Tired? Weak? Feeling irritable? Perhaps it’s not what you think…maybe you have iron deficiency. Because low iron in women is so common we asked a professional for some advice on how to detect, get tested and be treated for iron deficiency.

Although we used to believe that only low hemoglobin made women feel tired, we have good studies now that show low iron stores—even if hemoglobin is normal—can make women feel tired, weak and dizzy as well as have them experiencing poor concentration, mood changes and poor sleep. In Western countries, 40% women of childbearing age have iron deficiency (ferritin < 30) and 4% have iron deficiency anaemia.

Who is most at risk?

Menses and pregnancies reduce women’s iron stores dramatically. Most women need some iron supplementation if they have heavy menses or are pregnant as it is very difficult to get enough iron from diet alone. We now also have effective ways to treat low iron by pill and, in some cases, by intravenous iron if needed. Studies show treating iron deficiency can drastically improve quality of life for women with low iron.

Pregnant women are especially at risk of being iron deficient and iron deficiency in pregnancy has been linked to low birth weight, postpartum depression and increased risk of blood transfusions for mom at delivery. Also, low iron stores in mom are linked to low iron stores in baby and iron is necessary for normal neurological development in infants.

How do I know if I have low iron?

There are many ways to measure iron but to look for low iron stores your ferritin should be checked, which is a simple blood test. Usually, hemoglobin should also be checked at the same time with a complete blood count to look for anemia.

How can you tell if you’re one of the 40% with low iron? Aside from a blood test, you should also be on the lookout for these warning signs:

1. Exhaustion

The body uses iron to make hemoglobin, the substance that carries oxygen in our red blood cells. When you don’t have enough oxygen circulating, you start to feel extremely tired and worn down. 

2. Breathlessness

Whether you’re playing at the park with the littles, working out at the gym or even just walking down the street and you feel as though you can’t catch your breath. Why? Those pesky oxygen molecules again…they have no hemoglobin to carry them around.

3. Difficulty Doing Your Normal Workout

Struggling to do the same number of reps you whizzed through a few weeks ago—even though you haven’t been slacking off? Low iron levels can lower your endurance.

4. Crazy Sore Muscles

If you actually do drag yourself to the gym, you’ll probably feel the burn for longer than normal afterward. Not having enough iron deprives your muscles of their ability to recover properly, leading to aches and pains.

5. Poor Concentration and Lack of Interest

Feeling like all you want to do is crawl under a rock? Not even tempted out by the latest preview for Game of Thrones? Apathy is another possible by-product of that altered neurotransmitter synthesis.

6. Paler than Normal Skin

Are coworkers commenting that you’re looking a little bit like a True Blood vampire? They might not mean it as a compliment (though some of them are hot!).  A washed-out appearance can be caused by reduced blood flow and decreased number of red blood cells.

7. Brittle Nails

Nails chipping and breaking easily? Even the cutest mani/pedi can’t hide thin, frail fingernails and toenails.

8. Weird Cravings

Some women who are extremely iron deficient have cravings to chew ice or eat unusual substances (called “Pica”). Get your ferritin checked NOW.