Iron Deficiency: The Overlooked Cause of Fatigue, Hair Loss & Brain Fog | Episode 61

In this episode of The Hormone Café, Dr. Sarah Pederson explains why you can be iron deficient even when you have been told your bloodwork is normal. She discusses the importance of testing ferritin, common symptoms and causes of low iron, and why identifying the root cause is just as important as replacing iron. In This Episode, You’ll Learn 🩸 Iron Deficiency vs. Anemia Iron deficiency and iron deficiency anemia are not the same. You can have depleted iron stores while your red blood cell count and hemoglobin remain normal. Anemia may not develop until the deficiency becomes more severe. This is why checking a complete blood count alone may not provide the full picture. ⚠️ Symptoms of Low Iron Iron is essential for carrying oxygen throughout the body and supporting energy production and neurological function. Possible symptoms include: Fatigue and weakness Hair shedding Feeling cold Headaches Shortness of breath A racing heart or heart palpitations Difficulty exercising Brain fog and difficulty concentrating Irritability or low mood Restless legs Craving ice 🔍 Common Causes of Iron Deficiency Dr. Pederson explains that low iron can be caused by: Heavy or prolonged periods Fibroids or uterine polyps Irregular ovulation Thyroid or hormonal concerns Pregnancy Restrictive diets Vegetarian or vegan diets without careful iron planning Gastrointestinal bleeding Celiac disease, H. pylori, SIBO, or poor nutrient absorption Replacing iron is important, but the underlying reason for the deficiency must also be identified and treated. 🧪 Which Labs Should Be Checked? A complete iron evaluation may include: Complete blood count, or CBC Ferritin Full iron panel Transferrin saturation Inflammatory markers when appropriate Ferritin reflects stored iron, but inflammation can make it appear higher than it truly is. Dr. Pederson explains why clinicians should evaluate the full picture rather than relying on one number alone. 🤰 Iron During Pregnancy Iron requirements increase significantly during pregnancy because the body is producing more blood and supporting the growth of the placenta and baby. Dr. Pederson recommends monitoring ferritin throughout pregnancy, especially when fatigue worsens or iron stores were low before conception. 🥩 Supporting Healthy Iron Levels Iron can come from both animal and plant-based foods. Sources of heme iron include: Red meat Shellfish Chicken Organ meats Plant-based sources include: Lentils and beans Tofu Spinach and kale Pumpkin seeds Pairing iron-rich foods with vitamin C foods, such as bell peppers, broccoli, or citrus fruit, may help improve absorption. 💊 Oral and IV Iron Some patients may benefit from oral iron, while others may require an IV iron infusion because of severe deficiency, absorption concerns, side effects, or an inadequate response to supplements. Iron dosing and treatment should be personalized and monitored by a qualified healthcare professional. Follow-up testing helps confirm whether iron stores are improving. Weekly Challenge If you have symptoms of iron deficiency or have never had your ferritin checked, ask your healthcare provider whether you need: A complete blood count Ferritin A full iron panel If your iron is low, work with your provider to identify the root cause, create a treatment plan, and schedule follow-up testing. Key Takeaways You can be iron deficient without being anemic. Ferritin is an important marker of stored iron. Heavy periods, pregnancy, diet, and gut absorption issues can contribute to low iron. Normal ferritin does not always rule out deficiency when inflammation is present. Treatment may include dietary changes, oral supplements, or IV iron. Finding and treating the root cause is essential. Iron levels should be retested to make sure treatment is working. Resources & Next Steps If you are experiencing fatigue, hair loss, brain fog, heavy periods, shortness of breath, or other possible signs of iron deficiency, Vera Health & Fertility can provide a comprehensive evaluation and personalized treatment plan. 📍 Westminster, Colorado 🌐 verafertility.com 📧 @verafertility