Always Tired? You Could Be Iron-Deficient

Chronic fatigue, brain fog, poor sleep, feeling weak or lightheaded are just of few of the signs of iron deficiency anemia. While iron deficiency anemia is most common in woman of child-bearing age due to menstruation, it can also occur in older adults for a variety of reasons, including after a viral infection such as Covid 19. Identifying the underlying cause of your iron-deficiency is your first step toward regaining vitality.

Iron-Deficiency: What Are Symptoms?

 Iron deficiency anemia occurs when the body lacks sufficient iron to produce adequate amounts of hemoglobin, the protein in red blood cells that carries oxygen. This leads to a decreased ability to transport oxygen throughout the body, resulting in symptoms like fatigue, weakness, and shortness of breath. Iron deficiency anemia can impact multiple areas of your health producing a variety of symptoms beyond fatigue including:

• Shortness of breath
• Weakness or poor exercise tolerance
• Dizziness
• Mood changes
• Irregular or racing heartbeats
• Headaches
• Poor concentration/memory
• Cold hands and feet
• Brittle nails, hair loss or hair that breaks easily
• Sores in your mouth or tongue
• Craving to eat ice, dirt or clay
• Tingling or unusual sensations in your legs
• Frequent infections
• Digestive issues

Iron-Deficiency: What Causes It?

There are several different factors which can lead to iron deficiency anemia:

• Menstruation: Iron deficiency anemia is one of the most common deficiencies amongst young women. A history of heavy periods or long periods is most often the cause. Consulting your gynecologist is important to determining if your heavy periods are caused by conditions like endometriosis or uterine fibroids.
• Pregnancy: During pregnancy, a woman’s iron stores may be depleted as her body increases its overall blood volume and provides hemoglobin (a substance which carries oxygen) to the developing baby.
• Diet: A lack of iron in your diet can also lead to iron deficiency. Vegetarians are at particular risk due to the fact that the type of iron provided by a plant-based diet is not as easily absorbed by the gut as the type of iron found in animal protein. Even if you are not a vegetarian, you can still become iron deficient if your diet lacks foods that are rich in iron.
• Poor Gut Health: Impaired absorption of iron due to inflammatory bowel diseases, frequent use of antacids, Celiac Disease or even weight loss surgery can result in iron deficiency anemia. Chronic blood loss as a result of chronic ulcers or inflammatory bowel disease can also lead to a depletion of iron stores. Moreover, research into the gut microbiome -the bacteria that live in your gut – has shown that the type of bacteria in your gut influence both your absorption and storage of iron.
• Chronic Conditions & Cancer: Chronic kidney disease impairs your body’ ability to produce the iron-containing red blood cells. Individuals with colorectal cancer can develop iron deficiency anemia due to chronic bleeding.
• Post Covid 19 Infection: It is well-established that viral infections often disrupt iron production and storage. This disruption can occur through direct viral interference mechanisms and through the inflammatory response triggered by the infection. Similarly, Covid 19 infections can disrupt both your body’s production of iron as well as the storage of iron. In fact, individuals with signs of slow resolving inflammation and iron dysregulation early after their Covid 19 infection were found to be at higher risk for developing Long Covid. Other viral infections can also trigger this form of iron deficiency.

Iron-Deficiency Anemia: How You Can Test for It & How to Address It

Testing for iron deficiency anemia involves a simple blood test. If you do have iron deficiency, your practitioner may recommend a certain supplement for iron replacement or specific dietary changes to increase your iron intake. Too much iron can also lead to health issues, so it is important to have your practitioner not only monitor your iron levels but also identify the underlying cause of your iron deficiency anemia.

The functional medicine approach to iron deficiency anemia always looks at each patient individually to create a personalized plan that addresses your root cause(s).

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References

Bazdar, S. et al. Hemoglobin and Its Relationship with Fatigue in Long-COVID Patients Three to Six Months after SARS-CoV-2 Infection. Biomedicines. 2024 Jun 1;12(6):1234.

Hansen, A. et al. Iron dysregulation and inflammatory stress erythropoiesis associates with long-term outcome of COVID-19. Nat Immunol. 2024 Mar 1;25(3):471–482.

Kumar, A. et al. Iron deficiency anaemia: pathophysiology, assessment, practical management. BMJ Open Gastroenterol. 2022 Jan 7;9(1).

Lei, W. et al. Gut microbiota and risk of iron deficiency anemia: A two-sample Mendelian randomization study. Medicine. 2025 Feb 21;104(8):e41617

Malesza, IJ, et al. The Dark Side of Iron: The Relationship between Iron, Inflammation and Gut Microbiota in Selected Diseases Associated with Iron Deficiency Anaemia—A Narrative Review. Nutrients. 2022 Aug 24;14(17):3478.

The contents of this blog are intended for educational purposes only. The information presented here is not a substitute for proper medical attention, diagnosis, or treatment by a qualified healthcare professional. Always seek the advice of your healthcare provider before starting or making any changes to an existing treatment plan, exercise program or dietary regimen, and before using nutritional supplements.