Women are three times more likely to feel fatigued than men. One in four North American women has low iron, or iron deficiency anemia, characterized by symptoms such as fatigue, peeling fingernails, hair loss, poor concentration, heart palpitations, pale skin, and dark under-eye circles.

So important is iron to health that even a mild deficiency can affect your ability to perform everyday mental and physical tasks. And you do not have to be diagnosed as anemic to feel the effects of low iron.

In a 2003 British Medical Journal clinical trial involving non-anemic women, simply taking 10 mg per day of elemental iron dramatically improved unexplained fatigue.

Iron is not only involved in energy production in the body but also in other functions including detoxification, cell protection, hormone manufacture (predominantly estrogen and progesterone), and the action of serotonin, your “happy” hormone. Even heavy metal toxicity is related to low iron. Women with low iron often are more susceptible to higher mercury levels.

For all these reasons, persistently low iron— even in those not considered anemic—is a serious concern.

Women are more susceptible than men to iron deficiency due to blood loss during their monthly cycles. Yet over 57 percent of women do not get adequate levels of iron from the diet. Women require up to 20 mg of iron daily during the childbearing years, but most get less than 10 mg per day from food, and often it is poorly absorbed. Important iron blood tests

Low iron status is commonly overlooked. Have your serum ferritin checked by your doctor. This will tell you how much iron is stored in your body and is a good indicator of whether you are low in iron or suffering iron deficiency.

A blood test that checks hemoglobin levels will only catch the problem once iron stores are close to depleted. Testing hemoglobin alone is a bit like checking to see if the barn door is unlocked when all the chickens are already escaping down the road. For hemoglobin, the test range is 117- 160g/L for women and 131-180 g/L for men. A ferritin test will be 15-160ug/L for women and 15/410 ug/L for men.

Remember, even a low-normal iron can cause the symptoms mentioned above.

Why do doctors prescribe high-dose iron?

When you look at the label of an iron supplement, make sure it states “elemental iron” amounts so that you know what you’re getting. Research has shown that 10 milligrams of elemental iron taken daily can improve low iron symptoms quickly and without the side effects of high iron, which include nausea, diarrhea, vomiting, black stools, and stomach pain. Common iron supplements recommended by your doctor provide these approximate elemental iron amounts:

• A 300 mg tablet of ferrous gluconate A 300 mg tablet of ferrous sulphate contains 60 mg of elemental iron.
• A 300 mg tablet of ferrous fumarate contains 99 mg of elemental iron.

Liposomal iron: A girl’s best friend

Not all iron supplements are equal. Make sure the iron you are taking states amounts of “elemental iron” on the package—10 to 30 milligrams per day is the preferred dose. Liquids are easier to digest and absorb than tablets that are coated and contain fillers and binders that make them hard.

Liposomal iron is the best choice. Iron delivered in a liposome improves iron absorption because the iron is able to travel through the acidic stomach and is delivered to the receptor in the small intestine. As a result, hemoglobin and ferritin increase quickly and the iron does not cause the stomach upset and constipation associated with iron tablets.

You can take liposomal iron with or without food, which is unique because most iron supplements must be taken alone to promote absorption. Liposomal iron is so safe that everyone, including children and pregnant and breastfeeding women, should use it.

Some forms of iron are better absorbed than others. Recent research indicates that the absorption of liposomal iron in the form of ferric pyrophosphate, tested two hours after oral administration, is five times greater than ferrous fumarate, the most common iron recommended by doctors. And after 12 hours, the total iron count in blood for liposomal iron was far higher than all other regular forms of iron. In short, liposomal iron raises levels quickly and effectively.

There is no need to drag through your days feeling tired or suffering from other iron deficiency symptoms. Reclaim your “get up and go.

Lorna Vanderhaeghe, MS, is a woman’s health expert who has been researching nutritional medicine for over 25 years. With degrees in nutrition and biochemistry, she is the author of ten books including A Smart Woman’s Guide to Weight Loss and A Smart Woman’s Guide to Heart Health.