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I’m still tired ! The role of iron deficiency in chronic fatigue

As we age the biochemical hormones that support our bodies diminish with time. Nutritional deficiencies which we may tolerate in our 20s and 30s predispose us to fatigue, injury and eventually the degenerative diseases which we associate with old age. Our bodies have an amazing capacity to compensate for biochemical imbalances.

Iron deficiency is the most common nutritional deficiency in the world.

We often see women with severe iron deficiency anaemia, developed over many years through low dietary iron and heavy periods, cope well until stressed with other illness. The same degree of anaemia arising from injury and acute blood loss would have resulted in hospitalisation and blood transfusion. Symptoms of iron deficiency include:

  • Exhaustion, headaches, shortness of breath on exertion, muscle ache and cramps

  • Brain fog, poor memory, and decreased concentration

  • Rapid pulse and palpitations

  • Increased anxiety

  • Depression

  • Increased number of infections

Often we see women given the all-clear on iron levels from their medical doctor, when in fact a severe iron deficiency may be present. This is because the common screening blood test done for iron is not indicative of the true usable iron in the red cells and in the tissues which require this essential mineral.

Many people are confused about the difference between iron deficiency and anaemia. Immature red blood cells require iron in the form of ferritin to mature and act as oxygen carriers from the lungs to all cells in the body. Iron deficiency is the first step in the development of a decrease in the amount of oxygen-carrying, iron rich haemoglobin within each red blood cell. As red cells are deprived of their quota of iron they become contracted and smaller (known in medical terms as microcytic). As the process of iron deficiency worsens, anaemia develops when the immature red cells, deprived of their quota of iron, fail to survive their infancy and eventually the number of mature red cells decrease.

Raw iron, or serum iron levels can be normal, or in fact high, when a severe iron deficiency may be the cause of all that tiredness. Raw iron needs to be converted to useable iron in oder to be available for use by the body. Full iron studies are the tests required to completely rule out an iron deficiency, so commonly debilitating women today. These include serum ferritin (usable iron) and transferring saturation (essentially the saturation of the oxygen carrying red blood cells with iron. Be aware also that blood results which fall into the lowest 25% of the reference range for these tests may not be an accurate indicator of optimal iron levels.

Attempting to exercise with the legacy of iron deficiency is a recipe for exhaustion and an increase in adrenal stress.


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