Iron Deficiency, Anemia, and Depression

Iron deficiency is one of the most common nutrient deficiencies in the world. In Canada alone, it is estimated that 5% of Canadians and 8% of females have low serum ferritin levels.

Iron is an essential nutrient affecting every cell in the body and exhibiting multiple functions. It is important for oxygen transport, immune function, neurotransmitter metabolism, energy production, and even the production of DNA. Iron deficiency can lead to several health concerns including fatigue, dizziness, headaches, restless legs, impaired immune function, among other symptoms.

There is an accumulating body of evidence that iron deficiency results in psychological and neurological impairments including issues with memory/learning capacity, motor skills, as well as emotional/psychological regulation. Iron deficiency has been linked to anxiety, depression, sleep disorders, and restless leg syndrome.

A recent study published in 2020 showed that iron supplementation in the iron deficiency group was associated with a significantly lower risk of the psychiatric listed above compared with those who were not supplemented. Additionally, this study showed that iron supplementation in female subjects was associated with lower risk of anxiety, depression and sleep conditions even if they did not qualify as having iron deficiency anemia.

These results confirm reports from previous studies suggesting that iron affects brain activity.

The link between iron deficiency and mood could be due to the link between iron and the feel-good neurotransmitters serotonin and dopamine. In addition, iron has been shown to affect glutamate and GABA in the brain affecting mood, memory and learning.

“But, I’ve been tested and was told that my levels are fine”

Ferritin is the storage form of iron and is the diagnostic test of choice when testing for iron deficiency. Studies state that ferritin levels of <15 ug/L is diagnostic of iron deficiency.

The problem is that:

• Lab ranges differ depending on labs and location. The ferritin lab reference range in Ontario goes from 5-272 ug/L therefore, individuals are deficient long before their labs are flagged. In BC this range is from 20-200 (and flags for borderline deficiency when less than 40).
• Many health care practitioners only order the test CBC to look at hemoglobin levels when assessing their patient for anemia. The problem is that hemoglobin is used to assess for severity of anemia but is only suggestive of iron deficiency and is therefore NOT the diagnostic test of choice for iron deficiency.
• Even when using ferritin, symptoms may begin when ferritin levels are less than 30, before true deficiency which is indicated by ferritin levels of less than 15.

If you are suffering from depression, anxiety, restless legs or sleep disturbances, your ferritin levels need to be tested. Iron replacement should begin even if levels are boarder line, whether or not anemia is also present. Lastly, if you are a woman with heavy or erratic periods and consistently low ferritin, addressing your period must be part of the treatment plan.

At Health Over All, we look at bloodwork with a careful eye in order to catch deficiencies before they are severe enough to be flagged. We assess the whole person to treat all of the factors that could be contributing to your symptoms, because we understand that you are not “fine” even though your bloodwork is “within normal range.”

If you are looking for a tailored approach to your health, follow the link to book your alignment call. 

In health,

Dr. Lisa Maddalena, ND