Is my anxiety really an anemia?

After six years in practice, I’m still continuously surprised by how many women are anemic. This is important because anemia can cause symptoms of depression and anxiety. There are multiple forms of anemias including iron deficiency anemia and vitamin B12 and Folate deficiency anemia. Women have a higher tendency towards iron deficiency anemia because of blood loss during menstrual periods. “But I’ve been checked”, you might say, “my hemoglobin was normal.” Many conventional care practitioners are only looking at a hemoglobin level to check for an iron deficiency anemia. While this is a valuable test, I find a ferritin to be more indicative of quality-of-life in my patients. I prefer a hemoglobin to be in the range of 13.5 to 14.5 and a ferritin in the range of 50 to 100 in menstruating women. Any ferritin under 30, I consider to be anemic. Anything under 20, I consider an "under the floor" functioning level.

Common signs of iron deficiency anemia  include:

• Headaches
• Depression
  
• Anxiety
• Sensitivity to cold / cold hands and feet
• Desire to chew ice
• Short attention span
• Brain Fog
• Fatigue
• Heavy periods - (Bonus! - Improving iron status can make periods less heavy! Score!)
• Dizziness
• Restless leg syndrome
• Heart palpitations
• Shortness of breath
• Hair loss (Ferritin should be >75 for optimal hair maintenance) 

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If an iron deficiency is discovered, it’s important to note that the next step is not to just supplement iron. I prefer to ask WHY. Why are you anemic? My starting list to investigate usually includes: heavy menstrual periods, a vegetarian diet or a diet low in high iron foods, celiac disease or gluten sensitivity, digestive issues (constipation, diarrhea, abdominal pain), and/or chronic infections. It is possible to have multiple issues contributing at once. Supplementing iron should always be done with care. It is possible to supplement too much iron. I like to monitor ferritin and other iron markers while treating with iron and getting to the root cause of the issue. Talk to your doctor to see if checking for an anemia could help you. 

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