Iron Deficiency Anemia in Peri-Menopause

Today we are talking about something very near and dear to my heart, something that I personally struggled with in my peri-menopausal journey and that is iron deficiency anaemia.

My personal story of anemia started in early 2021 with a fibroid and a couple of polyps causing dysfunctional uterine bleeding. My menses were NOT normal. I had flooding bleeds, and at my worst, I could fill my pad, and period undies and have blood in my socks within an hour. I also had clots the size of my hand and prolonged bleeds lingering the entire month. Dysfunctional uterine bleeding is not normal but it can happen in peri-menopause. I had an extreme case but even slightly longer or slightly heavier periods can contribute to a deficiency over time. Iron deficiency is the most common nutrient deficiency and dysfunctional uterine bleeds are the main cause of iron deficiency at this stage of life.

The interesting part of my story is when it all turned south. You see if this happened in any other year things would have been different. Living in Australia in 2021 meant we were in our 2nd and longest COVID lockdown. This meant all elective surgeries were cancelled and Telehealth became the main way to have your medical appointments. Unlucky for me, because iron infusions aren’t something you can have done via telehealth. Lucky for you I learnt so much during this time that I can share with you.

But let's start with what is iron and why is it so vitally important for life. Like all other minerals iron is essential. This means you must consume an adequate supply as your body can not produce it and if there is inadequate supply, deficiency occurs. In iron's case, it creates iron deficiency anemia and untreated anemia can be life-threatening as I found out the hard way.

Iron is a key building block for your blood, and it is needed for red blood cell shape. Hemoglobin is a protein that carries iron in the blood and it gives blood its red colour. The main purpose of blood is to carry oxygen around your body. Every single cell in your body needs oxygenation, therefore anemia has the ability to affect every single part of you.

Symptoms linked to anemia include fatigue, dizziness, shortness of breath, difficulty swallowing, palpitations or the sensation of a racing heartbeat, lack of concentration, brain fog, memory issues,  pale skin, headaches, leg cramps, restless legs, insomnia, mood disorders, and more. I certainly experienced this sensation of a whole body shut down.

At my worst, I lost over 1/2 of my blood supply. My hemoglobin was 60 grams/litre and the normal range is around 120-160 grams/litre. For my overseas friends, your country may measure in grams/decilitre and in this case, my level was 6 and your range around the 12-16 mark. 

It's an extreme case by far and it would not have ever happened if it wasn’t for lockdown.  I really hope it never happens to anyone else but I tell you this as I was in good shape for my situation due to my knowledge and it's this knowledge I want to share. You see usually the body shuts down at around a 40% loss. In the ER they kept asking who I was as they couldn’t believe I was conscious, able to walk to the bathroom and hold a conversation. That being said I wasn’t well either.

So let me tell you what I did differently

The first thing was the route of iron administration. You see I could not find a facility that would give me an iron infusion so that was off the table. I was taking oral iron but I couldn’t get enough in without affecting my bowels. The problem I had with my bowels was that any straining at all would trigger my menstrual flow to increase. Even an easy movement increased blood flow so straining was definitely not an option. Homework assignment number 1 was to investigate alternative routes of iron administration and I discovered transdermal iron cream. Lifesaver number 1. Getting iron in via the skin. I am a huge fan of transdermal iron as it bypasses the digestive system, reducing absorption issues and constipation while allowing a much higher dose than oral supplementation. Best of all I felt the improvements pretty quickly. Heads up I continue both oral and transdermal as my oral product also contained copper, but more about that later.

The second discovery. Blood is more than just iron. There is a good amount of water and electrolytes too. So my next step was adding in a daily or should I say twice daily electrolytes. With lots of water. Again the improvement was pretty fast. This is the reason why one of my core messages is the importance of good electrolyte balance as I believe they really helped me out of a serious hole. But it's not just me saying this. A 2021 study titled Evaluation of serum electrolytes levels in patients with anemia also discovered the link between anemia and electrolyte imbalance. The main electrolyte of concern is sodium they found sodium levels to be significantly lower in anemic patients and be a possible contributor to many of the symptoms of anemia such as fatigue, brain fog, and other neurological symptoms, heart symptoms like palpitations, or racing heartbeat, muscle pain, headache, etc. In my experience adding electrolytes made the biggest difference to my palpitations.  I could almost time it, they would roughly ease up about 15 minutes post electrolyte consumption and this is why my daily dosage turned into twice daily. My body was telling me it needed more and was responding when I did. So Lifesaver # 2 optimizing electrolyte balance. My additional 2 cents here is that quality is more important than quantity. Look for a clean product if you want to try this. By clean I mean no sugar, or artificial sweeteners, no colour, flavours or preservatives.

The third and a surprising discovery. As my life force faded my intuition became clearer or maybe it was because of the lockdown and the busyness of life stopped that I had time to sit and listen to what my body was telling me. It was asking for Vitamin A. Each day I would look in my supplement cupboard and ask what my body what it wanted and each day it asked for Vitamin A. So I took it without question not knowing the impact Vitamin A has on iron metabolism.

After I recovered I looked it up and found it helps in many ways. Mainly it improves iron absorption via the digestive system and it also plays a role with copper in increasing ceruloplasmin. I think of ceruloplasmin as a cup that holds and transports iron in and out of your cells.

Some of the other nutrients I took included a high dose B complex. Vitamins B6, B9, and B12 are all needed for healthy red blood cells. Having a B vitamin deficiency creates red blood cells that are too large, this is called macrocytic anemia. If your red blood cells are the wrong shape they can’t function properly and you don’t get adequate oxygenation of the body.

I have mentioned copper a few times already without explaining it. Copper is another essential mineral, it is a key building block in the creation of ceruloplasm. I think of it as a cup that holds iron but it probably makes more sense to see it as a bus as it stores and transports iron in and out of cells. If you are someone who has been lucky enough to have an iron infusion but the iron doesn’t hold, seriously consider copper but please get tested first before trying it, as too much is just as problematic as too little.

In your body, you have synergistic or supportive nutrients and you have antagonist or competitive nutrients. In regards to iron, we have discussed some of the supportive nutrients but others include nutrients like Vitamin C. Most people already know that vitamin C helps with iron absorption but some of these others might be new to you Vitamin D, Vitamin E, Magnesium, Selenium, and zinc. It's not about taking everything, it's about discovering what individual minerals you are low in at the same time as nutrient deficiency doesn’t happen in isolation.

When it comes to substances that hinder iron absorption some of these might be new to you. Calcium is one that surprises many as dietary and supplemental calcium can block iron absorption. Heavy metals toxicity especially high levels of lead, cadmium, and mercury can compete with iron for absorption, other toxins such as mycotoxins from mould are also problematic here too.

On the food front phytates, polyphenols like tannins, and oxalates are all known to reduce iron absorption. Phytates are high in nuts, seeds, legumes, and grains - soaking, sprouting, and fermenting them deactivates the problematic component.

Tannins are high in tea and coffee. Drinking these with or after meals reduces iron absorption but drinking them away from iron-containing meals isn’t a concern.

Cruelly Oxalates are found in many vegetarian iron food sources and make the iron found in these foods less absorbable, they are in foods like spinach and kale.

That being said when I was unwell my body was craving blueberries, I was eating an organic punnet of blueberries daily and I would eat frozen ones when I couldn’t get fresh.  I didn’t think too much about this at the time, but afterward, I discovered blueberries are a low-oxalate vegetarian form of non-heme iron. Plus they are full of Vitamin C and other antioxidants that assist with iron absorption.

It must be said the best iron food sources contain heme iron and heme iron is only found in animal products.

Getting back to my story, when I was in ER my surgery was upgraded from elective to essential which meant I could have it, but my blood levels were too low to operate so I had 2 blood transfers, an iron infusion waited a few days, rechecked and was cleared for surgery.  I had both corrected my iron deficiency and the source of my iron loss.

Finding out why your iron levels are low in the first place, and correctly this will help to prevent future occurrences. Apart from dysfunctional uterine bleeds you might like to consider these other reasons for low iron in peri-menopause

• Not consuming enough iron in the diet, with vegan/vegetarian diets being most at risk.
• Digestive disorders minimising iron plus co-factor absorption.
• Other bleeds such as a gastroIntestinal bleeds

Today has been a rather personal story and I hope you have learnt from my experience.

You can see why I’m so passionate about minerals and getting them optimised so you can experience true health. If you are struggling with iron or other mineral imbalances consider jumping on a discovery call with me and seeing if I can help you correct this. Click here to book a discovery call.