Iron Deficiency By Dr. Kim Bretz

September 25, 2022

Thank you to Dr. Kim Bretz, who is a naturopathic doctor working and living in Waterloo Region for contributing to this blog. Kim is a speaker, consultant and adjunct faculty at the University of Waterloo, Pharmacy.

You’d think that working in healthcare with people with gut/hormone issues & fatigue, I’d be much more in tune with my own energy levels. But after a very rough couple years, this spring, I found myself exhausted and overwhelmed with the smallest things. And worse, in my plan to help deal with my burnout, I’d promised myself I’d be getting back into workouts.

Yet, even after committing to working out, they not only weren’t feeling like they were helping, I was actually feeling like I was getting worse. Worse in how I was feeling and worse in the workouts. Everything felt like I was moving through thigh deep water. I’d noticed that I was tired to the point I wanted to sleep mid-afternoon and could actually nap (which wasn’t typically a thing for me), I was more snappy (than usual), I wasn’t sleeping well, I wasn’t interested in much and even walking up the stairs with laundry felt like a marathon, my hair was coming out in handfuls when I showered and my heart rate was spiking with the simplest of tasks.

But I still told myself it was burnout. Until that day when I realized that everything I talked about with my patients was not being done by me. I needed to first make sure that there was nothing else going on before I decided it was just burnout (and having something else going on didn’t mean I wasn’t also burned out). So I quickly got it set up to get testing done and within a day found out that I was iron deficient. Not a little bit iron deficient but ‘congratulations for walking, you’re so iron deficient’ level (which is one of the categories I have for patients). It didn’t seem possible. I had tested less than two years previous and my numbers were normal enough.

The good thing is, while I might not love taking iron supplements, I had something to treat. The harder part is that we then need to figure out why we’re low and make sure levels are increasing – if we don’t deal with the underlying issue, it can continue. There are some really common reasons people are iron deficient – here are a few:

Menstruating – especially with a heavy period or when your cycle gets closer & closer together. It’s hard to make up for the losses.

Diets low in iron – that can include vegetarian and vegan diets but can also just be low nutrition diets, in general

Gut disorders – if you have gut issues, you can have issues absorbing your iron

Being an athlete – whether it’s due to the extra nutrition requirements of an athlete or a combination of the above things, iron deficiency is common in athletes, especially female athletes

The great thing is, I’m feeling much better. A workout with cardio doesn’t make me want to sob (although it’s still hard) and I’m feeling like I’m slowly starting to make gains again. If you’re feeling tired, it might be more than you think – talk to your healthcare provider.

Iron Deficiency Fast Facts:

Iron deficiencies are common – but it’s not safe to take iron without testing to know first. Too much iron can be harmful.

You can be iron deficient – which causes symptoms - without being anemic

The range listed on your blood work doesn’t mean things are healthy – it’s just the reference range for where 95% of the reference population sits. Being just above normal is generally not going to be good enough.

If you have an inflammatory condition, the regular test we use (ferritin) can be ineffective. Inflammation causes ferritin to increase masking an iron deficiency. In cases of inflammatory conditions (like IBD or PCOS) it might be better to use iron/TIBC for testing.

Iron deficiency can be treated but should be monitored to ensure your levels are going up but not going to high

If you don’t deal with the reason(s) you’re deficient you may end up needing to take long term iron supplement or even get infusions to help keep yourself feeling healthy & strong