By Kelly Nicholas - Bachelor of Applied Science in Human Movement, Bachelor of Health Science in Paramedicine
I bet you either know someone who is iron deficient or are iron deficient yourself? With some reports stating that up to 18% of 'healthy' women are low in iron, it's no wonder iron deficiency is a common discussion point amongst women!
I first discovered I had low iron after having kids (shockingly I thought most of my symptoms were because I had 2 kids under 2!) I can't even recall why I had routine bloods, however my GP rang and said my ferritin levels (the stored iron) were 'unrecordable.' The acceptable range is about 20-200ng/mlt. (Mine were less than 5!) And so began my journey of iron deficiency.......
What are some of the causes of low iron?
inadequate iron intake due to a diet that doesn’t provide the daily nutritional needs or that’s heavily restricted
inflammatory bowel disease which affects absorption
increased iron requirements during pregnancy
blood loss through heavy periods or internal bleeding
Excessive exercise and some medications
What are the symptoms of low iron?
Unusual tiredness - iron plays an important role in the production of haemoglobin - the protein in red blood cells that carries oxygen from the lungs to tissues. It also transports carbon dioxide out of your cells and back to your lungs to be exhaled. Without enough haemoglobin, less oxygen reaches your tissues and muscles, depriving them of energy. Your heart also has to work harder to move more oxygen-rich blood around your body, which can make you tired. See image below.....
Paleness - the haemoglobin in red blood cells is what gives blood its colour. Paleness may be noted in the face, gums, nails and under the eyelids and is usually in cases of moderate to severe iron deficiency anaemia. As a paramedic, it can be very obvious when we go to people with severe iron deficiency and/or low haemoglobin. The extreme pallor and shortness of breath that usually accompanies it are noted as soon as we walk in the door!
Shortness of breath - again haemoglobin is the culprit here! When haemoglobin is low, the tissues receive less oxygen and so your breathing rate will increase as your body tries to get more oxygen. Doing normal activities such as walking may therefore cause shortness of breath. For me, when my iron was super low, I really noticed when I was doing a warm up with you all at class that I could barely talk through it!
Headaches and dizziness - this link is not super clear however headaches seem to be more prevalent in women with iron deficiency.
Heart palpitations - again with low haemoglobin, the heart has to work harder with less oxygen circulating. This was another obvious symptom for me. I actually did an ECG on myself at work when I felt the palpitations (it was quite uncomfortable) and noted that I was in bigeminy (every second beat was followed by an ectopic or 'rogue' beat). This definitely improved when my iron stores went up!
Restless leg syndrome - around 25% of women experience this! This phenomena is the strong urge to move your legs at rest and can also cause strange crawling or itchy sensations in your skin. It is often worse at night which can lead to poor sleep.
Dry itchy skin and damaged hair - again with less oxygen circulating, the skin integrity is compromised as cell growth for hair and skin is reduced due to low oxygen. In hindsight, I did notice dry skin with low iron however I have always suffered from dermatitis and so put it down to that!
Feeling depressed- as a result of all the above symptoms, a feeling of helplessness can overtake you. If you are sleep deprived, feeling tired and lacking energy, you may suffer depressive symptoms.
So what should you do?
Check in with your Doctor! Always consult your GP and never self diagnose or take supplements without a blood test. Taking iron supplements when not required can cause toxicity.
What did I do?
Well to be honest I tried everything! In the early days, I had an iron infusion, which sky-rocketed my stores up to 170! Unfortunately this is a bit of a band-aid approach and alas, they dropped off again over time. My main problem was really heavy periods causing excessive blood loss and therefore iron. I tried the Mirena IUD (it fell out after 18 months and was never great for my body). I tried the pill however I had breakthrough bleeding constantly and didn't see much change in periods. One of the best things I did was see Nicole Woodcock who is a naturopath. I really understood more about nutrition and what foods I needed to help my issues - I am a big believer in "food as medicine." Through this journey, I also discovered I had quite significant gut issues and was regularly constipated (this can also be a symptom of low iron!). I try to eat less inflammatory foods now which includes a lot less red meat - while most people believe this is one of the best sources of iron (it is more readily absorbed than plant based iron), there is actually lots of iron in foods such as dark green leafy vegetables, nuts and seeds. It's a great idea to consume iron-rich foods with vitamin c as this will help absorption. My change in diet has most certainly helped a lot of my symptoms!
Finally, after years of tolerating the yoyo world of low iron, I saw a Gynaecologist and had a uterine ablation. (see image below). Basically, I was diagnosed with a very thick endometrium which was causing the heavy periods. The ablation cauterizes the lining of the uterus so that it never builds up again during your cycle. I only had this done in September and my first blood test post the surgery in December showed that my iron stores had climbed to 20 (that's big for me!). I'm due for my next iron check now and have been taking supplements since so watch this space..... In the past, I have taken supplements however have had little impact on my stores because of the continued loss due to heavy bleeding. I'm really keen to see how my iron stores trend going forward!
Well I hope you enjoyed reading about my journey with iron deficiency. I am always happy to share my experiences in the hope of spreading the word about issues that may be taboo (such as periods!). I strongly encourage you to see your GP if any of this resonates with you. There are many different options and strategies that are tailored for your individual needs. I also believe in holistic advice and enjoy merging Western medicine with naturopathic remedies to achieve good health.