Running on Empty? Iron Deficiency May Very Well Be The Cause



Feeling sluggish, weary, and fatigued and can’t seem to shake it? Big culprit could be an iron deficiency.

If you’re a premenopausal woman, your lack of energy could simply be a lack of iron (Fe). In fact, “less than 25 percent of women of child-bearing age consume sufficient dietary iron”, says nutrition specialist Roger Clemens of the USC School of Pharmacy. “And a poor iron status can contribute to that ‘tired’ feeling, and poor intellectual performance.” Are you running on empty? It’s time to find out, fill up, and feel better.

Iron is an important dietary mineral involved in many vital functions. One of its main jobs is to transport oxygen in the body. Iron is needed to make hemoglobin, a substance in red blood cells that carries oxygen from the lungs to fuel your organs, tissues, and muscles. When iron levels dip, the body is short on oxygen, resulting in a lackluster, lifeless feeling. The phrase “tired blood” actually means blood that is low in iron. And “tired blood” means a tired you.

But feeling weak and rundown is only part of the iron issue. Proper functioning of the immune system also relies on a sufficient amount of iron. Running on empty, therefore, can lead to a suppressed immune system, which increases the body’s susceptibility to infection and disease. And a recent study indicates that even mild iron deficiencies can slow a woman’s ability to think clearly, concentrate, and remember things.

Iron shortages occur for a variety of reasons including a lack of iron in the diet, poor absorption, or because of blood loss. Heavy menstrual bleeding is a key cause of iron deficiency in women, but bleeding caused by conditions such as ulcers, hemorrhoids, and cancer can also be the culprit.

Storage Units

Iron-deficiency doesn’t develop immediately. The body stores extra iron in the liver, spleen, and bone marrow for use should there be a shortage. The average adult male has about 1,000 mg of stored iron (enough for about 3 years), but women on average have only about 300 mg (enough for about 6 months). If dietary intake isn’t adequate for the body’s needs, iron is released from the reserves to meet the shortfall. Low iron intake over a long period can lead to a depletion of these reserves, especially if the body is losing blood, as it does during menstruation. If this depletion isn’t corrected, it progresses to iron deficiency, eventually leading to full-blown iron-deficiency anemia.

It’s easy for people to overlook the symptoms of iron deficiency because it develops slowly and the warning signs are mild. In fact, the symptoms can be so subtle that a woman who feels sluggish may reach for a cup of coffee when her real problem could be iron. Mild iron deficiency is marked by vague symptoms of tiredness, headaches, irritability, or depression. It may also affect a person’s ability to concentrate, learn, and remember. As the deficiency gets worse, the more serious signs and symptoms of anemia start to surface, including pale skin, brittle fingernails, weakness, apathy, breathlessness (especially on physical exertion), reduced immune function, inadequate temperature regulation, and a loss of appetite.

The Recommended Dietary Allowance for iron is 10 mg daily for men and postmenopausal women and 15 mg for women of childbearing age. But getting enough iron means more than just adding up the milligrams in your diet. The capacity of the body to absorb iron from the diet depends on a variety of factors, including the amount of iron stored in the body (absorption increases when the body’s iron stores are low and decreases when the stores are sufficient), the kind of iron in one’s diet, and the presence of absorption enhancers and inhibitors in one’s diet.

Filling Up

There are two types of iron found in foods: heme, found in meat, poultry, and fish and non-heme, found in plant sources (see list of iron-rich foods). While heme iron is easily absorbed in the body, non-heme needs a little help. According to Harold Sandstead from the Department of Preventive Medicine & Community Health at The University of Texas Medical Branch, “iron absorption from plant sources is increased by simultaneous consumption of organic acids such as ascorbic acid (vitamin C).”

Consider starting your day with a bowl of iron-fortified cereal paired with a glass of orange juice (loaded with vitamin C). For lunch, fill a burrito with iron-rich black beans (loaded with non-heme iron) and diced tomatoes (for vitamin C). The possibilities are endless. Another way to promote iron absorption is to eliminate pairing coffee and tea with iron-rich meals. Substances in these beverages bind with iron and make it less absorbable. Calcium also blocks iron absorption. In fact, as little as one glass of milk reduces the amount of iron that can be absorbed by 50 percent.

While most women can get all the iron they need by making healthy food choices, if you are a vegetarian (see Meatless Matters), pregnant (the rapid growth rate increases the demand for iron), donate blood regularly, or are dieting (iron intake often reflects calories consumed), you may need to take an iron supplement. Talk with your health professional before taking iron because getting too much iron can be more dangerous than not getting enough. Also keep in mind that iron-deficiency symptoms are similar to those of other health problems and diseases, making it very difficult to self-diagnose anemia. If you think you might be running on empty, talk to your doctor about the simple blood test you can take to find out.

Meatless Matters

Because vegan diets only contain non-heme iron, iron recommendations are higher for vegetarians than for non-vegetarians. The RDA for iron is 14 milligrams per day for vegetarian men and post-menopausal vegetarian women; it’s 33 milligrams per day for women prior to menopause.

List of Iron-Rich Foods to Shop For

Fortified cereal




Kidney beans

Lima beans

Navy beans

Black beans

Pinto beans


Brussels sprouts



Sweet potatoes

Black-eyed peas





Enriched rice and pasta

Whole wheat bread











Lean beef



Black molasses

By H.K. Jones, R.D.

Healing Lifestyles & Spas Team
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