Quick shout out to those lovely people at the CAI, here I am keeping it casual chatting about how iron deficiency can affect production of dopamine (and thus noradrenaline, adrenaline) and serotonin.
Thus, leading to chronic pain/fibromyalgia, ADHD, brain fog, depression/anxiety, restless leg syndrome, fatigue and more.
Now all of this is usually occurring in the absence of anemia.
We use FERRITIN as our (reliable) proxy marker for our iron reserves, and the level of 15 ng/ml ish is used as the cut off for gross iron deficiency because most people (not all) become anaemic (low haemoglobin) at this point (though we can argue at which point you call haemoglobin low!).
How common is iron deficiency anaemia in general population?
Well, it depends on who you are testing. The key variables are:
- Age
- Biological sex
- Obesity
And combining those, if female, and of menstruation age, or pregnant.
Some of the following statistics are going to shock you.
From a huge public health England study.
Chidren aged 1.5 -3 years old:
- 2.9% had haemoglobin below the anaemia threshold of 110 g/L.
- 35.1% had ferritin below the lower limit, which was <12 µg/L for this age group (I would argue this is far too low, and we should be aiming for 50 ng/ml. What % are below 50 ng/ml?! – And what is that doing to their behaviour?)
Once we get a bit older, things improve, to a degree, especially the boys.
I would draw your attention to the female 11-18, and remember this is low FERRITIN classified as under 15 ng/ml, which is really low.
10.6% are anaemic and 27.7% are iron deficient.
Clearly, we know why, females of that age menstruate and lose blood monthly (and are also growing at a rapid rate).
But if we look at another study, but this time with a wider criterion, of FERRITIN under 30 ng/ml, it gets serious.
We do not have 11-18 year olds but we do have 18-20 and 55% are under 30 ng/ml.
But they also have another category of functional iron deficiency which they use FERRITIN 30-99 ng/ml, with rates as high as 60% and now the boys are back with higher %.
Note for the clinic: if the patient is over 50 ng/ml and not symptomatic, I would leave iron alone.
But if they have pain, mental health, fatigue, restless legs etc, and are between 50 and 95 ng/ml ish, I will push them to 100 ng/ml.
A sub-group of patients have issues with iron transporter and need to get higher levels to get iron into the brain.
So what are you going to do?
If the NHS has done it, easy, if not, OPTIMAL TESTING can do it with a finger prick, £39 for ferritin, £50 full iron panel, £65 iron panel plus CRP for inflammation.
Here is the action plan:
Red meat (and offal if they can) plus x1 capsule of our IRON BISGLYCINATE three times a day, re-test in 2-3 months.