“Iron deficiency is one of the leading contributors to the global burden of disease”, noted the authors of a review published in the Lancet.
While iron deficiency can occur with and without anemia, it is not unusual to see a patient with an abnormal or suboptimal iron panel. (Suboptimal iron is very low iron that may not meet the diagnostic criteria for deficiency.)
Low iron can cause many symptoms, including tiredness, brain fog, muscle weakness, worse anxiety, feeling chilly, easy bruising and more. It can also be indicative of other issues.
As we know, everything is connected in different ways. Certain conditions, including chronic disease, cancer and genetic variation, can affect your iron status. Menstruation also affects iron status.
If your iron is low, you want to make sure to rule out blood loss – this is something your doctor should be able to assess and/or refer you for if they are concerned. You should also have a conversation with them about other factors and how to improve your iron status.
- For example, cooking with cast iron, eating more iron-rich foods, pairing iron intake with supports like vitamin C, possible iron supplementation, and so on.
- It’s worth noting that supplementing iron can have side effects, usually on the GI system, and these can often be minimized by using a form of iron that’s better for your body.
If your iron is high, your doctor should create a plan with you to lower your iron – this will vary depending on your specific picture. High iron is less common to see, but should be addressed ASAP as it increases cardiovascular risk and can indicate other concerns.
Do you know what your iron status is? If you’re unsure, ask your doctor. Your iron levels should ideally be evaluated with a panel rather a single test.
Your body has different ways of using iron and reflecting that to us in your blood work.
Here’s the basics to ask about:
- Total iron: measures iron in your blood
- Ferritin: measures your longer term iron storage
- % saturation: measures how much iron your cells are carrying around
- TIBC (binding capacity): measures how tightly your cells want to hold onto iron, to carry it throughout your body
Of course, you’ve gotta take all this in the context of your own health – so talk with your doc about what’s right for you.
Last note: if you are a post-menopausal female and have not had your iron checked at some point past menopause, make sure to ask your doctor to check it now. I recently had a patient in this situation, and when I ran a routine iron panel for her it was nearly off the chart high – her % saturation was in the high 90’s, when it’s supposed to be somewhere in the range of 20s-40s, not to mention other markers!
(Review in Lancet – DOI: 10.1016/S0140-6736(20)32594-0)
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