Tired All the Time? Understanding Hidden Iron Deficiency in Women

Fatigue, brain fog, and shortness of breath: could it be more than just a busy life?

We all feel tired now and then, especially when juggling work, family, and daily demands. But if your exhaustion is constant, the kind that no amount of sleep or coffee seems to fix, it may be time to look deeper.

As a doctor, I’ve seen many women blame low energy on stress, poor sleep, or just getting older. But in a surprising number of cases, the real culprit is iron deficiency, and it often goes undiagnosed.

What You Need to Know

Iron is essential for producing haemoglobin, the protein in red blood cells that carries oxygen throughout your body. Without enough iron, your cells don’t get the oxygen they need, leading to fatigue, weakness, and reduced mental clarity.

Even if you’re not anaemic, you can still be iron deficient. This is especially common in women due to menstruation, pregnancy, certain medications, or diets that lack sufficient absorbable iron.

Early signs include:

• Constant fatigue

• Pale skin

• Brain fog or trouble focusing

• Shortness of breath with minimal exertion

• Feeling cold all the time

• Hair thinning or increased shedding

These symptoms are often subtle and easy to dismiss. But left unaddressed, low iron can impact everything from your mood to your immune function.

Why It Matters

Iron deficiency is the most common nutrient deficiency worldwide, yet many women don’t know they have it. Blood tests may appear “normal” if ferritin (your iron storage protein) is not specifically checked.

In my practice, I’ve seen how even a mild drop in iron stores can affect quality of life. Patients who felt flat, foggy, or low in motivation often experience a dramatic improvement once their iron is replenished.

This is especially relevant for women in their 30s to 50s, who may be losing iron monthly, managing hormonal shifts, or simply not absorbing enough from their diet.

What You Can Do

If you suspect low iron, don’t guess. Ask your healthcare provider to test ferritin, iron saturation, and haemoglobin together, this gives a clearer picture than a basic full blood count alone.

In the meantime, here are some practical steps:

• Prioritise iron-rich foods like lentils, eggs, red meat, tofu, spinach, and pumpkin seeds.

• Pair plant-based iron with vitamin C (such as lemon or bell peppers) to improve absorption.

• Avoid tea or coffee with meals, as they can reduce iron uptake.

• If supplementing, choose a well-absorbed form like iron bisglycinate or a chelated formula, and take it on an empty stomach if tolerated.

Some women need more than dietary adjustments, especially if stores are very low or if they have absorption issues. Your doctor can guide you on the safest and most effective options, which may include temporary supplementation or iron infusions.

Doctor’s Insight

I always remind my patients that tiredness isn’t a personality trait. If your energy feels out of sync with your lifestyle, your body might be asking for help. Iron deficiency is treatable and correcting it can bring a profound shift in how you feel day to day.

I’ve seen women go from barely getting through the afternoon to feeling sharp, vibrant, and motivated again, all because they addressed this one missing link.

Disclaimer:
This article is for informational purposes only and does not constitute medical advice. Please consult your healthcare provider for personalized guidance.

References:

1. World Health Organization: Iron Deficiency Anaemia Fact Sheet

2. Mayo Clinic: Iron Deficiency Anaemia - Symptoms and Causes

3. National Institutes of Health: Iron - Fact Sheet for Health Professionals

4. British Journal of Nutrition (2021): Iron status in women of reproductive age

5. Cleveland Clinic: Iron Tests and When to Get Them