An association exists between low iron and mental health_._ Not getting enough iron from your diet, or having a condition that restricts its absorption, can result in psychological problems such as iron deficiency depression, reduced cognitive function, and impaired growth and development in children.
An iron deficiency left untreated can lead to iron deficiency anemia, which can have symptoms ranging from extreme fatigue to increased risk of chronic disease.
Why You Need Iron
Iron is a mineral that is essential for the production of healthy red blood cells, which contain an important protein called hemoglobin. Almost 7 to 8 percent of your total body weight is blood, and about 70 percent of your body's iron is found in hemoglobin and muscle cells.
Iron-rich blood transports oxygen and nutrients to your lungs and all parts of your body to carry out many functions, including helping to eliminate fatigue, regulate body temperature, control muscles and synthesize collagen. Iron plays a role in maintaining a healthy immune system by carrying antibodies that fight infection.
Some iron is stored in your body as ferritin. Men can store enough iron for about three years, whereas women can only store enough for about six months. When iron storage gets low, hemoglobin levels decrease and can result in iron depletion or iron deficiency anemia.
How Much Do You Need?
The daily iron requirement your body needs for optimal health has been determined by the Institutes of Medicine according to age and gender. These amounts represent the total recommended intake from food, multivitamins and supplements.
- Children 1 to 3 years of age: 7 milligrams; 4 to 8 years of age: 10 milligrams; 9 to 13 years of age: 8 milligrams
- Teens 14 to 18 years of age: boys —11 milligrams; girls —15 milligrams
- Adults 19 to 50 years of age: women — 18 milligrams; men — 8 milligrams
- Adults 51 years and older: 8 milligrams
- Pregnant and lactating women: 9 to 27 milligrams
Many foods contain iron. Heme iron, the type found in animal-based foods, is more easily absorbed than iron from plant sources, called non-heme iron. Some foods, such as breads and breakfast cereals, are fortified with non-heme iron to help you maintain a healthy level of iron. Choose from these good sources of iron:
- Meat, such as organ meat, beef, turkey, lamb
- Fish and seafood, such as tuna, oysters, clams, shrimp
- Vegetables, such as spinach and peas
- Beans and legumes, such as kidney, lima, lentils
- Nuts and some dried fruits, such as raisins
To make iron from food more bioavailable to your body, include vitamin C-rich foods or beverages with your meal.
Read more: Foods That Inhibit Iron Absorption
Are You Deficient in Iron?
The most common cause of iron deficiency is from loss of blood. Some situations that may put you at risk for being deficient in iron can result from:
- Frequently donating blood
- Having a medical condition that causes genitourinary bleeding, such as from the bladder, prostate or urethra, or respiratory tract bleeding, such as from an infection
- Experiencing heavy menstrual periods
- Blood loss from conditions such as peptic ulcer, a colon polyp, hiatal hernia or uterine fibroids
- Health condition that inhibits absorption of iron, such as Crohn's disease, gastric bypass surgery or celiac disease
- Pregnancy and increased demand of iron for tissue growth and bleeding during delivery
- Eating a vegetarian or vegan diet
If you risk having a low-iron level you should be aware that a deficiency may not be immediately noticeable and can go undiagnosed as your body uses its stored iron. When the iron in your body is depleted, the results can be serious health problems or iron deficiency anemia. According to an article in Clinical Case Reports, published in June 2018, 10 to 20 percent of menstruating women have an iron deficiency and 3 to 5 percent are anemic.
The journal Lancet, published in February 2016, reported that several chronic diseases are frequently associated with iron deficiency anemia, including chronic kidney disease, chronic heart failure, cancer and inflammatory bowel disease. Additionally, many symptoms of a deficiency in iron are psychological and characterized by irritability, anxiety, depressed mood, muscle and joint pain and low-iron brain fog.
Fatigue and Weakness
Initially, iron deficiency symptoms may be mild and the first signs of psychological problems are commonly extreme tiredness and exhaustion. If your body does not get enough oxygen from hemoglobin, your muscles and tissues will be deprived. Nearly half of people with iron deficiency experience physical fatigue and lack of energy.
Without enough oxygen-rich blood traveling through your body, feelings of tiredness and shortness of breath can make you feel cranky, dizzy and have headaches, or experience difficulty concentrating, resulting in poor productivity at work.
Anemia and Depression
Anemia left untreated could cause psychological symptoms such as iron deficiency depression, cognitive disorders or deterioration of an existing psychiatric condition.
A study in the journal of Neuropsychiatric Disease and Treatment in October of 2015 found the frequency of anemia was higher in chronic psychiatric patients than in the general population. Results of the study reported an association with anemia and depression in 22 percent of patients. Anemia was diagnosed in 25 percent of patients with bipolar disorders and 24 percent of patients with other neurological symptoms.
Another study using historical reports from 1,000 Japanese participants found iron deficiency anemia was higher in depressed men and women compared to the control group. Conclusions, published in Psychiatry and Clinical Neurosciences in July 2018, reported iron deficiency was associated with higher psychological distress.
Because iron deficiency has a known negative impact on brain function in children, a review was conducted to also identify the effect of iron deficiency on mental health in women of childbearing age.
The study, published in the Journal of Nutritional Science in April 2013, found evidence that supplementation of iron had a small improvement in symptoms of fatigue and moderate improvement in mental health scores and cognitive function in women, especially with the task of arithmetic, which is a measure of working memory.
Restless Legs Syndrome
Iron insufficiency is the single most consistent finding and the strongest risk factor associated with restless legs syndrome, according to John Hopkins Medicine.
The National Institute of Neurological Disorders says restless legs syndrome is characterized as a neurological sensory disorder with symptoms that are produced from the brain. It happens when you have an irresistible urge to move your legs often because of uncomfortable sensations such as pulling, creeping, throbbing, crawling and often stabbing pain that occurs mainly at rest.
Over time, restless legs syndrome may contribute to psychological issues such as insomnia, stress and anxiety over getting to sleep. Restless legs syndrome can cause daytime sleepiness that affects mood, concentration, impaired memory and may interrupt carrying out daily tasks.
Developmental Delays in Children
Anemia in pregnancy has numerous health consequences for the baby including increased risk of:
- Severe illnesses
- Decreased cognitive performance
- Spinal and brain defects
Pregnant women who are anemic in pregnancy also have an increased risk of miscarriage, stillbirth and low birth weight, according to Pan American Health Organization.
Children who are iron deficient may be impaired in their ability to function properly. Iron deficiency, left untreated, can affect your child's growth and development. However, most signs and symptoms of low iron levels in children don't appear until iron deficiency anemia occurs. Talk to your doctor if your child shows the following signs of iron deficiency such as:
- Extreme fatigue and weakness
- Pale skin
- Chest pain, fast heartbeat or shortness of breath
- Headache or dizziness
- Cold hands and feet
- Inflammation or soreness of your tongue
- Brittle nails or spooning of the nails
- Cravings for unusual substances, such as ice, dirt or starch, called pica
- Poor appetite
Is This an Emergency?
- American Society of Hematology: "Blood Basics"
- University of California San Francisco: "Health: Hemoglobin and Functions of Iron"
- National Institutes of Health: "Iron"
- Cleveland Clinic: "Iron-rich Foods and Anemia: Management and Treatment"
- Clinical Case Reports: "Iron Deficiency Without Anemia – A Clinical Challenge"
- Lancet: "Iron Deficiency Anaemia"
- Danish Medical Journals: "Fatigue and Acute/Chronic Anaemia"
- HealthLinkBC: "Iron Deficiency Anemia"
- Neuropsychiatric Disease and Treatment: "Frequency of Anemia in Chronic Psychiatry Patients"
- Psychiatry and Clinical Neurosciences: "Association Between Iron-Deficiency Anemia and Depression: A Web-Based Japanese Investigation"
- Journal of Nutritional Science: "Iron Deficiency, Cognition, Mental Health and Fatigue in Women of Childbearing Age: A Systematic Review"
- John Hopkins Medicine: "Neurology and Neurosurgery: Causes of Restless Legs Syndrome"
- National Institute of Neurological Disorders and Stroke: "Restless Legs Syndrome Fact Sheet"
- Pan American Health Organization: "Iron Deficiency Anemia: Research on Iron Fortification for Efficient, Feasible Solutions"
- Mayo Clinic: Children's Health: "Iron Deficiency in Children: Prevention Tips for Parents"