The Perils of Iron Deficiency

Written By: Vidya Sinha

Before reading this article, I’d like you to acknowledge that I am not a medical professional, nor do I claim to possess all the nuanced answers to questions regarding iron deficiency. My goal is simple: to compile the conclusions of relevant studies and provide a foundational overview of what these negative consequences may encompass. 

If you suspect that you may be suffering from iron deficiency, I urge you to pursue further research and consult a doctor. Proceed with caution; you will thank yourself for it immensely. 

Some Prerequisite Knowledge

You’ve probably heard the medical terms “anemia,” “ferritin counts,” and “iron deficiency.” While these are related concepts, they refer to different things. Allow me to explain: anemia refers to a deficiency of red blood cells. Red blood cells are crucial to transporting oxygen throughout the body, and oxygen is a necessary ingredient in cellular respiration, the process that keeps your cells functioning. 

Iron deficiency, on the other hand, refers strictly to the deficiency of iron. Iron is a crucial component of hemoglobin, which composes red blood cells, so iron deficiency and anemia are inextricably linked, although they can exist independently. An individual can be anemic but not iron deficient, and vice versa, although it’s quite common for the two deficiencies to coexist. Ferritin tests are often used as a proxy for iron deficiency, because ferritin is the protein that encapsulates iron in the body, and low ferritin counts usually signify low iron levels. 

But wait. We’re not done talking about the importance of iron! Iron is a cofactor in 80 enzymes, which means that these enzymes require iron to carry out their functions. Some of these enzymes are involved in DNA repair and synthesis. Iron even behaves as an  immune regulator, controlling the activity of immune cells such as macrophages and neutrophils.

From this information, it seems that a lack of iron could potentially spell doom on many levels beyond the context of anemia. Keep this in mind!

Iron Deficiency Impacts

For readers interested in rigorously interpreting studies for themselves, I encourage you to peruse the source list. This section is restricted to a general conclusion of the findings.

There aren’t many scientifically robust studies that investigate the relationship between iron deficiency and physical or mental abilities, but the ones that do present striking results. 

In one study conducted with three different groups of women: healthy individuals, individuals with an iron deficiency but no anemia (IDNA) and individuals with both anemia and an iron deficiency, (IDA) the results demonstrated significant discrepancies regarding performance on cognitive tests. In the baseline tests, IDA women performed considerably poorer than both the IDNA women and the healthy women, while the IDNA women either performed as well as the control group or slightly worse. 

Then, some of the women were given iron supplements to increase their ferritin levels (treatment group), while some were not (control group). The results were astounding:

The black bars signify the women who did not gain ferritin, while the gray bars signify the ferritin-responders. The difference is immense: the ferritin-responders saw a considerable increase in their performance. Growth of this magnitude could translate to 5-10 IQ points or an entire inch of height. 

Other studies find a similar trend within the realm of physical performance, as iron deficiency severely impairs aerobic capacity and consequently athletic performance. Moreover, moderate iron deficiency can reduce endurance capacity by as much as 47 percent. This is certainly a salient difference! 

Could You Be At Risk?

Again, I’m not a medical professional, but it is generally known that vegans and regularly menstruating people are highly susceptible to iron deficiencies. If you’re in one or more of these groups and have experienced symptoms related to iron deficiency, it may be wise to get tested. You could be doing yourself an immense favor.

Works Cited

Puig, S., Ramos-Alonso, L., Romero, A. M., & Martínez‐Pastor, M. T. (2017). The elemental role of iron in DNA synthesis and repair. Metallomics, 9(11), 1483–1500. https://doi.org/10.1039/c7mt00116a

Ni, S., Yuan, Y., Kuang, Y., & Li, X. (2022). Iron metabolism and immune regulation. Frontiers in Immunology, 13. https://doi.org/10.3389/fimmu.2022.816282

Zhu, Y., & Haas, J. D. (1998). Altered metabolic response of iron-depleted nonanemic women during a 15-km time trial. Journal of Applied Physiology, 84(5), 1768–1775. https://doi.org/10.1152/jappl.1998.84.5.1768

Haas, J. D., & Brownlie, T. (2001). Iron deficiency and reduced work capacity: A critical review of the research to determine a causal relationship. The Journal of Nutrition, 131(2), 676S-690S. https://doi.org/10.1093/jn/131.2.676s