The Iron Deficiency Epidemic among Female Lifters

Author: Dani Shugart

Introduction

There exists a silent yet significant epidemic affecting female lifters. This condition leads to muscle weakness, fatigue, and cognitive impairment. Addressing this iron deficiency is crucial, and the following provides insights on how to combat it.

If you find yourself constantly exhausted and missing workouts, it's likely not due to a lack of willpower or competence. Instead, it could be a sign of a serious underlying physiological issue. But there's no need to panic, as there are straightforward solutions available.

Personal Experience: A Struggle with Iron Deficiency

"Thought I Was Dying. Didn’t Care."

I experienced symptoms such as being perpetually cold, extremely fatigued, and emotionally volatile. No energy drink could rouse me from this state, and workouts only exacerbated my discomfort. I lay in bed, marveling at how others seemed to live with such ease, as even the simplest tasks like standing, moving, feeling happy, or thinking felt like Herculean efforts.

When my boyfriend (now husband) called to offer to make me dinner, I was unable to decide. The thought of driving anywhere was overwhelming, and I found myself in tears. I couldn't precisely articulate what was wrong; nothing physically hurt, yet everything felt dreadful.

My limbs felt incredibly heavy. I had to leave a group fitness class because the mini - barbell was too burdensome to hold. Coincidentally, that same week, a nurse refused my blood donation due to insufficient iron levels. Eventually, I realized a potential connection between these events. I began supplementing with iron, and within days, I started to feel more like my normal self—decisive, happy, strong, and energetic. Although I may still have been iron - deficient, the supplementation was sufficient to alleviate my anemia.

It's important to note that I'm not a medical professional, and I don't advocate for blindly supplementing without proper blood tests and a doctor's recommendation. Over the years, I've learned that relying solely on a diet rich in spinach and red meat isn't always enough to maintain adequate iron levels. Low iron is a serious concern, and diet alone often can't prevent its onset. The following information will help you understand how to avoid this issue.

The Role of Iron in the Body

What the Heck Does Iron Do, Anyway?

Iron is an integral component of hemoglobin, which is responsible for facilitating the delivery of oxygen by blood cells to muscles, the brain, and all other organs. Logically, insufficient iron can slow down bodily functions, resulting in lethargy, weakness, cold intolerance, and an overall sense of malaise.

Regardless of how much red meat you consume, if your iron levels are chronically low, supplementation may be necessary. Runners, lifters, women with intense exercise routines, or those with heavy menstrual periods may not be able to overcome an iron deficiency solely through diet. While an occasional extra steak might make you feel better, this is likely due to its palatability rather than a significant improvement in iron levels. If your iron levels are chronically low, consistent supplementation, similar to the regularity of a drug user's heroin injection, is required to raise and maintain optimal levels.

Low iron is less prevalent in men as they don't experience monthly blood loss like women. However, male endurance athletes, regular blood donors, or those with internal bleeding or other conditions causing blood loss are at risk. Similarly, post - menopausal women who engage in intense gym workouts or endurance sports may also have low iron levels.

The Impact of Slight Iron Deficiency

A Slight Deficiency Sucks Too

Even if your iron levels aren't low enough to be classified as anemia, a slight deficiency can cause a variety of symptoms that you may not even be aware of. Low iron is associated with:

• Cravings

• Cold intolerance

• Constipation

• Depression

• Dizziness

• Fatigue

• Hair loss

• Headaches

• Irritability

• Muscle weakness

• Non - restorative sleep

This is just a partial list. When my iron levels dip, I experience mini - blackout spells and dizziness upon standing, which adds an interesting challenge when loading a barbell or placing dumbbells on the ground after a set of walking lunges. I've also endured a month - long fungal infection that made my life miserable, and it turns out this may be linked to low iron as well.

Understanding Iron Levels: Adequate vs. Optimal

Adequate vs. Optimal Levels

To assess your iron levels, a CBC (complete blood count) and a serum ferritin test are required. Pay attention to your ferritin serum levels; ferritin is the protein in the blood that transports iron. The minimum level should be 30 ng/mL, with an ideal range between 50 - 150 ng/mL. These figures are based on the expertise of Dr. George Juetersonke, a progressive D.O., who deems anything below 30 ng/mL as too low.

Consider the analogy of filling your car with gas. Do you wait until it runs out and you're stranded on the freeway, or do you refill when the gauge indicates low fuel? Most doctors tend to only diagnose low iron when your "car" (your body) has essentially broken down, often waiting until you're anemic before suggesting improvement.

Why wait until your quality of life deteriorates when you can address sub - optimal iron levels proactively? The problem is that many general practitioners consider a ferritin serum range of 15 - 150 ng/mL to be acceptable. So, if you're at what they consider an "adequate" level of 15 ng/mL and you're experiencing sluggishness, weakness, and a low mood, your doctor may diagnose you with something else or assure you that you're fine, simply because your ferritin serum is within their defined "adequate" range. All you may need to do is let your iron levels deplete further, feel even worse, and then perhaps your doctor will recommend raising them.

At a ferritin serum level of 18 ng/mL, I was informed that my iron deficiency was "moderately severe" and that I needed to supplement immediately. My doctor has since been regularly testing and monitoring my blood levels until they stabilize around 80 ng/mL—five times the amount many doctors consider sufficient—because he aims for his patients to perform at their best.

Moreover, while most doctors state that the healthy range for men is 50 - 150 ng/mL, they consider it acceptable for women to be as low as 15 ng/mL. This is unjustifiable. Body size and musculature do not account for such a significant discrepancy. In reality, both men and women need ferritin serum levels between 50 - 150 ng/mL. Although there may be differences in medical opinions on this standard, it's advisable to aim for the higher end of the range to avoid deficiency.

Increasing Iron Levels

How Do I Get It Up?

Foods rich in iron include meat, liver, poultry, seafood, dark leafy vegetables such as spinach, legumes, and, in extreme cases, human blood (for vampires or cannibals). Combining these with vitamin C - rich foods can enhance iron absorption. However, if you have heavy periods or engage in intense exercise, dietary iron may not be sufficient, and supplementation may be the only way to raise and maintain optimal iron levels. As a meat - eater, I find that consuming red meat five times a week only barely keeps me above the anemia threshold, making supplementation essential.

When looking for supplements, consider those containing:

• Ferrous sulfate

• Ferrous gluconate

• Ferrous fumerate

• Ferrous bisglycinate

• Supplemental iron derived from whole - food sources like liver or beet root

If your iron levels are extremely low, you may need a high - potency supplement that exceeds the typical daily recommended amount. It may take several weeks to raise your iron to optimal levels, even with this high - dose supplementation. Once optimal levels are reached, you can likely reduce the dosage to a maintenance level. This is why it's crucial for you and your doctor to monitor your lab results, as excessive iron levels can lead to serious problems.

One of the unfortunate side effects of iron supplementation is constipation. Fortunately, there are non - constipating iron supplements available. You can also mitigate this issue by taking a magnesium - containing supplement (available on Amazon) at night.

Depression or Anemia?

Depression or Anemia?

In the United States, one in four women are on mood - related medications. Is it really the case that a quarter of American women are depressed, anxious, bipolar, etc.? These are indeed real biological issues, but if they are also a consequence of anemia or a similar problem, addressing the root cause will alleviate the debilitating symptoms.

If you're unaware of your anemia and visit a doctor with the symptoms described above, there's a possibility of being misdiagnosed with depression, chronic fatigue, or another condition. For example, if I had been prescribed Prozac years ago when I was crying for no apparent reason, feeling apathetic, and struggling to function normally, I would have had to deal with the side effects of the drug on top of my anemia.

The Hypothyroidism Connection

The Hypothyroidism Connection

Thyroid hormones play a pivotal role in metabolism, so hypothyroidism is a serious concern. The relationship between impaired thyroid production and low iron levels is complex and intertwined.

Many doctors debate which comes first: Does impaired thyroid hormone production lead to low iron levels, or vice versa? The answer is that both can be true. My doctor has noted that many women are misdiagnosed with hypothyroidism when, in fact, their iron levels are simply low. However, other doctors argue that low iron is a consequence of hypothyroidism.

Indeed, impaired thyroid function, along with associated digestive and gut issues, can impede nutrient absorption, making it difficult for the body to utilize the iron it consumes and supplements with. Conversely, inadequate iron levels can also impair thyroid function.

Therefore, if you're getting a CBC test, it's advisable to also have your thyroid hormones checked. If possible, seek the assistance of a professional who can guide you through these complex issues. If you don't find relief, consider consulting another professional or conducting further research on your own.

The Importance of Blood Testing

Get Your Blood Tested

Find a doctor who will involve you as an active participant in addressing the root cause of the problem. Alternatively, you can get your blood tested independently to directly assess your numbers. Stay informed about your own health, as an outdated doctor may lead to you suffering unnecessary consequences.

The best doctors will empower you with knowledge about your body, while the worst will keep you in the dark or provide poor advice. Remember that if necessary, you can get your blood screened without a doctor's supervision. Know which tests to request and what numbers to look for.