Iron is one of the most common nutritional deficiencies among women (and the most controversial). Low iron levels can affect your health well before it shows up on a lab test. As a naturopathic physician, we see symptoms of low iron before a patient has entered the “anemic” category.


Iron is a component of hemoglobin. Hemoglobin carries the oxygen in red blood cells from your lungs to the rest of your body.  The human body is made up of cells that require oxygen to make ATP (energy) and function optimally. We also require iron for estrogen and progesterone production as well as proper immune function.


The issue can be the bioavailability, AKA the “absorption ability“, of iron. This is dependent on the source of iron in the foods we choose as well as our digestive health.  KEYNOTE: A person’s digestive health is the foundation for all nutritional deficiencies because even if we are eating or supplementing with specific nutrients, we need the proper terrain to absorb them.


Iron requirements depend on gender and stage of life. Women of course are the population of concern due to iron demands in childbearing years, but also high-level athletes can have issues with maintaining and generating iron stores. Here is a bit more information on some situations where iron is SUPER important.


As a woman, once we are pregnant, our iron demands go way up.  Iron is required for placental development, estrogen and progesterone production (main reason for miscarriage and fertility issues), infant brain development, and infant iron stores for the first 6 months of life. Iron deficiency is even linked with post partum depression. If you have a history of iron deficiency during pregnancy, unfortunately you’re iron deficiency risk increases for the next pregnancy.


During exercise and training, our endurance capacity depends on the ability to oxygenate tissues. Iron is required to oxygenate tissues and cells. This is mostly shown in an athlete’s amount of energy and aerobic performance. Depending on an athletes diet and iron stores will determine whether or not they would benefit from iron supplementation


There are two forms of iron, heme or non-heme. Heme iron is more “bioavailable” (a term I mentioned earlier), and is found in animal sources. Non-heme is found in plants and isn’t absorbed as well. As a vegan or vegetarian it is important, and can be more of a challenge, to maintain adequate iron levels. If any symptoms of low iron arise, it can be more challenging and therefore is more important to replenish and build these stores as a vegan or vegetarian, so make sure your blood levels are sufficient to maintain overall health.


Supplementing with iron isn’t always the answer, as a matter of fact, supplementing when you don’t need to CAN BE HARMFUL.  You need to run proper blood work to determine your iron stores and decide whether you would benefit from iron supplementation. Here are some symptoms that may indicate a need for lab investigation into your iron levels before supplementing:

  • Fatigue and weakness
  • Hair loss or weak nails
  • Bruise easily
  • Depression/low mood
  • Poor sleep and concentration
  • Increased infections (Colds & flu’s)
  • Dizziness/faintness
  • Cold hands and feet
  • Ringing in the ears
  • Restless leg syndrome
  • Headaches
  • Cracks in the corner of your mouth

If you are experiencing any of the above symptoms, I recommend seeing your local Naturopathic Physician to investigate your iron status. There may be an easy fix for your lack of energy and poor motivation.

All the best in life and health,

Dr. Heather Iverson, ND


Brownlie, Thomas, et al. “Tissue iron deficiency without anemia impairs adaptation in endurance capacity after aerobic training in previously untrained women.” The American journal of clinical nutrition 79.3 (2004): 437-443.

Bothwell, Thomas H., and Robert William Charlton. “Iron deficiency in women.” (1981).

Looker, Anne C., et al. “Prevalence of iron deficiency in the United States.” Jama 277.12 (1997): 973-976.

Allen, Lindsay H. “Anemia and iron deficiency: effects on pregnancy outcome.” The American journal of clinical nutrition 71.5 (2000): 1280s-1284s.

Haas, Jere D., and Thomas Brownlie. “Iron deficiency and reduced work capacity: a critical review of the research to determine a causal relationship.” The Journal of nutrition 131.2 (2001): 676S-690S.