What Are Symptoms of Low Iron Levels?

Fatigue, Low Stamina, Low Energy, and Difficulty Concentrating

When iron levels are low, you may feel weak, tired, and like you have brain fog, and this can be true even if levels aren’t low enough for you to be diagnosed with anemia. Iron is crucial for the mitochondria—the energy-producing structures in cells—to function. And this affects both physical and mental energy.

We talk a lot about breathing at goop, and the calming power of deep belly breathing. But breathing wouldn’t accomplish much without red blood cells (RBC) to deliver oxygen from the lungs to the rest of the body. And inside RBC it’s the iron in the red hemoglobin molecules that carries oxygen.

A fire needs oxygen to burn, and it’s the same for the tiny fireplaces in our cells, the mitochondria, that burn fuels and produce heat and energy. When RBC have enough iron, they can provide body tissues with the oxygen they need. When iron or other nutrients—folate, B12, and copper—needed for healthy RBC are low, this affects physical stamina and strength, as well as mental focus and clarity.

Pale Skin, Hair Loss, and Brittle Nails

When levels of hemoglobin and RBC are low, mucous membranes of the eyes and mouth look pale, and light-colored skin loses its rosy glow. Hair and nails are affected also, with low iron being a common cause of hair loss. It’s also linked to spoon-shaped nails and ridges in nails.

Restless Legs Syndrome

It’s complicated, but iron deficiency appears to contribute to restless legs.

What Are Risk Factors for Iron Deficiency?

Menstruation

Iron is lost with blood, and that happens with childbirth and monthly with menstruation. We may take heavy periods for granted, but needing to change your tampon every hour means that it’s time to consult with your doctor.

Pregnancy and Childbirth

In addition to blood loss while giving birth, a lot of iron is used in the womb to grow a baby.

Growing

Iron is needed to form new tissues. This is a big deal for toddlers, adolescents, and athletes.

Being Vegetarian

The iron in vegetables is absorbed only about one fifth as well as the iron in meat.

Celiac Disease

Many nutrients are not well absorbed in celiac disease because of damage to the intestine and chronic diarrhea. There’s more information about celiac disease in our goop PhD article.

How To Determine Your Iron Status

Ask your doctor for a ferritin blood test—a sensitive measure of iron status—in addition to the standard hemoglobin test. You can have “normal” hemoglobin levels and still have suboptimal iron status. For historical reasons that may not be valid, it’s considered acceptable for women to have lower hemoglobin levels than men. A hemoglobin level of 12 would flag a man for treatment, while a woman may be told that she is fine, that she doesn’t need to worry, and that low iron is not the cause of her fatigue.

How Can I Support Healthy Iron Levels?

Maximize Absorption from Food

The perfect iron-depleting storm combines heavy periods, being vegetarian, and drinking tea with meals. Vegetarians are more likely to be low in iron than meat eaters because we absorb a much greater portion of the iron in meats and seafood than in plant foods. And dairy products don’t contain much iron. We don’t know why, but even a little meat mixed with vegetables increases the iron you get from the veggies. Beans and green vegetables are good vegetarian sources of iron.

If you like to drink tea and coffee with meals, be aware that they inhibit iron absorption. Instead, have some orange juice or other fruits and veggies that contain vitamin C, which promotes absorption.

Take an Iron Supplement

When I ask people who seem tired and pale whether they’ve tried iron supplements, what I’m frequently told is that they have tried but stopped because the pills upset their stomach. That’s why goop’s formulators included a gentle form of iron called ferrous bisglycinate chelate (Ferrochel^®) in the Everyday Glow Multivitamin. This form is much less likely to cause gastrointestinal discomfort than the ferrous fumarate and ferrous sulfate commonly found in supplements, as has been demonstrated in multiple clinical trials. It is also absorbed more completely, when compared with other forms of iron.*

Everyday Glow also contains vitamin C to support iron absorption.*

How Long Will I Need to Take Iron For?

Be patient and maintain a consistently healthy iron intake, because optimizing iron status is not a quick fix. It will take at least a week or two, and up to several months, to see progress.