Fatigue is such a common symptom. Almost all of my patients list it as one of their problems. Sometimes the cause is complex and difficult to uncover, while other times it’s relatively simple. The most common cause of fatigue in pre-menopausal women is chronic iron deficiency and it is greatly underestimated as a cause of severe disabling low energy. Many women put up with this for years because they find that oral iron supplements are not strong enough or that they cause digestive upsets.

Iron is an essential mineral for human and animal life. Three quarters (75%) of the body’s total iron content is found inside the red blood cells and is part of a protein called hemoglobin that enables red cells to carry life giving oxygen to every cell in our body. Ten to twenty percent of iron is stored in a protein called ferritin. The rest, which is not very much (5 to 10% of the total body iron), is transported around the body on another protein called transferrin and a small amount is free in the blood.

Your doctor can organize tests to measure all these different forms of iron with one simple blood test and this enables us to see if you have too little iron in your body or too much iron in your body or just the right amount!

Symptoms of iron deficiency may include

  • Dizziness and light headedness
  • Fainting
  • Mental fogginess and slowness
  • Chronic fatigue
  • Weakness of the immune system
  • Scalp hair loss
  • Shortness of breath and poor exercise tolerance
  • Fertility problems in women
  • Inability to lose weight

Common causes of iron deficiency

  • Heavy and/or too frequent menstrual bleeding. Progesterone cream helps to lighten and regulate menstruation.
  • Blood loss from the bowel. This could be due to a hidden intestinal cancer, polyps, hemorrhoids or inflammatory bowel disease
  • Inadequate iron absorption from the gut caused by celiac disease, small intestinal bacterial overgrowth, inflammatory bowel disease, lack of stomach acid, antacid drugs, surgery for weight loss (gastric bypass, sleeve gastrectomy). Digestive enzymes and betaine hydrochloride are wonderful for helping iron absorption from food or supplements. Vitamin C helps increase iron absorption, so you should always consume vitamin C rich foods or a supplement along with iron rich foods.
  • Chronic diseases such as autoimmune disease, kidney disease, arthritis, chronic infections and cancer, or anything that causes chronic inflammation can cause low iron. See my autoimmune disease book for information on how to address this.
  • Vegan diet or diet low in animal foods such as red meat, seafood, poultry and eggs.

It can take more than 6 months to rebuild iron stores in people with a severe deficiency.

The above statements have not been evaluated by the FDA and are not intended to diagnose, treat, cure or prevent any disease.