LIFESTYLE NEWS - “It’s all just too much” – it’s the lament so many women 25 years and over seem to be sharing. But there could be an underlying reason say experts, who are urging patients and medical professionals alike to consider whether low iron stores and/or anaemia is what’s quietly stealing women’s energy.

Low iron stores and anaemia are a growing health crisis affecting entire generations of young women, yet it remains largely unaddressed in many mainstream conversations. 

This, while women around the world are trying to stay ahead of the juggle struggle – determined to live their best lives while succeeding at work, building and maintaining healthy relationships and friendships, raising children and keeping an eye on their ageing parents. 

It’s a lot! And if your iron stores are depleted, it will feel like too much. 

Fatigue, insomnia, hair loss, dry skin and brittle nails, anxiety and depression are just some of the common symptoms, which too often women and their health care providers write off to “a busy life”.

Increased awareness among healthcare providers, better screening protocols for at-risk populations, and more available education to help women recognise and advocate for proper treatment of anaemia-related symptoms are needed to address this alarming global rise of anaemia and low iron stores in women.

New research shows that anaemia affects an estimated 30% (539 million) of women aged 15 – 49 years worldwide. In Africa, 43% of reproductive-age women suffer from anaemia. 

Health advocates say the alarming statistics explain why so many young women are experiencing overwhelming fatigue, anxiety, and depression during what should be their prime years.

“We’re seeing women in their 20’s, 30’s and 40’s who feel like they’re drowning physically and emotionally, and it’s being normalised as just ‘part of modern life’,” says anaemia awareness advocate and head of the Cape Town Infusion Centre, Sister Karin Davidson. 

“The reality is that feeling constantly exhausted, anxious, or like you're “living underwater” isn’t normal – it’s often a sign of iron deficiency and/or anaemia, a completely preventable and treatable condition.”

The hidden symptoms

While common medical symptoms of anaemia include fatigue, shortness of breath, dizziness, pale skin, hair loss, difficulty concentrating, and heart palpitations, health experts are increasingly concerned about the other symptoms that young women have been taught to normalise. 

Symptoms like anxiety that seems to come from nowhere, persistent depression, insomnia, overwhelming exhaustion, and brain fog.

There is a fundamental link between anxiety and depression and low iron stores and anaemia. Iron is an essential component in the production of serotonin – your brain's “happy chemical”, explains Sister Davidson. 

“When iron levels are low, the body struggles to produce adequate serotonin, which directly impacts mood, sleep patterns, and overall sense of wellbeing. Low iron and anaemia fundamentally alter how young women experience life – and when you’re in the prime of your life, that’s a travesty.”

Sister Davidson explains that normalising heavy menstrual bleeding is also causing many women to be suffering in silence “heavy menstrual bleeding is one of the leading causes of low iron stores and anaemia in women. Population based studies indicate that heavy menstrual bleeding may affect up to 50% of women of reproductive age, and blood loss from heavy menstrual bleeding is a key contributor to iron deficiency and anaemia. The problem is compounded as girls are now commencing menstruation earlier than previous generations,” she says.

High-risk categories 

Working women: Irregular eating patterns and stress can lead to poor iron intake. Hustle culture, the 9-5 and entrepreneurship can be tiring of course, but for the most part should feel exhilarating – when it feels like it’s physically destructive, there could be something else like low iron stores or anaemia at play. There is a direct correlation between low iron stores and cognitive function and women in their prime working years deserve to feel vital.

Vegans and vegetarians: Plant-based iron is less easily absorbed than iron from animal sources, putting vegan and vegetarian women at higher risk without proper dietary management. While good nutrition can help maintain healthy iron levels, it is almost impossible to rectify low iron stores through diet alone. “More young women than ever before who devise their own diets are simply not getting adequate nutrition,” says Sister Davidson.

Athletes: Intense physical activity increases iron needs, and female athletes often have higher rates of iron deficiency. More women than ever are focused on physical fitness, but this can also place extra pressure on iron stores if nutrition is sub-par.

A concern amongst medical professionals is patients who don’t receive adequate testing or treatment. 

“We see many cases where women's concerns are dismissed as ‘just stress’ or ‘part of being a woman’. Your symptoms matter, and you deserve to feel vibrant and energetic. If your doctor dismisses your concerns, seek a second opinion – a simple test will determine your iron store status,” says Sister Davidson.

Treatment and prevention solutions

Medical experts recommend young women request full iron studies to get an accurate reading. Oral iron supplements in appropriate dosages are typically a first-line treatment for low levels.

For moderate to severe cases, or when oral supplements prove insufficient, medical-grade iron infusions can rapidly restore iron levels, typically requiring only one to two treatments to achieve optimal results.

The years between 25 and 40 should be about making the most of every element of your life – work, play, family and you time – not about rationing your energy like it’s a precious commodity. 

As Sister Davidson advocates in her practice, “‘Think Iron. Check Iron. Take Iron. Your future self will thank you for taking action now”.

Suspect you might be at risk?

• Track symptoms and menstrual patterns.
• Request comprehensive iron testing from healthcare providers.
• Seek second opinions if concerns are dismissed.
• Consult registered dietitians for nutritional guidance.

Did you know? 

• It is almost impossible to correct anaemia by diet alone.
• Oral iron can work but takes time and needs to be taken correctly.
• Pairing iron-rich foods with vitamin C sources enhances absorption.
• Tea and coffee should be avoided with iron-rich meals.
• If anaemia correction is time sensitive such as in pregnancy or before surgery, or if oral iron doesn’t work, you may need intravenous iron supplementation.
• Only medical-grade scripted iron infusions are proven to improve iron and haemoglobin levels.
• Any intravenous iron should be administered by a licensed medical professional in a licensed medical practice.
• Many medical aid schemes will fund a necessary medical-grade iron infusion from overall annual limits (hospital benefit) or from Prescribed Minimum Benefits (PMB) provided relevant clinical criteria are met.

The Cape Town Infusion Centre is committed to managing iron deficiency and anaemia, to empowering patients, and to improving lives. Please contact them if you would like any further information.

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