Iron Deficient Anemia

Iron Deficient Anemia is a condition up to one third of woman may suffer from. Women who are moving into menopause are more likely to become anemic (3). Anemia effects cognitive or thought process. It impacts attention, learning, and intellectual ability. This is partly due to iron’s effects on memory (long term, short-term, and working memory) as well as emotional well-being (3). Iron may play a similar role in mood regulation. There is some data to indicate that low iron levels may underlie the symptoms of depression in some cases (3). Iron is needed for the “feel good neurochemical” dopamine’s receptors to work properly (4). Dopamine  may also be important to the learning process.

Anemia is often caused by one or more of the following: heavy periods or menorrhagia (1), medical conditions like hypothyroidism, or the use of medications like non-steroidal anti-inflammatory drugs (NSAIDs) or antacids (2).

Hypothyroidism can cause anemia in both those with subclinical hypothyroidism and overt hypothyroidism (6). Anemia can also by a symptom of more serious health problems. Disrupted nutrient absorption due to gastrointestinal problems (irritable bowel syndrome (IBS), coeliac disease, or parasitic problems may account for six percent of women with anaemia (5). Infectious diseases, (hook worm), Renal disease, and auto immune problems may be responsible for anemia (5). Low iron levels are also linked to vaginal infections (7).

Anemia is often diagnosed when a test shows a haemoglobin of 12.0g/dL or below, though other tests may be necessary as hemoglobin can be higher than this, but the person being tested may still be anemic (5). The most common cause of anemia in peri-menopausal women is iron deficiency. Diets low in iron rich foods (protein, fortified cereal grains, and green, leafy, vegetables) may be the culprit (5). Deficiencies in folate and vitamin B12 can also impact iron deficient anemia.

Diagnosis of anemia usually starts with blood tests focusing on deficiencies in iron, vitamin B12, and folate levels. Other medical tests (liver, thyroid etc.) may also be necessary.

Treatment for anemia

Medical treatments: iron supplements combined with B12 and folate may be recommended. Iron supplements should be taken with vitamin C as this helps with absorption. Avoid taking these with calcium supplements or calcium rich foods, as calcium may disrupt iron absorption. If oral iron does not work, then intravenous iron may by prescribed. Side effects of oral iron can include diarrhea, constipation and abdominal pain, heartburn, blackened stools, and feeling ill (2). Take iron with food if possible.

Once your iron levels return to normal your doctor may recommend you stop taking the supplements after another three months have passed.

Non-medical treatments: revolve around dietary changes. Try to get more protein rich foods. Good sources are: fish, eggs, meat, (red and white); vegetarian sources include brown rice, nus and seeds, pulses (beans and legumes), dried fruit, and iron-fortified bread and cereals, and dark green, leafy, vegetables (2).

Try to combine these foods with  vitamin C rich foods or supplements as to increases iron absorption.

Avoid taking iron with the following as it reduces absorption: tea or coffee, antacids or proton pump inhibitors (PPIs), wholegrain cereals that have phytic acid (as this stops the absorption of iron from other sources), calcium rich foods or supplements (2).

Taking too much iron can be problematic or even fatal. High quantities of iron can cause liver failure, intestinal and stomach problems, and even dangerously low blood pressure, and death. Higher than normal iron levels may also be implicit in heart disease in women with type II diabetes (8).



1 Cemcor centre for menstrual cycle and ovulation research at UBC website. Webpage: very heavy menstrual flow. Retrieved from:

2 British National Health Services website. Web page: Iron deficiency anaemia-treatment. Retrieved from:

3 Lomagno, K.A., Hu, F., Riddell, L.J., Booth, A.O., Szymlek-Gay, E.A., Nowsen, C.A., & Byrne, L.K. (2014).Increasing iron and zinc in pre-menopausal women and its effects on mood and cognition: A systematic review. Nutrients 6 (11), 5117-5141.doi: 10.3390/nu6115117

4 Youdim, M.B., Ben-Shachar, D., Ashkenazi, R., & Yehuda, S., (1983). Brain Iron and dopamine receptor function. Advances in Biochemical Psychopharmacology, (37), 309-321.

5 Kaushik, G. Midlife and Beyond, GM2 (2009). Anaemia in the post-menopausal woman. GM2 Midlife and Beyond, June, 37-40. From gm journal website, webpage: Anemia in the post-menopausal woman. Retrieved from:

6 website. Webpage: study looks at link between anemia and hypothyroidism. Retrieved from:

7 Hemalatha, R., Ramalaxmi, B.A., Swetha, G.K., Rao, D.M., Charyulu, S., & Kumar, D. (2012). Nutritional status, bacterial vaginosis and cervical colonization in women living in an urban slum in India. International Journal of Nutrition and Metabolism 4 (5) 77-82. Doi: 10.5897/ijnam12.005.

8 Web MD website. Webpage: find a vitamin or supplement: iron. Accessed on 5/11/2017. Accessed at:

The information on this site is for educational and informational purposes only.  It is not to take the place of medical advice or treatment.   Seek out a qualified health care provider if you have questions or need help.  Dr. Grant is not responsible for any possible health consequences of anyone who follows or reads the information in this content.  Everyone, but especially those taking medication (over the counter or prescription) should talk with a physician before undertaking any changes to their lifestyle or diet (including taking supplements).