How women can manage low iron

Iron deficiency is common among premenopausal women
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Feeling tired or struggling to concentrate? It could be the mid-year slump or it may be an iron deficiency.

Low iron affects 1 in 10 pre-menopausal women in Australia and is a topic I talk to my clients about frequently. So why is low iron so common in women and what supplement and nutrition strategies can you use to manage it?

Low iron in women

Iron is a mineral that we get through the food we eat. Our body is very good at recycling its stores of iron but when we lose iron through blood loss, are having trouble absorbing iron or are not eating enough iron rich foods, we can experience iron deficiency. 

If iron deficiency is not treated it can progress to anaemia, which is when our body does not have enough healthy red blood cells to deliver oxygen to our muscles and organs. 

Women who are pre-menopausal require more iron in their diet as they lose iron in their period. Therefore they need to replenish their iron stores more frequently. Pregnancy is another phase when our iron requirements greatly increase, putting women at higher risk of an iron deficiency. 


Daily iron requirements

Men and
post-menopausal women

8 mg/day


18 mg/day


27 mg/day

Other groups at increased risk of an iron deficiency are:

  • People who follow vegetarian or vegan diets.
  • Endurance athletes.
  • People with coeliac disease, ulcerative colitis, or Crohn’s disease.
  • People who regularly take aspirin, ibuprofen or other non-steroidal anti-inflammatory drugs.

Signs of an iron deficiency

Common signs of an iron deficiency include:

  • Unexplained tiredness.
  • Poor concentration.
  • Having pale skin (also called pallor).
  • Shortness of breath when doing gentle exercise.
  • Poor appetite.

These symptoms alone cannot diagnose an iron deficiency. Getting a blood test with your doctor is the only way to diagnose an iron deficiency. 

A blood test called a full blood count will look at your iron stores and your red blood cells to determine if you have a minor iron deficiency or the more serious iron-deficiency anaemia. 

The best treatment for an iron deficiency is an iron supplement, dietary changes, and identifying the cause of the low iron. 

Unexplained tiredness is a common symptom of iron deficiency
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Iron supplements

Taking an iron supplement is the best way to treat an iron deficiency as it helps to quickly restore iron levels and treat anaemia. You will likely require iron supplements for 3-6 months. 

Iron tablets are the most effective way to treat an iron deficiency as they contain more iron than liquid or gummy supplements. Your doctor will advise you on the dose of iron supplement you need. 

To improve absorption of iron supplements, take the tablet on an empty stomach and avoid taking calcium supplements at the same time as calcium can inhibit iron absorption. 

Side effects from iron tablets

Many people experience side effects from iron tablets. Common side effects are constipation, nausea, reflux, and diarrhoea. If you are experiencing uncomfortable symptoms you can try these strategies:

  • Take the tablet after a meal.
  • Start with a smaller dose and gradually increase.
  • Try a slow release tablet as these are better tolerated.
  • Discuss taking a supplement second daily or weekly with your doctor.

Side effects of too much iron

Having large doses of iron or taking iron tablets for a long period of time can result in a build up of iron in your body. This can cause irritation to your gastrointestinal system resulting in vomiting, nausea, or bleeding. Toxic levels can also build up in your organs and impair their function. 

To prevent this from occurring always discuss the dose of your iron supplements with your doctor and get repeat blood tests to determine if you can come off the iron supplements.

Red meat is an excellent source of haem iron
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Food sources of iron

Eating a varied and balanced diet enables you to reach your iron goals and maintain your iron stores when you stop taking supplements. There are a few tips that can enhance your ability to absorb iron. 

Haem vs non-haem iron

There are two types of iron in food – haem iron and non-haem iron.

Haem iron is found in animal products and our body is excellent at absorbing this form of iron. Women often eat less meat than men, but you don’t need to have a giant steak for breakfast, lunch, and dinner to meet your needs. A palm-size serving of animal protein can provide up to 4mg of iron (20% of your daily needs). Good sources of haem iron include:

  • Beef
  • Kangaroo 
  • Chicken 
  • Pork
  • Fish
Pairing tomato with wholegrain bread is a great way to boost iron absorption
Image via Pexels

Non-haem iron is found in plant foods such as wholegrains, nuts, seeds, legumes, and leafy greens.

Our body struggles to absorb non-haem iron. Despite this, you can meet your daily iron needs on a plant-based diet. The secret is pairing non-haem iron with vitamin C rich foods!

Vitamin C boosts our body’s ability to absorb iron. Foods that are rich in vitamin C include strawberries, oranges, lemon, kiwi fruit, pineapple, capsicum, tomato, and broccoli. Here are some suggestions for non-haem iron and vitamin C pairings:

  • Spinach + broccoli
  • Chickpeas + lemon juice
  • Tofu + capsicum
  • Baked beans + tomato sauce
  • Peanut butter + strawberries
  • Wholemeal bread + tomato

Coffee and tea reduce the absorption of iron

Coffee and tea contain tannins which can inhibit your ability to absorb iron. If you struggle with low iron, drink your coffee or tea at least 30 minutes before or after a meal to prevent this reduction in absorption. 


Women are at greater risk of an iron deficiency due to menstruation and pregnancy. Being aware of the symptoms of low iron and speaking with your doctor and dietitian early can help manage your low iron levels and help you get your energy back and prevent anaemia.

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