Brain Fog, Fatigue, and More: Signs of Iron Deficiency and When to Get Tested
Brain Fog, Fatigue, and More: Signs of Iron Deficiency and When to Get Tested
Have you ever trudged through a day feeling unusually tired, forgetful, or just not quite yourself? It happens to everyone now and then, but if you’re dragging day after day, it might be worth checking your iron levels.
Iron plays a vital role in your health. Your body uses it to make hemoglobin, a protein that carries oxygen in your blood. When iron levels are low, fatigue, brain fog, sleeplessness, and other debilitating symptoms start to set in.
“Iron deficiency is often underrecognized and underdiagnosed because many of its symptoms overlap with other conditions,” says Kara Fialkowski, a nurse practitioner at University of Utah Health's Iron Deficiency Clinic. “But once iron deficiency is identified and treated, people often notice a big shift in how they feel.”
Signs of Iron Deficiency
Iron deficiency doesn’t look the same from person to person.
Common symptoms include:
- Fatigue
- Brain fog
- Headaches
- Dizziness
- Hair loss
- Restless legs
- Exercise intolerance
- Unusual cravings
- Chewing on ice
If these symptoms sound familiar, consider asking your doctor to run your bloodwork with a specific focus on ferritin, a protein that helps store iron.
“It can be a little tricky to diagnose if certain labs aren’t checked specifically,” Fialkowski says. “Your routine annual bloodwork may not catch it unless you ask for iron studies—including ferritin.”
Who Is Most at Risk of Developing Iron Deficiency?
Anyone can develop iron deficiency, but some people are at higher risk than others.
- Frequent blood donors: Donating blood saves lives, but it can also lower iron stores—your body’s reserve supply of iron.
- Menstruating women: Heavy periods are one of the most common causes of iron deficiency. It’s important to talk to your doctor about treatment.
- Post‑menopausal women: After menopause, iron deficiency can develop for various reasons, usually related to the GI tract, medications, or chronic inflammation.
- Pregnant and breastfeeding women: During pregnancy, a growing baby relies on the mother’s iron supply. Women who begin pregnancy with low iron levels may become deficient more quickly.
- People with digestive conditions: Crohn’s, ulcerative colitis, and celiac disease are common GI conditions that cause chronic hidden blood loss or malabsorption in the small intestine.
- People who’ve had gastric bypass surgery: Certain weight-loss surgeries affect part of the digestive tract where iron is absorbed, increasing the risk of deficiency.
- Endurance athletes: Long‑distance runners and other endurance athletes may experience microscopic bleeding and increased inflammation, which can contribute to lower iron levels.
How Is Iron Deficiency Treated?
Without treatment, iron deficiency can progress to anemia, which may require blood transfusions. But even without anemia, the symptoms can take a toll on your quality of life.
Fortunately, several treatment options are available.
- Iron-Rich Foods: Animal‑based iron (heme iron), such as red meat, is absorbed most efficiently by the body. Plant-based iron, such as leafy greens, beans, and lentils, is harder for the body to absorb. Iron-fortified foods, such as certain cereals, can boost intake.
- Oral Iron Supplements: Many over‑the‑counter iron supplements work well. In fact, the body absorbs iron supplements taken every other day more effectively than those taken every day.
- IV Iron Therapy: For people who cannot tolerate oral supplements or need more aggressive treatment, intravenous (IV) iron can quickly replenish stores.
You don’t have to be severely deficient to qualify. You can start feeling a difference after just one dose. Most people notice improvements within two to four weeks.
Feeling Better Starts with Finding the Cause
Iron deficiency is more common than many people realize. A staggering one in four Americans may have some form of iron deficiency. Yet because the symptoms often develop gradually, it’s easy to miss the warning signs.
The good news is that treatment can make a significant difference.
“Most patients start to feel noticeably better after treatment,” Fialkowski says. “The brain fog begins to lift, exercise tolerance improves, sleep gets better, and overall energy starts to come back. I often hear patients say, ‘Oh, I didn’t realize how crummy I was feeling until I got treatment.’”
If you’ve been struggling with unexplained fatigue, brain fog, or other symptoms, talk to your provider about whether your iron levels could be contributing to how you feel.
Specialized Iron Deficiency Care at University of Utah Health
University of Utah Health’s Iron Deficiency Clinic provides specialized care for people with mild to severe iron deficiency.
“We take any patient who has iron deficiency and we care for them long‑term,” Fialkowski says. “Unlike many other iron deficiency clinics, we’re usually able to see our patients within a week. We also work closely with infusion teams, pharmacists, and referring providers to streamline care.”
The clinic focuses on identifying the cause of iron deficiency, restoring healthy iron levels, and helping patients prevent future problems.