What
if
your
exhaustion
wasn’t
just
because
of
family
stress,
work
tasks
and
social
obligations?
While
those
things
can
certainly
cause
fatigue,
it
turns
out
iron
deficiency
―

which
is
present
in
roughly
one-third
of
women
who
get
a
period
―
can
be
the
culprit.

“Many
people
think
[iron
is]
just
another
vitamin,
like
you
just
didn’t
take
your
iron,
or
you
didn’t
get
enough
in
your
diet,
but
it’s
totally
not
that.
Iron
is
a
very
important
mineral
…
that’s
involved
with
every
cell
in
the
body
utilizing
energy,”
said

Dr.
Steven
Fein,
a
hematologist
and
owner
of

HemeOnCall,
women’s
health
centers
that
treat
iron
deficiency,
abnormal
blood
counts
and
more
hematology
issues.

“Your
muscles
cannot
contract
without
iron.
Your
brain
cannot
think
without
iron,”
he
explained.

The
issue
is
most
prevalent
in
premenopausal
women.
“We
think
that
about
30
million
U.S.
women
have
iron
deficiency,”
Fein
said.

Iron
deficiency
can
cause
a
host
of
issues,
including
a
condition
called
iron
deficiency
anemia.
“You
can
imagine
it
like
a
spectrum
where
iron
deficiency
without
anemia
is
the
milder
version,
and
then
if
you
get
to
a
point
where
you
have
iron
deficiency
anemia
…
if
you
get
to
that
point
where
you’re
that
severe,
then
the
symptoms
are
all
the
worse
—
more
fatigue,
more
tiredness,”
Fein
said.

About
15%
of
American
women
have
iron
deficiency
anemia,
and
another
15
or
20%
have
iron
deficiency
without
anemia,
according
to
Fein.

“Anemia
…
means
that
the
iron
is
low
enough
that
the
bone
marrow
has
essentially
failed
to
keep
up.
It
needs
iron
to
make
red
blood
cells,
and
it
just
can’t
make
enough
because
it
doesn’t
have
the
right
supplies,”
explained

Dr.
Joseph
Shatzel,
a
classical
hematologist
and
associate
professor
in
the
school
of
medicine
at
Oregon
Health
and
Science
University.

Neither
iron
deficiency
or
iron
deficiency
anemia
should
be
ignored,
as
they
both
can
cause
health
problems.
Both
can
be
diagnosed
via
blood
tests
ordered
by
your
doctor.

But
getting
diagnosed
may
take
some
self-advocating.
“We
do
not
have
a
routine
recommendation
in
the
U.S.
to
screen
for
iron
deficiency,”
Shatzel
said.
As
a
result,
the
problem
often
goes
unaddressed.

Here’s
what
to
know
about
iron
deficiency
and
iron
deficiency
anemia,
including
the
signs
you
should
bring
up
with
your
doctor:

Fatigue
and
brain
fog
are
frequently
reported
symptoms
of
iron
deficiency
and
iron
deficiency
anemia.

Women
are
often
saddled
with

the
mental
load
when
it
comes
to
caring
for
children,
partners,
parents
and
completing
must-do
tasks
around
the
home.
This
is
often
associated
with
more
fatigue
and
lower
mood.
And
while
that
is
certainly
true,
iron
deficiency
can
play
a
role
here
as
well.

The
most
common
symptom
of
iron
deficiency
and
iron
deficiency
anemia
is
fatigue,
“but
difficulty
concentrating,
or
poor
concentration,
that
sort
of
mental
fog
…
is
well
noted,”
Shatzel
explained.

Signs
of
iron
deficiency
also
include
impaired
memory
and
mood-related
complications,
Fein
added.

Research
shows
that
low
iron
can
worsen

depression
and
anxiety,
too.
People
may
also
have
trouble
catching
their
breath
after
exercise
or
going
up
stairs,
according
to
Fein.
It
may
also
cause

you
to
feel
dizzy
or
lightheaded.

“Sometimes,
people
have
weird
cravings
like
chewing
ice
or
craving
ice,”
said
Fein,
who
noted
that
restless
leg
syndrome
is
also
reported.
Hair
thinning
is
another
indicator,
according
to
Shatzel.

Iron
deficiency
and
iron
deficiency
anemia
are
common
in
people
who
menstruate
because
of
the
blood
loss.

“Every
time
you
have
a
menstrual
cycle
…
you
lose
blood.
Blood
is
really
your
main
store
of
iron,”
said
Shatzel,
noting
that
it
only
takes
a
small
amount
of
blood
loss
to
spark
the
problem.

The
body
absorbs
iron
very
slowly,
and
this
is
intentional
“because
if
you
do
get
excessive
iron,
that
can
be
a
health
risk
as
well,”
Shatzel
explained.

“Probably
about
half
of
the
women
who
have
low
iron
have
heavy
periods
that
they
don’t
even
realize
a
lot
of
the
time,”
Fein
said.

There
are
also
other
causes
of
iron
deficiency,
including
inflammatory
bowel
disease
and
Crohn’s
disease,
Fein
noted.
The
problem
can
also
be
a
sign
of
colon
cancer,
a
gastric
ulcer
or
even
Celiac
disease,
according
to
Shatzel.
These
issues
can
happen
in
both
men
and
women,
but
in
men,
the
underlying
cause
of
iron
deficiency
is

often
more
severe.

There’s
also
been
a
rise
in
people
getting
gastric
bypass
weight
loss
surgery,
“which
causes
iron
deficiency
on
purpose
by
causing
malabsorption
of
all
nutrients,”
Fein
said.

But
it’s
largely
an
issue
among
women
with
periods
and
bleeding
disorders,
Fein
added.

Iron
deficiency
and
iron
deficiency
anemia
is
common
in
pregnancy
and
can
cause
complications.

Iron
deficiency
and
iron
deficiency
anemia
is
also
common
(and
under-diagnosed)
in
pregnant
people,
according
to
both
experts,
which
can
be
particularly
dangerous.

Research
shows
that
iron
deficiency
can
cause
complications
in
pregnancy
for
both
the
mother
and
the
baby,
Shatzel
noted.
These
include
complications
like
preterm
birth,
low
birth
weight
and

developmental
delays.
If
moms
are
fatigued
already
from
low
iron,
they’re
less
able
to
push,
resulting
in
more
C-sections,
Fein
said.

C-sections
are
more
risky
than
vaginal
delivery.

“And
this
is
a
public
health
problem
that
affects
Black
people
disproportionately,
because
it
turns
out
that
half
of
[pregnant]
Black
people
have
iron
deficiency,
and
a
third
of
non-Black
[pregnant]
people
have
iron
deficiency,”
Fein
added.

Treating
low
iron
can
improve
quality
of
life.

Getting
iron
levels
to
a
healthy
range
not
only
brings
your
body
back
to
where
it
should
be,
but
can
make
life
more
enjoyable,
too.

Treating
iron
deficiency
is
done
in
one
of
two
ways,
either
by
oral
iron
pills
or
IV
therapy,
Shatzel
explained.
The
best
remedy
depends
on
the
person.
Your
doctor
can
help
you
get
the
right
treatment,
but
experts
say
IV
iron
often
tends
to
be
more
effective.

If
left
untreated,
in
rare
cases,
blood
transfusions
are
necessary,
Shatzel
said.

It’s
also
important
to
treat
the
underlying
cause
of
iron
deficiency,
which
for
many
women
is
heavy
periods,
and
can
benefit
from
birth
control
and
other
medical
interventions,
according
to
Shatzel.
But
since
low
iron
can
also
be
caused
by
GI
issues,
GI
workups
are
sometimes
necessary
to
figure
out
the
best
treatment
plan.

“I
think
the
biggest
thing
in
the
general
population
is
the
quality
of
life.
It’s
pretty
clear
people
feel
better
when
they’re
not
anemic
and
their
iron
is
at
a
good
level,”
Shatzel
said.

Iron
deficiency
can
make
folks
tired,
unfocused
and
anxious,
which
impedes
day-to-day
functioning,
whether
that’s
spending
time
with
loved
ones,
going
to
work
or
heading
out
for
a
hike.

With
normal
iron
levels,
athletic
performance
will
likely
improve,
making
that
run,
dance
class
or
HIIT
class
a
little
less
tiring.
Or
you
may
find
you
have
enough
energy
for
better
performance
at
work,
said
Fein,
as
heavy
periods,
tiredness
and
brain
fog
can
result
in
missed
work
days
and
trouble
concentrating
on
tasks.

“At
the
very
least,
it’s
a
quality
of
life
issue
for
all
these
women,”
Fein
said.
“And
not
only
that,
it’s
a
gender
inequality
issue
to
the
point
[where]
a
woman
may
not
be
able
to
function
well
at
work.
They
may
not
get
the
job
promotion
or
the
salary
that
they
deserve
because
they
have
this
[issue],
whereas
men
do
not
have
this
problem.”

“My
general
sense
of
this
is
that
it
hasn’t
really
been
as
important
as
it
should
be
to
the
medical
community
because
this
is
a
very
common
thing
that
the
majority
of
people
suffering
from
are
women,”
Shatzel
said.

If
you
get
a
period
and
suffer
from
brain
fog,
fatigue
or
any
of
the
symptoms
associated
with
iron
deficiency
and
iron
deficiency
anemia,
it’s
worth
talking
to
your
doctor
about
potential
testing.
It
may
be
the
step
you
need
to
take
to
start
living
a
more
enjoyable
life.

The
original
version
of
this
story
was
published
on
HuffPost
at
an
earlier
date.