Iron Supplement Boosts Energy in Women with Unexplained Fatigue
September 25, 2003—Women suffering from unexplained fatigue may be able to increase their energy level by taking supplemental iron, according to a new study in British Medical Journal (2003;326:1124–7). This is the latest of several published studies to demonstrate that iron deficiency, even in the absence of anemia, is a common cause of fatigue in adult women and that iron supplements significantly improve energy levels.
Iron deficiency is a common problem; one study suggests that it may affect as many as 20% of women of childbearing age. Severe iron deficiency results in anemia, which itself can cause fatigue. In most women with iron deficiency, however, the deficiency is not severe enough to cause anemia. As iron plays a key role in many body functions, including energy production, muscle contraction, and brain function, one does not need to be anemic to experience the ill effects of iron deficiency. The most common complaint with iron deficiency is fatigue, but other symptoms may include hair loss, brittle nails, poor memory or concentration, insomnia, anxiety and depression. In children, severe iron deficiency may lead them to eat dirt (a condition called pica).
In the new study, 136 non-anemic women between the ages of 18 and 55 years with persistent fatigue were assigned to receive 80 mg per day of iron (from ferrous sulfate) or placebo for four weeks. Their levels of fatigue, depression, and anxiety were measured initially and after four weeks of treatment. Blood levels of hemoglobin and ferritin (a measure of body iron stores) were also measured at the same intervals.
The women who took the iron supplement had a 29% decrease in their level of fatigue, compared with a 13% decrease in those taking a placebo. More than half of all participants had significantly reduced ferritin levels (less than 20 mcg per liter) at the start of the study, suggesting they were iron deficient. The benefit of iron therapy was only observed in women whose initial ferritin level was less than 50 mcg per liter, suggesting that fatigue in women with normal ferritin levels cannot be attributed to iron deficiency.
Iron deficiency often goes undetected, since the ferritin test is not typically included as part of routine blood work. More commonly used lab tests, such as red blood cell count and hemoglobin and serum iron levels will often fail to identify women with iron deficiency. However, iron deficiency is only one cause of fatigue, so other explanations should be investigated before starting treatment. Taking supplemental iron may also be harmful for some women. A common genetic disorder called hemochromatosis causes excessive accumulation of iron in the body; individuals with this disorder who take supplemental iron could develop liver disease or other serious problems. Excessive amounts of iron may also lead to constipation and abdominal pain. Iron should only be taken after having specific blood tests to make sure it is safe.
Foods that contain iron include red meat, dark green leafy vegetables (such as kale, chard, and mustard greens), legumes, nuts, and molasses. Taking small amounts of vitamin C or taurine can increase the absorption of iron, while coffee, tea, soy products, and calcium can inhibit iron’s absorption when taken at the same time.
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Darin Ingels, ND, MT (ASCP), received his bachelor’s degree from Purdue University and his Doctorate of Naturopathic Medicine from Bastyr University in Kenmore, WA. Dr. Ingels is the author of The Natural Pharmacist: Lowering Cholesterol (Prima, 1999) and Natural Treatments for High Cholesterol (Prima, 2000). He currently is in private practice at New England Family Health Associates located in Southport, CT, where he specializes in environmental medicine and allergies. Dr. Ingels is a regular contributor to Healthnotes and Healthnotes Newswire.
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