Transcript

Hello. Hello. Welcome back to the Hormone Hub Podcast, your go-to source for all things related to women’s health, hormones, perimenopause, menopause, and all the [00:01:00] fun things. I’m your host, Kylie Pinwill, and today we are having a look at the importance of iron. And particularly your levels during perimenopause and menopause because iron plays a crucial role in so many of our, you know, body functions.

And when we have an iron deficiency, it can certainly lead us to a range of symptoms and health issues and oh yeah, like so many of our blood tests, normal is not okay. We want it to be optimal. So we’re gonna jump into the connection between iron and hormone balance and you know, I’m gonna give you some practical strategies that you can use to ensure that you have adequate iron levels.

Now, just as a precursor to this, I have just spent the weekend at a Women’s Wellness Conference and we had lots of speakers on all things from[00:02:00] iron status in women and the connection to women’s health, to adenomyosis and endometriosis, the connection between the pill and mental health. The connection between, you know, Women’s hormones and burnout, you know, that’s not gonna come as a surprise to too many of us, you know, and so many other great topics. So it’s given me, you know, some great sort of clinical insights and, you know, little gems that I’m gonna share with you over the next few weeks of podcasts just to kind of keep you up to date with, you know, the latest. 

So for those of you who dunno, you know, I’m actually a clinical nutritionist, so my qualification is in nutritional medicine and I’m accredited with the Australian Traditional Medicine Society or ATMS. And part of our accreditation is to, you know, ensure that we have ongoing and continuing professional development.

So this means we’re up to date with the latest [00:03:00] research, the latest, you know, clinical practices. It’s all evidence based, so there’s a lot of, you know, Let’s face it, there’s a lot of BS floating around on Facebook land, but you know, I’m trying to do what I can to make sure that you are informed with credible knowledge and also give you the practical things that you know you can do with that as well.

Alrighty, so let’s jump in to, you know, have a look at the connection with iron and women’s health in general. You know, it’s not really exclusive to perimenopause and menopause, but a lot of the symptoms do overlap. So where we’re sort of might be looking at, you know, oh my God, is that perimenopause?

Oh my God, is that menopause? It can also be, and I think we, we, because we’re sort of focusing on hormones, we kind of sometimes, unless we’ve got that blood work in front of us, we can often miss the, you know, importance of actually what’s going on with your iron levels as well.[00:04:00] So it’s certainly something that I look at with all of my clients when we go through their blood work.

But, you know, for all of you out there listening, you know, who may not be a client of mine, I just sort of wanna flag the whole iron thing, and what it means for you. So, like I said, there is a big crossover between the symptoms of iron deficiency and you know, some of the perimenopause and menopause symptoms.

And if we know how to, you know, deal with this and address iron deficiency properly, it can oftentimes alleviate some of these symptoms. So when we are looking at iron like a big one, and the, you know, the obvious one we all would think of is fatigue and exhaustion. And again, it’s a busy time of life, so there’s a lot of underlying things, you know, that can potentially cause this fatigue.

So certainly iron is one of them. Shortness of breath is another one. So, you know, if you’ve been following my Instagram recently, you [00:05:00] know that I’ve been doing lots of walking and lots of hiking because I have a larapinta trek coming up, which I’m very excited about. And I have been doing my best to up my fitness.

And then some days, you know, I do notice that out of breath, kind of, you know, feeling. And I have always been prone to sort of low iron as well, so it, it is something that I’m very aware of. Shortness of breath is another, heart palpitations, and chest pain as well. And again, you know, if we’ve got those symptoms going on, we do want that medically checked, of course, every time. Dizziness and light-headed can also be a sign of low iron. Also as can low blood pressure. As can low blood sugar.

So again, it’s, there’s lots of crossovers with a lot of these symptoms. So it’s, it’s good to be aware that there’s multiple causes and get them all checked out. Now a big one I see is hair [00:06:00] loss. And I think, you know, because it does freak out a lot of women for good reason when we are washing our hair and all of a sudden we are losing big handfuls.

So certainly my first port of call would be, you know, definitely low iron. So if a client comes in and she says, oh my God, I’m losing hair, low iron, that’s where I’d start. Then, you know, low iron, low thyroid can also lead to, you know, hair loss. And we’ll talk about the link between low iron and, and low thyroid.

And also if there’s, you know, the good old changing hormones. So lower levels of estrogen can also impact, you know, that, that loss of hair. So, so it’s that multi kind of factorial thing that we need to think about. Now, you know, but if we can address the low iron, you know, it, it can stop that hair loss in its tracks too.

 Brain fog is another, you know, thing that we can attribute to hormones, but we can also attribute that back to low iron as well. And [00:07:00] one interesting thing that came up on the weekend was how low iron affects our mental health. So, you know, when we are looking at brain fog, the inability to think clearly, you know, not being able to cope, anxiety and depression, you know, again, a lot of these can be due to our changing hormones, but they can also be linked to low iron.

And it’s interesting because they quoted a study where one in four women who were treated with an iron infusion had actually been incorrectly medicated for depression and anxiety. So, you know, they didn’t actually, you know, they weren’t actually depressed. They didn’t actually have anxiety, but you know, once they’d had that iron infusion that sort of, you know, remedied itself.

And the reason why, because iron is an essential nutrient for all of our neurotransmitters, you know, the development, the function of them. So it’s, you know, it’s responsible for, for making those [00:08:00] neurotransmitters and ensuring they fire off properly to our brain to keep us happy.

 Other signs of low iron can be headaches, it can be muscle cramps. You know, we always sort of think magnesium first for muscle cramping, but it can also be low iron. And restless legs is another one too. So if you are, you know, one of these, you know, it’s really common, you know, lying in bed and all of a sudden your legs sort of kick out, you know, randomly, it’s called restless legs and often can be linked back to low iron. 

Now another really interesting one, which you know, I don’t, I don’t think I’ve talked about this before, is, you know, low iron can cause heavy periods. Okay? So, and then obviously heavy periods can also cause low iron.

So it’s that chicken and an egg thing. But certainly when we are in perimenopause, our periods are changing, you know, for a lot of women, you know, their periods become heavier. And you know, it’s interesting to get that iron checked [00:09:00] and, you know, address that iron deficiency to help with, you know, as well as hormone imbalancing, but also address that low iron and to help with that blood loss as well.

So iron is important because it, it plays a huge role in our body. You know, it’s helps the production of our red blood cells. It helps oxygen transport around our body. It’s essential for, you know, energy metabolism. And it helps with our production of ATP, which is our main kind of energy currency in our body.

 Iron’s also essential for our thyroid function, which is responsible for our metabolism, you know, together with zinc, selenium, iodine, you know, and a whole bunch of other nutrients as well. So it’s really important, you know, to support our, our mental health, our immune health, our overall vitality and energy that we work on supporting our iron levels as well.[00:10:00] 

And it’s, you know, it’s good to know that iron or, Not good, but interesting to note that iron deficiency is one of the most common nutrient deficiencies worldwide. And you know, it makes sense that it actually affects more women due to, you know, that monthly menstrual blood loss as well.

This Hormone Hub episode is sponsored by the Well Balanced Woman. If you’ve been on a hormonal rollercoaster, feeling bloated, your digestion isn’t the best. And you know, you’re sick and tired of feeling lethargic with your weight creeping up then this is the right program for you. I’m right there with you across the 12 weeks to hold your hand and I’ll give you a loving kick up the bum, if you need it. 

The well-balanced woman is your personalized four phase program created to help you regain your energy, balance your hormones and fire up your metabolism so you get the results you’re after. The link with all the details is on our show notes or over at [00:11:00] kyliepinwill.com/wellbalancedwoman. 

Kylie: So what are the causes of low iron? Alright, so first up, you know, and there’s a number of different things, but first up is, you know, how are we getting it from our diet? Okay. So certainly, you know, animal products, red meat are the easiest form for our body to digest. So there’s a protein that’s transported, you know, with the iron and it lands on our gut cells, our gut grabs that iron and brings it into the cells. So this is what we call our heme based iron. So, you know, so that’s the easiest one. It’s 10 times more effective for our body to absorb iron from meat than it is from plant-based sources of iron. Now, this is not to say that, you know, I’m advising you to start eating meat.

So if you’ve chosen a vegetarian or a vegan diet, You know, it’s, it’s an individual choice [00:12:00] and I’m totally happy to support you in that. And I certainly support my clients in that. But my advice is to, you know, simply just not exclude meat, but instead, you know, make sure you’ve got a well constructed diet and it’s balanced to give you that full nutrition support.

 If you are not having animal sources of iron you need to consider, you know, where is your iron coming from, where is your zinc coming from, where is your b12, your omega 3s, you know, all of those things that are readily available in animal products. You need to sort of work a bit harder and take responsibility for your nutrition as well.

Make sure you are getting those nutrients into your diet. So whether that is in the form of, you know, multivitamins or you know, iron supplements. And also too, like I would recommend, you know, for everyone, not just for plant-based eaters, but a regular blood test every year just to [00:13:00] keep an eye on where your iron is at because you know, it’s so important cause it does have all those knock-on effects further down, you know, and other impacts on your body as well.

Okay, so the next reason that we might have low iron stores is we might not be absorbing it. Okay? So if you are not absorbing iron, your levels will slowly fall over time. So if we, we all have about 3000 to 4,000 milligrams of iron, you know, in our body, and about a thousand milligrams of that is held in our iron stores.

So it’s our ferritin. So our ferritin is the stores of iron that we have in our body. So to maintain that, we just need to absorb about two to four milligrams of iron a day. So it can take like a long time to, you know, develop an iron deficiency. So, you know, what they talked about on the weekend was it can take three to seven [00:14:00] years to develop iron deficiency and at that point your body is sort of empty of iron and you need about a thousand milligrams to catch up.

 And when we are looking at sort of restoring an iron level, it’s really hard to do that on diet alone. Okay. So our iron is absorbed in our, what we call our duodenum. So it’s the little bit of the small intestine that’s, that sits just beyond the stomach. So this is where, you know, if we were to have like gastric bypass surgery and this is where people who’ve had weight loss surgery can become nutrient deficient. It’s also the section of the gut that’s affected by celiac disease, so, you know, just not absorbing those nutrients from food. If you have Crohn’s or IBD any form of weight loss surgery can impact the, you know, that absorption of iron.

 Medications can also inhibit the absorption of nutrients. So [00:15:00] things like antidepressants, anti-anxiety, PPIs, beta blockers, you know, there’s a huge range, statins, and also the contraceptive pills. So these can all inhibit the way we absorb iron. 

Another really interesting thing that came up on the weekend was the fact that we never actually recovered our iron stores after pregnancy.

So, you know, if we have 3000 to 4,000 milligrams of iron, you know, floating around our body and a thousand in stores, if we lose 500 of those just during childbirth and then another 500, you know, making a placenta and growing a baby, you know, a lot of times, you know, we, we give birth, we lose blood, you know, we deliver that placenta, the baby, you know, and then we never actually recover.

So we’re exhausted anyway. We’ve got baby brains. So we’ve got that brain fog going on. Postpartum depression, you know, there’s a link [00:16:00] that they found with postpartum depression and low iron. So if we’d never actively worked on recovering our iron stores, it could well be, you know, and we’ve continued to go on and have periods, you know, every month.

So we’re constantly sort of losing that, that blood level and that iron stores and we are not actively replenishing it. You know, it there, there’s a lot of women out there who just never recover. So, you know, 5, 10, 15, 20 plus years down the track, we’ve never replenished those iron stores. And then, you know, we sort of touched on heavy periods, so when we are losing, you know, more blood every month, so a normal period was, I think they quoted sort of 20 to 30 to maybe 50 mils a month is a normal period, so more than 50 mils a month is, you know, considered a heavy period.

And 20% of women have what they consider heavy [00:17:00] menstrual bleeding. So obviously this is hard to measure. So unless you are using a menstrual cup, you know, we actually don’t know how much we’re losing. But if you sort of think, if, you know, they, they’re sort of on the weekend, they classified heavy bleeding as you know, needing to change protection every two hours.

Or, or more, or, or the need to double protect. So a tampon and a pad, or if you needed to get up at night, you know, to, to change a pad or change a tampon. If you sort of, you know, it’s stay home because you know of the fear of accidents. So you’re taking time off work. You’re, you know, choosing not to leave the house, because your bleeding is so heavy.

And also the passage of clots as well. So this is what they sort of classed as as heavy periods. Now, heavy periods obviously, you know, cause low iron, but also like I mentioned before, low iron can also cause heavy periods. So we really need to address both. So address that iron deficiency [00:18:00] plus also support that, you know, and those heavy periods are driven by that imbalance in that estrogen progesterone ratio.

So we need to sort of make sure we’re addressing the iron and we’re also addressing that, uh, hormone imbalance. We can also lose iron, you know, through excessive sweating. So if you’re an exerciser, and they looked at runners and triathletes in particular. If you have sort of any ongoing inflammation, because if we think that iron is needed for that tissue repair, so any sort of inflammation in your body, any injuries, you know, any sort of iron goes off as part of that repair response.

 And our, we need iron for our thyroid, like I said, so, you know, if our iron is low, it’s going to negatively impact our thyroid, which is gonna negatively impact our metabolism. So you can kind of see, you know, the, the relationship there between, [00:19:00] you know, iron deficiencies and, you know, those hormonal imbalances that can happen during perimenopause particularly, but also then flow into menopause as well.

So, yeah, so definitely exacerbated sort of fatigue, brain fog, mood disturbances. So it’s really important to get on top of this. So, When we are looking at our blood work, what is normal, and we’ve talked about this before, what is normal and what is optimal is two entirely different things. So when they’re looking at iron stores and the best indicator of our iron status is our ferritin.

So ferritin shows us how much iron we have stored. So ideally, you know, optimally we would have between sort of 60 to kind of 120. Okay. So, you know, if it drops, if our ferritin drops to about [00:20:00] 50, you know, we’re still kind of, you know, in the Okay zone. Then if it drops to, you know, it’s sort of between. If we sort of think about ideally say over 50 or 60, our reserve ferritin and our reserve stored iron is anything over 30.

So if we are between 30 and 50, we are dipping into our reserves. So we’ve hit kind of like the warning signs. And then if we are sitting under 15, and I see all the time, so many women with ferritin under 15, this is where we are running on empty. So this is where we need to, you know, consider do we need an iron infusion.

Because you know, you can’t come back from that just on diet alone. So we need to have a look. Do we need to supplement? Do we need to, you know, have an iron infusion? So certainly if you are sitting under 15, I would be pushing the conversation [00:21:00] with your GP towards an iron infusion. If you are in between, you know, say 30 and 50, this is where we would have to look at, you know, improving your diet, including, you know, lean meats, poultry, fish, legumes, leafy greens, you know, plus supplements as well.

 Also, having these iron rich foods together with vitamin C is gonna help, you know, increase that absorption. So, you know, capsicum, peppers, Leafy greens, tomatoes, oranges, you know, any of those sort of vitamin C rich foods, broccoli, all of those. And then, you know, including foods high in iron, you know, so obviously we’ve got the, The animal base.

But if you are vegetarian, vegan, you know, we need to have a look at, you know, things like tahini, tempe, tofu, water cress, spinach, sunflower seeds, [00:22:00] pumpkin seeds, sesame seeds, pine nuts, parsley, miso, hazelnut, you know, those sort of foods to get, you know, that, that plant-based iron in again, together with that vitamin C.

So when we are looking at supplementing, so, you know, certainly, you know, like I said, anything, if you are under 50, we need to look at, at supplementing, just to sort of boost that iron absorption. Now the problem is with a lot of the over-the-counter iron supplements, they come in a form that, you know, creates anything like constipation, stomach cramps, nausea, diarrhea, you know, and when the iron supplements that are meant to be helping us, you know, with that, start creating extra symptoms, it’s not the right form.

So, and again, it means that we are not gonna absorb the nutrients and the iron we need from those supplements. [00:23:00] So I recommend getting a therapeutic dose of iron in the form of bisglycinate. So this is, or this bisglycinate, you know, it is better absorbed by your body and it’s more likely to make a difference.

So ideally we want 20 or more milligrams of elemental iron in that bisglycinate form. And you know, you might pay a few more dollars for those supplements, but at least you know it’s gonna be better absorbed and more likely to make a difference. So again, it’s gonna take time to come back from that.

So you need sort of full iron supplementation, you know, for at least six months, and then get tested again before you come off it. And you know, if you need to be on those supplements for a longer period of time, then you know, so be it. We want those levels over 50. If you are not responding to the supplements, you know, again, I would sort of encourage you to have a look [00:24:00] at, you know, do you need an iron infusion?

Now I just sort of wanted to mention here, thalassemia. This is an inherited disorder whereby the body has sort of like an abnormal production of the, you know, the chains of hemoglobin. So it’s often seen in people of Greek, Italian, middle Eastern, south Asian, and, you know, African descent. It often presents with similar symptoms to iron deficiency. And, you know, it can, you can still be anemic and have thalassemia, but it does, it means that your body doesn’t get rid of iron as easily. So these, if you know you have thalassemia or your iron, your ferritin levels are particularly high, it’s worth sort of getting that checked out. And then, In that case, iron supplementation is definitely not for you. So I just sort of wanted to make that clear that it’s always good idea to test your [00:25:00] bloods first and then go. 

All right. Well, I hope it was helpful. I know I’ve just blurted a whole lot of information at you, but yeah, if you need any help with supplements or recommendations on which brands I would use or suggest, then you know, just hit reply and let me know.

Okay, everyone, I will see you in the next episode. Bye for now.