Iron Supplements Improve Unexplained Fatigue in Premenopausal Women
A reader (thanks, Dan!) pointed out a follow-up study to one I had included in VeganHealth’s article Iron, about iron supplementation in women with unexplained fatigue who have low iron stores but do not technically have anemia. I updated the article:
“Two studies from Switzerland have shown that iron supplementation can reduce fatigue in premenopausal women (1, 2) whose hemoglobin levels are above 120 g/l (and thus not diagnosed with anemia). The most recent, from 2012 (2), was a double-blinded, randomized controlled trial in which 80 mg of ferrous sulfate (an iron supplement) per day for 12 weeks increased hemoglobin in women who had average serum ferritin levels of 22.5 µg/l. This increase in hemoglobin was matched with a 50% reduction in symptoms of fatigue (compared to only 19% for placebo). Improvements in hemoglobin were seen after 6 weeks.”
This study got me thinking… I remember back around 2001 when I was doing my dietetic internship at Georgia State. I was able to spend some time working at a couple of alternative health clinics that specialized in helping people with chronic fatigue. At that time, they were putting pretty much everyone on a low carb diet, which translated to more meat. I actually don’t know if many people made any sort of recovery from the fatigue – my memory is that one person I counseled had made a significant recovery while another hadn’t made any improvement, but I have no idea what the success rates were for the clinics. To the extent that a low carb diet helped, I wonder if it was merely due to the women getting more heme iron and curing an undetected deficiency.
Improving iron status is worth considering for anyone with fatigue whose hemoglobin is on the lower end of normal and who has a serum ferritin less than 50 µg/l.
Iron does seem to be a possible culprit in three of higher profile cases of young women becoming ex-vegan that come to mind, and perhaps it’s something to which our movement needs to be paying more attention.
While the studies above used iron supplements to increase iron status, don’t forget that adding a significant amount of vitamin C to meals has been shown to be better for increasing iron absorption than increasing iron (more info).
1. Verdon F, Burnand B, Stubi CL, Bonard C, Graff M, Michaud A, Bischoff T, de Vevey M, Studer JP, Herzig L, Chapuis C, Tissot J, Pécoud A, Favrat B. Iron supplementation for unexplained fatigue in non-anaemic women: double blind randomised placebo controlled trial. BMJ. 2003 May 24;326(7399):1124. | link
2. Vaucher P, Druais PL, Waldvogel S, Favrat B. Effect of iron supplementation on fatigue in nonanemic menstruating women with low ferritin: a randomized controlled trial. CMAJ. 2012 Aug 7;184(11):1247-54. | link