal women have low iron stores.
Rates of low iron may be higher among vegetarians, vegans & food insecure populations.
Low iron can impact infants, toddlers, and kids too.

Symptoms

Low iron is worth addressing, even without anemia. It can cause a variety of symptoms like fatigue, restless leg syndrome, fibromyalgia syndrome, and cognitive issues.

During pregnancy, iron stores deserve close attention, as low iron levels can contribute to poor neurodevelopmental outcomes in infants.

Diagnosis

Iron deficiency is typically diagnosed using blood tests for serum ferritin (SF).

Low ferritin indicates low iron stores – this is not the same thing as being anemic. Anemia diagnosis requires other tests like hemoglobin, hematocrit and RDW. Low iron stores often precede anemia.

Causes

Inadequate dietary iron intake (e.g. lack of iron-rich foods, or pairing with absorption inhibitors)
Blood loss (e.g. heavy periods, blood donation, or illness – like stomach polyps)
Impaired iron absorption (e.g celiac disease)
Pregnancy (elevated iron needs)

My story

I get my iron levels checked every few years, as they are often borderline. Supplements have typically helped me get them to a healthy range. Last month, they were far under the cutoff for “deficient”, which prompted my current focus on low iron awareness.

For me, there are likely two causes:
I haven’t been mindful about loading up on iron-rich foods
I’ve donated a lot of blood in the last 2 years (3x per year). This is not enough to replenish between visits with my current iron intake.

Too much iron is toxic. Consult with a qualified healthcare professional before ramping up iron. 

I hope this primer was helpful. It’s by no means comprehensive. I urge you to check out other resources to learn more. 

General Resources

Mayo Clinic resources on iron deficiency

The treatment of iron deficiency without anaemia in otherwise healthy persons
https://smw.ch/article/doi/smw.2017.14434

Resources for Vegetarians & Vegans

Plant-focused registered dietitians: Dr. Pamela Fergusson, Desiree Nielsen

Iron and vegetarians/vegans by Jack Norris, RD (VeganHealth.org)
https://veganhealth.org/iron/

Iron Status of Vegetarian Adults
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6367879/