MegaFood’s Dr. Erin Stokes Answers Your Most Common Questions About Low Iron in Women

Last Update: December 21, 2023

Dr. Erin Stokes has seen a lot of health conditions during her time as a Naturopathic Doctor and Medical Director for MegaFood, but she’s fostered a particular interest in one: iron deficiency in women. “It is the most common nutrient deficiency in the world,” Dr. Stokes shares. But despite its prevalence, the symptoms of iron deficiency (and the ways we test for it) are still a bit difficult to comprehend.

“Women may or may not be seeing a doctor regularly, and that can lead to undetected iron deficiency, and then these women are living with what can be debilitating fatigue. That’s why I’m really passionate about the issue,” Dr. Stokes says.

What Does Iron Do in the Body?

“Iron is an important component of hemoglobin, and hemoglobin is a protein in our blood that delivers oxygen to all of the tissues in our body,” Stokes explains. “Hemoglobin delivers oxygen to our brain and to our muscles, and hemoglobin needs iron. You can think of it as a messenger traveling all throughout our body, dropping off oxygen that is needed by our brain, needed by our muscles, needed by everything. Hemoglobin can’t do its job without iron, so iron indirectly is connected to oxygen delivery. If you don’t have enough iron, you are literally not going to get enough oxygen throughout your body.”

Who is at Risk for Iron Deficiency?

Dr. Stokes says that menstruating women are some of the highest-risk cases for iron deficiency, particularly if they have heavy periods. “If a woman has a heavy cycle, month after month of heavy bleeding, over time she could become iron deficient,” Dr. Stokes says. She also recommends talking to your doctor right away if you suspect that you may be bleeding more than a normal amount during menstruation (this may mean you’re changing your tampon every hour, or passing clots larger than the size of a quarter). For many women, their iron deficiency may go undetected simply because they don’t realize or don’t discuss the heaviness of their menstruation. “It’s something that a lot of women don’t really talk about. Even in this age of being more transparent, a lot of women still don’t really talk about the nature of their menstrual cycle and how much they’re bleeding.”

Aside from women, other groups who may be particularly at risk for iron deficiency are teenagers, as they are going through a period of rapid growth; pregnant women; athletes, as they frequently use iron more quickly than those with less active lifestyles; and blood donors. If you fall into any of these groups and notice any of the signs of iron deficiency, Dr. Stokes recommends talking to your doctor.

What are the Symptoms of Low Iron?

“There are so many women out there who are feeling tired all the time and they don’t know why,” Dr. Stokes says. Fatigue is one of the main symptoms of iron deficiency, but there are also other signs to look out for.

The key symptoms of low iron in women are:

  • Fatigue
  • Clammy hands and feet
  • Difficulty concentrating
  • Paleness
  • Frequently feeling cold

While Dr. Stokes suggests paying attention to your symptoms, she also cautions against jumping to conclusions too quickly. “If you have these symptoms, you could be iron deficient,” Dr. Stokes says, “But it’s important to note that these symptoms are somewhat non-specific and could also be something else. You should investigate iron deficiency, but the main point is to work with your healthcare practitioner.”

How Do You Test for Iron Deficiency?

“Iron deficiency can be elusive because it may not show up on a standard blood test,” Dr. Stokes explains. “I recommend talking to your doctor about testing ferritin, which is the protein in red blood cells that stores iron.” Doctors often test for CBC (complete blood cell count), hemoglobin, and hematocrit, but Dr. Stokes explains that testing ferritin is an especially great way to uncover iron deficiency. She gives an example: “Say the gas light is on in your car. You’ve got to get gas, but your car is still running, still driving down the street at least for a little bit longer. That’s what happens when you have low ferritin. Your hemoglobin and hematocrit act may actually be normal, but ferritin helps make the complete picture of what’s really happening.”

What is the Difference Between Anemia vs. Iron Deficiency?

When discussing iron deficiency, many people jump quickly to anemia, though the two are not necessarily always linked. Anemia is a condition that occurs when the body produces a lower-than-normal number of healthy red blood cells. “Anemia is a disease state,” Dr. Stokes explains. “The term ‘anemia’ is used somewhat mistakenly. Often when people say anemia, they are implying that it’s iron deficiency anemia, but in fact there’s lots of different causes of anemia — there’s vitamin B12 related anemia, there’s all different kinds of anemia. That’s a good myth to clear up: anemia doesn’t always even mean iron deficiency anemia. [At MegaFood] we’re really focused on nutrient deficiency, because that’s something that we can address the way that we talk about vitamin D deficiency or any other deficiency. Supplements can’t ever claim to diagnose, treat, or cure any disease.”

How Can You Add More Iron to Your Diet?

Dr. Stokes is quick to say that one of her mantras is “Food first”. “At the end of the day, I’m a naturopathic doctor, so food is always first to get your nutrients.”

There are many iron-rich food sources that you can add to your diet to help improve your iron levels. Heme iron is found in animal-based foods (think of things like beef and liver). Non-heme iron comes from plant-based foods, like spinach, kale, and other leafy greens, as well as beans, lentils, and other legumes. “It’s a little corny, but Popeye wasn’t wrong,” Dr. Stokes jokes.

To prioritize adding iron into her diet, Dr. Stokes says she starts the day with a smoothie loaded with green vegetables, and for lunch or dinner, she suggests a “beans and greens” salad topped with raw cashews. Meat eaters can add in things like grass-fed beef, turkey, or venison.

What is the Best Iron Supplement For Women?

Dr. Stokes is a big believer in MegaFood’s Blood Builder. “One of the reasons I am really passionate about this issue is because I’ve literally seen hundreds and hundreds of women helped by Blood Builder,” she says.

“Part of what makes Blood Builder seriously a powerful solution is that it’s this exclusive form of fermented iron bisglycinate,” she says. She explains that many iron supplements come along with a host of negative gastrointestinal side effects, which make it difficult for many women to find an iron supplement they can handle. “There’s a study that shows that up to 50% of people will stop taking their iron supplement in the form of ferrous sulfate because they don’t want to deal with the side effects,” Dr. Stokes says. Because Blood Builder is made with a different type of iron, it doesn’t cause these uncomfortable side effects.

She also offers a little “pro tip” for those looking to add Blood Builder into their routine: take it alongside a Vitamin C supplement. “Vitamin C is a good teammate for iron in terms of helping facilitate optimal absorption.”

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before changing your diet or healthcare regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

This article is related to:

Supplements, Women's Health

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Amy Roberts

Amy Roberts is Thrive Market's Senior Editorial Writer. She is based in Los Angeles via Pittsburgh, PA.

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