Low iron is often associated with women, but how do you know when your iron levels are less than optimal? If you’re an athlete, pregnant, or have heavy periods, or maybe consume little to no red meat, then you may require more iron.
An optimal level for most women is somewhere in the range of 70 to 150ng/ml.
What is considered low iron levels for women?
Many women have low ferritin without overt anemia but
experience all of the symptoms of anemia. Another iron category that you may fall into is having low ferritin levels but high serum iron levels. If that describes you, check out this post to understand why your iron levels seem to be moving in opposite directions and what you can do about it.
A ferritin level below 50 for most women is an indication that supplementation is needed. However, if you are experiencing the following symptoms even if your ferritin is in the “normal” range or close to it, you may want to talk to your doctor to see if supplementation is right for you.
- Fatigue
- Dizziness
- Shortness of breath
- Hair loss
- Lump in throat
- Anxiety
- Increased heart rate
- Sore tongue
- Dark circles under eyes
- Restless legs
Increasing ferritin levels to 70 or higher nanograms per milliliter for at least 3 months has shown to be beneficial for hair loss as a result of iron deficiency.
It is hypothesized that the reason ferritin levels need to be up significantly before hair loss stops and regrowth occurs, is because the ferritin in your hair follicle is one of the last places the body is concerned about replenishing. Reduced ferritin in the hair follicle weaken the hair itself and lead to hair loss. Just be sure to also consume enough protein to maintain the infrastructure needed for vibrant hair.
What might make you more at risk for an iron deficiency?
Running
If you’re an athlete or work out hard on a consistent basis, then you may be at risk for iron deficiency. Iron is responsible for creating red blood cells that in turn transport oxygen in the body and no amount of caffeine or “super” supplement can make up for an iron deficiency. Without optimal iron levels, athletes will find themselves underperforming and many times push themselves even harder, further exacerbating an iron-deficiency.
35% of female athletes are iron deficient and 5% of male athletes are iron deficient.
European Journal of Applied Physiology
Hepcidin is a hormone that increases 3-6 hours post exercise and inhibits iron absorption and assimilation. Physical exertion itself can destroy red blood cells. Sweat and bleeding from the gastrointestinal tract can cause a loss of iron.
In fact, runners can be especially prone to iron loss via a process called, footstrike hemolysis. Iron is stored in red blood cells and when our feet hit the ground in running, that impact destroys red blood cells.
Pregnancy
Most women will need about 30mg of elemental iron a day during pregnancy to make up for the increased demand produced by the increased blood volume, developing baby, and placenta.
Iron is a key nutrient, responsible for the development of the baby’s’ brain (often we think about folate and choline but without enough iron no amount of folate and choline will matter), optimal oxygen levels, and overall growth and maturing the baby.
Many mothers take a prenatal supplement containing iron. Unfortunately, not only are the forms in even the best prenatal inferior related to absorption and side effects, their potency is hindered because of the packaging of other minerals like calcium which directly binds to and hinders iron absorption.
In the United States, 1 in 5 pregnant women develop iron deficiency by the end of their pregnancy.
Saudi Med J. 2015; 36(2): 146–149
Depending on your iron levels going into pregnancy or when you started taking iron related to your pregnancy, you may require more to meet the needs of your body. The demand for oxygen increases dramatically during pregnancy. Your metabolic rate increases by 15% and the amount of oxygen consumed increases by 20%.
In addition to these changes, the amount of air entering and exiting your lungs increases by nearly 50% when you are pregnant.
Menstruation
If you’re menstruating every month and not replenishing your iron stores by eating iron-rich foods or supplementing with iron, then you may be at risk of an iron deficiency. Losing red blood cells through menstruation every month can make it challenging for the body to maintain optimal hemoglobin levels needed to transport oxygen throughout the body. Heavy bleeding or prolonged periods can exacerbate low iron levels.
If you need menstrual support, Period Balance uses herbs and traditional tonics to soothe premenstrual pain and alleviate PMS.
A recent study found that out of 236 menstruating women 27% were iron deficient and 60% were severely iron deficient. The severely iron deficient group had ferritin levels less than 15 ug/L.
Nordic Federation of Societies of Obstetrics and Gynecology
Vegetarian and Vegan Diets
If you’re eating a plant-based diet, it may be a little more challenging to maintain optimal iron levels. One of the main reasons for this is how our body processes foods containing heme iron vs non-heme iron. Heme iron is found in meat, poultry, and fish. Non-heme iron is found nuts, grains, seeds, fruit, vegetables. Our body has an easier time absorbing heme iron found in meat than it does from non-heme sources.
If you are trying to maintain healthy iron levels, then consuming iron-rich foods such as spinach, Swiss chard, dried apricots, cacao powder, and cooked white button mushrooms may be sufficient. However, if you need to raise your iron levels, you will likely need to take an iron supplement.
While living a vegetarian/vegan lifestyle, it’s important to get your ferritin and iron levels checked consistently to make sure you’re staying in optimal range.
How do you raise ferritin levels safely and effectively?
Heavy periods, intense workouts, pregnancy, eating a vegetarian diet can all be contributing factors to low ferritin levels. That’s why as a woman you owe it to yourself to find out if your low energy is a result of low iron levels. I recommend getting the following blood marker levels checked (at the same time) in the morning while in a hydrated and fasted state:
- CBC
- Ferritin
- Iron
- TIBC
- Transferrin Saturation
- B12
- Folate
If you start supplementation, retest again in a month to make sure your iron levels are going in the right direction. A significant issue with most irons is a lack of absorption leading to oxidative stress and damage to the intestinal tract. This is why people experience side effects with most irons such as constipation, stomach pain, black stools.
For best results, take iron in the morning with a glass of water. Take with citrus fruits, berries to help improve absorption. Take away from dairy, supplemental calcium, coffee, supplemental fiber, tea, and wine or medication.
If you need an iron supplement that increases ferritin levels safely and effectively without the usual side effects, try Blood Vitality. Blood Vitality is a clinically tested blood building mineral formula that utilizes an extremely effective iron delivery system in the form of a whole rice protein chelate. This gets iron right where it is needed so women can get back to living their best lives.
Have you experienced low iron levels? I’d love to hear about it in the comments below.
References:
Iron considerations for the athlete: a narrative review. Sim M, Garvican-Lewis LA, Cox GR, Govus A, McKay AKA, Stellingwerff T, Peeling P. European Journal of Applied Physiology, July 2019.
DOI: 10.1007/s00421-019-04157-y
The impact of maternal iron deficiency and iron deficiency anemia on child’s health. Noran M Abu-Ouf, Mohammed M Jan. Saudi Medical Journal, Feb 2015.
DOI: 10.15537/smj.2015.2.10289
Effects of Anemia and Iron Deficiency on Quality of Life in Women With Heavy Menstrual Bleeding. Pirkko Peuranpää, Satu Heliövaara-Peippo, Ian Fraser, Jorma Paavonen And Ritva Hurskainen. Acta Obstetricia et Gynecologica Scandinavica, June 2014 DOI: 10.1111/aogs.12394
Hi Doctor! I worked with Dr Eric Osansky, a natural treatment doctor on my hyperthyroidism and after a year of healing gut, detoxing and rebalancing hormones, my thyroid T3 and T4 have been normal for 6 months now. But my ferritin has always been around 23. All other data in the Iron panel are very healthy (iron 102, iron binding capacity 307, situation 33%) and my RBC is good too, 4.42, square in the middle of the range. My thyroid antibodies are still high. Anti-TPO 300+, TSI 319.
What are the potential causes of my low ferritin but normal iron levels? How should I address it? How can I get my thyroid antibodies down? Thanks.
Recently had bloodwork done as part of year check-up. Ferritin level is high (337) but RBC (3.02), Hemoglobin (10.5) and Hematocrit (31.3) are low. I ordered Blood Vitality to take but very confused whether I should take it or not since my Ferritin level is high.
Hi Darlene, as I functional health coach I had to jump in. High ferritin with normal serum iron, TIBC, % saturation, low usually = inflammation. Low Hemoglobin and low hematocrit also a signal of inflamation (specially digestive). I don’t know exactly what has Blood vitality to let you know if you should take it or not. Hope this help.
Hello! I am 26 weeks pregnant and just received my blood tests back. My ferritin is VERY low (7 L) and my iron total is normal (164) my red blood cell count is low (3.69 L) and my % saturation is normal (34). I am weaning off a medication that ruined my life and health so it’s hard for me to take any supplements. I do take iron on its own and started that about a month ago. I have intense leg weakness, extreme fatigue, and dizziness. I have not of fear around my baby and delivery. Any suggestions?
It may help as RBC counts are low but you look like you have inflammation that is unchecked in your body. You really want to work with your doctor to figure out what is promoting the inflammation. A ferritin over 300 with low hemoglobin virtually always suggests excess inflammation. Let us know what you find.
Iron and TIBC
Test Current Result and Flag Previous Result and Date Units Reference Interval
Iron Bind.Cap.(TIBC) 392 ug/dL
UIBC01 205 ug/dL
Iron01 187ug/dL —>HIGH
Iron Saturation 48 %
Hemoglobin A1c 01 5.6 %
Ferritin01 11ng/mL—->LOW
What should I do to increase ferritin and decrease iron level?
Try a formula with supportive minerals and vitamins like Blood Vitality. https://drwholeness.myshopify.com/collections/nutritional-supplements/products/blood-vitality-1
After receiving the Covid vaccine, my ferritin levels dropped drastically. I had EVERY symptom on the list for iron deficiency including wanting to past out every time I walked up stairs, bent over or getting out the shower. After tons of urgent care doctors not testing my blood, I finally was tested in March 2022 and my ferritin was at 8 and iron at 26. Now in October 2022 my levels are at iron 21.29 and iron at 74, mist symptoms went away but my equilibrium still feels off. I currently take 40mg iron every other day with orange juice, what can I do to feel better and get my numbers up?
Wow that is rough! Have you tried a comprehensive blood builder like Blood Vitality? http://Www.optimizeiron.com
I take a multivitamin every evening after my meal and it says it has 100% iron. My last bloodwork from October says Ferritin 33 and Iron at 134. In June it was Ferritin 25 and Iron at 108 (Binding capacity 330, saturation 33)Should I be taking an additional iron only supplement in the morning?
(Current symptoms are nausea, pain in middle upper abdomen and no appetite with week long episodes of stronger nausea, fatigue and exhaustion. Generally feel great in the evenings and worse in the mornings. Also, keep waking up at 4am then toss and turn. All started after switching BC pills, but my main doc, hormone doc, and pharmacist all say that would not cause chronic issues. Had so much bloodwork done, CT scan, HIDA, Endoscopy, Coloscopy, Stomach emptying test. Seen two GIs. Current GI thinks I have Post Infection IBS, yet I never had an infection around the time this started nor do I have D or C.)
Oral birth control is a train wreck in my experience. I have seen countless women solve years of illness simply by stopping OCPs.
I RECENTLY HAD BLOOD WORK DONE AND MY IRON LEVEL WAS A 10.I DOO TAKE B12 SHOTS ONCE A MONTH.I’M A 60 YEAR OLD WOMAN WHAT SHOULD MY IRON LEVEL BE. THANKS
Ideal ferritin shoot around 70.
Check out http://www.optimizeiron.com
People please look into Spatone, a liquid iron supplement. It is very easily absorbed and helped to raise my ferritin quickly. Check out the reviews on Amazon. It really works!
Hello, I tha k you fir this post. I have been whole food plant based for 16 years and my blood work changed a year later after going plant based and has remained consistent with results. I can not get any answers form the 2 Hemotologists I have seen. They both say there isn’t a problem.
I can not understand why iron is high and ferritin is low end of normal. It would be a blessing to get your opinion.
Ferritin 60 normal
Transferrin 154 low
Tibc 223 low
Iron saturation 70 high
Wbc 4.6 normal
Rbc 3.80 low
Platelets 199 normal
Hemoglobin 13.2 normal
Hematocrit 38.6 normal
Mcv 101.6 normal but often runs high
Hello, I tha k you fir this post. I have been whole food plant based for 16 years and my blood work changed a year later after going plant based and has remained consistent with results. I can not get any answers form the 2 Hemotologists I have seen. They both say there isn’t a problem.
I can not understand why iron is high and ferritin is low end of normal. It would be a blessing to get your opinion.
Ferritin 60 normal
Transferrin 154 low
Tibc 223 low
Iron saturation 70 high
Wbc 4.6 normal
Rbc 3.80 low
Platelets 199 normal
Hemoglobin 13.2 normal
Hematocrit 38.6 normal
Mcv 101.6 normal but often runs high
Sorry, I forgot to add iron serum is 216 high
Hi.
I am having a few health issues. I went and had labs done and my iron level is a 22, iron saturation is a 6, and ferritin is a 7. I am having infusions done soon, but I feel horrible.
For the last 6 months I have been seeing quite a bit of blood in my stools. And feeling tired all the time. I plucked up the courage to see my doctors and she ordered lots of bloods. Some results have come back abnormal or borderline. I have to do a FIT test.
What could this possibly mean?
I don’t understand how my B12 can be normal, folate low and ferritin high….
Is this a liver problem?
Serum vitamin B12 level 415 ng/L – Normal
Serum folate level 1.8 ug/L – Below low reference limit
Serum ferritin level 225 ug/L – Above high reference limit
Serum alanine aminotransferase level 50 u/L – Above high reference limit
Mean cell haemoglobin concentration 345 g/L – Normal
Mean cell haemoglobin level 31.1 pg – Normal
AST serum level 39 u/L – Above high reference limit
AST:ALT RATIO 0.8 – Above high reference limit
I wish all doctors were educated on ferritin levels like you. I will be seeing my third hematologist tomorrow praying for a good outcome. I was first diagnosed in 2021 and began taking p.o. iron with very little improvement in my numbers. Ferritin level got down to a 3, iron saturation was down to 7%. EGD only showed severe gastritis from the oral iron which I had to stop. Colonoscopy negative. I was able to get two venofer infusions last June. That was after switching hematogists-the first one told me I was fine with a ferritin of 8. After two infusions it did get up to 49 but rapidly dropped within a couple months back to 20’s and now I am back down to 9 but current hematologist refusing to submit more infusions to insurance (they would approve I asked them) because my serum iron is normal and my hgb is normal. I was an endurance cyclist and have been unable to even get on my bike. The GI doctor said I simply do not absorb. I am also B12 and Vit D deficient. I take injections EOW for B12 deficiency. Ferritin education is lacking. I’m thankful for your knowledge and explanation on normal iron-they make you think you are crazy for your symptoms with normal iron and hgb. Praying for a better outcome and an infusion SOON.
Another tidbit-I had a uterine ablation in 2014 so I haven’t had a period since then and had a hysty in 2021 after my uterus decided to go crazy post vaccines.
My ferritin was 8.4 in February. I have been taking 325 mg of Ferrous Sulfate twice daily since then. In June, my Ferritin level was 12.2. My doctor thinks that a ferritin level of 13 is ok so he recommends I just need to keep taking my supplements because I am close. I had a gastric bypass 10 years ago and have long, heavy periods. I have read studies that indicate in my situation an iron transfusion makes more sense. I feel AWFUL all the time.
Fatigue
Dizziness
Shortness of breath
Anxiety
Increased heart rate
Sore tongue
Dark circles under eyes
Restless legs
I don’t know if I should keep pushing for the infusion or give up. What is your recommendation?
Keep pushing Amy. Can you gp private to get it done? I also suffer with horrific menstruation due to fibroids and endo/adeno. Tablets just don’t cut it for me because I lose so much blood. I start to become breathless and my heart starts to pound in my chest.
Hi Dr
My ferritin is sitting at 41 ug/L, but my iron saturation is 48 %( too high) , & transferrin 2.08.
what is the cause of this? Does this mean iron is not being absorbed properly?
Do I need more iron? I’m so confused. I’m an athlete & my heart rate is also high a lot of the times (for me) but my drs also overlook this as it is under 100bpm.
Hi! So glad I came across your article. How do you know if your body operates better in the optimal range? I’m 41 with two young kids and I have dealt with fatigue even before having kids. Most doctors only look to see if you are within normal range but not how far up you should be.
Still dealing with fatigue and thinning hair. Wasn’t sure if it could be iron or my bc pill which is progesterone only (Slynd).
Current Numbers
Ferritin: 78
Iron Saturation: 19%
Iron: 60
TIBC: 317
Hi! I have struggled with fatigue, tingling in hands and feet, low body temperatures, headaches, heavy periods, and restless legs for years. Doctors have run every test and everything comes back “normal” for the most part. High CRP, high estrogen, low progesterone. I eat a pretty clean pescatarian diet. My ferritin levels have ranged from 22-55 over the past 5 years (55 was when I was eating meat). I should definitely be inquiring more about my ferritin/iron levels right? This seems really low compared to what you’re saying is optimal. In the past I’ve had low ferritin, high iron, high iron saturation. I cook in a cast iron a ton so I figured that’s the cause of high iron. Thank you!!