Women and iron levels: Why yours may be low

Approximately 3 million people in the United States will be diagnosed with anemia during their lifetimes.

For women, though, iron deficiency is usually at the root of their anemia.

What is iron deficiency anemia?

Anemia is a condition characterized by lower-than-normal red blood cells, which are responsible for circulating iron-rich blood throughout the body. Low iron levels make it harder for your body to create those red blood cells.

To determine if you’re iron deficient, your doctor or other health care provider will look at several key indicators in your blood, explains Natalie Robinson, ARNP, an obstetrics and gynecology provider at MultiCare Women’s Center – Puyallup.

The primary indicator of iron deficiency is a hemoglobin count below 12, Robinson says. Hemoglobin is the iron-rich protein in red blood cells that carries oxygen.

If hemoglobin levels fall below 12, your provider will also look at your hematocrit levels (how much space red blood cells take up), ferritin (the blood protein that stores iron) and total iron binding capacity (the blood’s ability to carry iron throughout your body).

“Iron deficiency can sometimes be confused with dehydration, cardiovascular or thyroid disease and depression because of the similar symptoms,” explains Robinson. “A blood test is the only way to verify if it’s iron deficiency or if there’s something else going on.”

What are the warning signs of low iron?

Symptoms and severity will vary, but the primary signs to look out for include:

• Increased fatigue to a level that interferes with daily life. For example, you can’t function or focus because you’re so tired, or you can’t make it through the day without a nap.
• Eating ice chips to feel more alert and mentally sharp.
• Shortness of breath, especially during moderate activity like walking around the house.
• Lightheadedness or dizziness that isn’t brought on by something else, such as a virus or migraine.
• Changes in skin and hair growth, such as thinning/slow-growing hair or dry/itchy skin.
• Changes in heaviness or frequency of your period, such as a shortened cycle (e.g., from 28 to 21 days), more bleeding days or a heavier period than what’s typical for you.

“It really varies from person to person,” Robinson says. “I’ve seen patients with very low iron stores and they didn’t even know because they had no symptoms, and I’ve treated some patients who were borderline but felt extremely fatigued.”

For those who do experience persistent and severe symptoms, the mental health impact can become just as difficult to live with, she adds. When you’re too fatigued or out of breath to do the things you love, it can take a toll on your emotional well-being.

Why are women more susceptible to low iron?

One of the primary reasons women are more susceptible than men to iron deficiency is menstruation cycles, Robinson says.

“We see it a lot more with younger women as well, because they’re more likely to have heavy, frequent periods,” she adds. “For example, iron deficiency is less common for women who are in menopause and no longer having monthly bleeding.”

Curious about your iron levels?

Talk with your doctor

Iron deficiency is also more common during pregnancy, Robinson says. Supplying blood to both you and your baby increases the demand for iron and can become challenging for your body to keep up with.

Other potential causes of iron deficiency — not strictly limited to those with a uterus — may include nutritional deficiencies and an inability to properly absorb iron due to intestinal conditions like celiac disease.

How can you prevent and treat low iron?

The best way to maintain healthy levels of the vitamins and minerals your body needs to function is to ensure you’re getting them through foods or supplements.

Try incorporating more iron-rich foods into your diet, Robinson says, such as red meat, leafy greens and legumes. If you’re on a meat-free diet, she specifically recommends at least two iron-rich meals in your day.

An over-the-counter iron supplement or multivitamin can also help maintain healthy iron levels, but may be harsh on the stomach, Robinson says. Still, make sure to avoid antacids for at least 60 minutes after taking iron because they can block iron absorption.

If you experience an upset stomach, constipation or changes in stool color, consider taking the iron with foods that aid digestion, such as high fiber items, fruits or yogurt — or try gentle iron or slow-release iron. It may also be beneficial to increase your fiber and water intake and maintain regular physical activity to avoid constipation.

To increase iron absorption, take it with vitamin C (oral supplement or juice) during iron intake.

If pregnant, consider a prenatal vitamin that includes iron, Robinson adds. For those not trying to get pregnant, prescription contraceptives that lessen or stop your menstrual cycle may be a helpful option to discuss with your doctor or other health care provider.

Iron stores take at least six to eight weeks to restore, she says. Give yourself time, be consistent and talk to your provider if your symptoms persist.