I have often heard doctors accused of not make use of nutritionally-oriented therapies in their work. Actually, strictly speaking, this is not true. After all, any doctor who has advised women to take folic acid in pregnancy or suggested calcium supplements for stronger bones has, to some degree at least, engaged in the practice of nutritional medicine. Another nutrient much-favoured by medicos is iron. This mineral plays an important role in blood-building in the body, and is the number one treatment for restoring lost energy in individuals suffering from anaemia. However, recent studies have found that iron’s health-enhancing effects may also extend to individuals not afflicted with anaemia. Iron’s use by the medical establishment may be well-established, but there is evidence that doctors might do well to prescribe it with an even freer hand.

Iron’s prime role in the body is as an essential ingredient in the manufacture of haemoglobin – the substance responsible for delivering oxygen to the body’s cells. Low levels of haemoglobin – the medical term for which is anaemia – starves the tissues of oxygen, and commonly manifests as fatigue ad lethargy. However, studies show that the body can run very low in iron before haemoglobin levels drop significantly. This is important because, apart from its role in the manufacture of haemoglobin, iron is also integral to processes that generate energy in the body. What this means is that a deficiency in iron can cause considerable fatigue and weariness, even when blood tests show no sign of anaemia. Women of childbearing age seem to be particularly prone to iron-deficiency, mainly because significant quantities of this mineral can be lost in the menstrual blood each month.

In a study published recently in the British Medical Journal, iron therapy was tried in a group of non-anaemic women with unexplained fatigue. The women were first assessed for overall iron levels using a blood test known as the serum ferritin. Interestingly, despite not being anaemic, half the women in the study were found to have low ferritin levels (less than 20 micrograms per litre of blood). What is more, treatment with iron for just one month increased energy levels significantly better than placebo (inactive treatment), even in women with ferritin levels between 20 and 50 (iron levels traditionally classed as ‘normal’).

The results of this and other similar studies suggest that the accepted levels of ferritin in women are simply set too low. It is interesting to note that accepted levels for ferritin are lower for women than for men. Menstruation may put women at greater risk of low iron levels, but my attitude is that this is not necessarily something we should just accept as being part of their lot. In practice, I have seen plenty of worn-out women with ‘normal’ blood test results who feel much better when treatment with iron has boosted their ferritin levels into the 80s or 90s.

Checking ferritin levels before dosing up on iron is important, partly to establish whether there is any need for iron, and also because an excess of iron is potentially hazardous to the body. Those with ferritin levels on the low side may start by increasing their intake of iron-rich foods such as red meat, oysters, fish, dried fruit, and nuts and seeds. Iron supplementation, with an eye kept from time to time on ferritin levels, is a sensible option too. Experience shows that additional iron can be a real boon for those suffering from metal fatigue.

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