Do you have iron deficiney?
What’s not top of mind for many people is that a number of familiar daily struggles are classic signs of iron deficiency. Persistent fatigue, restless sleep, anxious moods, palpitations, brain fog, heavy periods, hair loss, joint aches and mood swings — which we tend to normalise as just part of being human in the modern world — can all be indicators. And it doesn’t take full-blown anaemia for iron deficiency to take its toll. Even a mild depletion can leave you feeling not quite yourself.
Iron deficiency: not rare, not niche
Iron deficiency is not a rare or niche problem. It is the most common nutrient deficiency in the world, affecting people of all ages and backgrounds. Women and children, however, carry the heaviest burden. For women, monthly blood loss through menstruation and the increased demands of pregnancy can rapidly deplete iron stores. For children, periods of rapid growth place heavy demands on their developing brains and bodies. And if a mother’s iron status is low during pregnancy, her baby may be born already at a disadvantage.
Large-scale studies underscore just how widespread this issue is. One investigation in Western Australia found that one in three children were iron deficient. A New Zealand study found that 55 per cent of women are affected by some degree of iron deficiency, while in Sweden a study revealed that 38 per cent of teenage girls were iron deficient. Among those following vegetarian, vegan or pescatarian diets, the number climbed to nearly 70 per cent. Millions of people are walking around every day battling symptoms they’ve come to accept as “just normal life” — when, in reality, their bodies are crying out for help.
Iron, mood and the mind
Most of us know that iron is essential for energy, but few appreciate how deeply it influences mental wellbeing. Iron is required to create key neurotransmitters — dopamine, serotonin, GABA and melatonin — the messengers that help regulate motivation, calmness, resilience and sleep. When iron is low, we cannot produce these chemicals in adequate amounts. The effects often begin subtly: a restless mind at night, a shorter fuse or a lack of drive. Left unaddressed, these can develop into anxiety, low mood and poor sleep.
Studies suggest that up to one in five women in Australia are misdiagnosed with psychiatric conditions such as depression, anxiety or insomnia, when the underlying issue is actually iron deficiency. Why does this happen so frequently? Partly because the profound impact of low iron is under-recognised and under-tested. Partly because its symptoms overlap so closely with mood disorders. This is why iron deficiency so often hides in plain sight — especially among adolescent girls.
Heavy periods, hormonal shifts and skin concerns frequently lead to prescriptions for the oral contraceptive pill, while the underlying deficiency goes unchecked. When mood changes follow, antidepressants are sometimes added, leaving a child on two of the world’s most powerful medications and the original problem unresolved. The consequences of misdiagnosis extend far beyond health. When someone believes they are “broken” or defined by the label of an illness, it can shape their choices in education, work and relationships.
Iron and the thyroid
Iron also plays a vital role in thyroid hormone production. This tiny butterfly-shaped gland in the neck regulates energy, metabolism, temperature and even mood. Yet its ability to function depends on having enough iron. Iron is required to produce thyroid hormones in the first place, as well as to convert the inactive form of thyroid hormone (T4) into its active form (T3) — the very hormone that fuels energy production in every cell. When iron is low, this conversion slows down.
The result? Fatigue that sleep doesn’t fi x, unexplained body fat changes, feeling constantly cold, hair thinning, dry skin and low mood. These are often chalked up to “thyroid problems” alone, yet in many cases iron deficiency is an invisible driver behind the scenes. For those experiencing signs of an underperforming thyroid, checking iron status can be a critical — yet too often overlooked — part of the puzzle.
Why iron matters through menstruation
For many women, menstruation is the single biggest factor influencing iron status — and is a major reason why a menstruating female needs 18mg of iron per day. Month after month, blood loss steadily draws on iron stores, and if those stores aren’t being replenished, deficiency soon follows. Heavy periods in particular can accelerate this process, leaving women exhausted, foggy and emotionally fragile — symptoms often brushed off as “just part of having a period”.
Yet these struggles are not inevitable. Fatigue, restless sleep, anxious moods, headaches and low resilience around the cycle are often early whispers of low iron. Over time, these can intensify into brain fog, palpitations, hair thinning or thyroid hormone changes. A woman who carries low iron through her menstruating years may arrive at perimenopause already running on empty. What might otherwise have been a more gentle transition can feel overwhelming.
This is why iron matters not just during menstruation, but across the lifespan. Protecting iron levels in the bleeding years not only supports energy, mood and resilience day to day — it also lays the foundation for a steadier, more supported journey into perimenopause and beyond.
Correcting iron deficiency
The good news is that iron deficiency is highly correctable — once we stop dismissing the signs. The first step is to increase your intake of iron-rich foods. Haem iron, found in animal foods, is absorbed most efficiently. Non-haem iron, from plant foods, is less readily absorbed. This is why people following a plant-based diet need almost twice the intake of iron compared with omnivores. Pairing plant-based iron sources with vitamin C — think spinach with lemon, or beans with capsicum — can boost absorption.
But food intake is only part of the story. Absorption itself is often the missing factor in stubborn cases. Gut health, undiagnosed coeliac disease, inadequate stomach acid, inflammation and certain medications can all interfere with uptake, as can drinking tea or coffee too close to an iron-containing meal.
Iron metabolism also depends on a symphony of other nutrients. Copper and vitamin A (along with beta-carotene) are essential for healthy iron storage and recycling. Copper helps iron get out of gut cells and into the blood, and also helps iron move into storage. Vitamin A is necessary for iron’s release from storage and improves its availability for use. You’ll find copper in foods such as shellfish, organ meats, nuts, seeds, legumes and dark chocolate. Vitamin A is present in liver and eggs, while beta-carotene comes from orange- and yellow-coloured vegetables and fruits like carrots, sweet potato, pumpkin and apricots.
Iron food guide
Animal sources of iron include red meat, off al (organ meats such as liver), sardines, mussels, shellfish and eggs. Plant sources include seaweed, parsley, greens (including spinach, silver beet and kale), goji berries, tofu, legumes, and nuts and seeds.
When food isn’t enough
For many people — especially menstruating and pregnant women, or children in rapid growth phases — supplementation may be necessary. But the type of iron chosen matters. Old-school supplements can be poorly tolerated and often face the same absorption hurdles as food. Newer ferritin-iron formulations (sourced from peas) are absorbed diff erently from all other forms of iron. In these, iron is naturally housed inside a protein shell.
Instead of exposing gut cells to “free iron” the way conventional iron supplements do (which can drive infl ammation, oxidative stress and gut-related side effects like constipation), ferritin-iron is primarily absorbed intact in the small intestine. For those who have struggled with conventional, synthetic iron supplements, ferritin-iron bypasses all the common absorption issues and has been shown to support the effective restoration of iron levels, without the side effects.
Correcting iron deficiency is not just about “getting more iron”. It’s about optimising absorption, ensuring the right cofactors are present and, where needed, choosing the most eff ective form of supplementation. When these pieces come together, the body can restore its status — and with this, energy, mood and resilience.
Where to from here?
If you recognise yourself in these symptoms, please know you are not alone — and you are not broken. Iron deficiency is the most overlooked reason people feel tired, foggy, anxious or fl at. The beauty of recognising iron defi ciency is that it can be corrected. With the right awareness, testing and approach, iron levels can be restored — often transforming not just physical energy, but also mental clarity, emotional steadiness and overall quality of life.
Your body’s whispers are worth listening to. They are not a nuisance to silence but a guide pointing you back to optimal wellbeing. When iron defi ciency is addressed, so much else falls into place — and life feels lighter and brighter again.
This article is featured in WellBeing Magazine 223
