Welcome to a new format here on the Brown Paper Nutrition journal. Each month we’re going deep on one nutrient or life stage – the real evidence, the practical eating, and the recipes to match – instead of a grab-bag of tips. First up: iron. If you’ve ever felt inexplicably flat, foggy or short of breath on the stairs, or noticed your focus and mood aren’t what they used to be – this one’s for you.
Why iron deficiency is so common in women:
Iron deficiency is the most common nutrient deficiency in the world, and women carry a disproportionate share of it. Globally, an estimated 30% of non-pregnant women aged 15–49 are affected by anaemia, and iron deficiency is considered the leading cause [1]. In Australia, the picture is similar: around one in five women of childbearing age experience some degree of iron deficiency, and dietary iron intake is inadequate in a substantial proportion of women in this age bracket [2].
The reason isn’t mysterious – it’s arithmetic. Regular blood loss through menstruation means women of reproductive age need almost double the iron of adult men (18mg versus 8mg per day under Australian Nutrient Reference Values), and most of us are trying to meet that requirement from a diet that hasn’t been built with it in mind [3]. Add a heavy period, a pregnancy, a plant-forward diet, or a period of restrictive eating, and the gap between what’s needed and what’s consumed widens further.
What iron deficiency actually does to your energy
This is the part that gets under-explained. Iron isn’t just “a mineral” – it’s the core component of haemoglobin, the protein in red blood cells that carries oxygen from your lungs to every tissue in your body [4]. When iron stores run low, haemoglobin production falls, oxygen delivery to your muscles and brain drops, and your body responds exactly the way you’d expect it to: fatigue, breathlessness on exertion, difficulty concentrating, and sometimes irritability, pale skin, or a noticeably reduced tolerance for exercise [4]. Iron is also a cofactor in enzymes involved in cellular energy production itself, so the fatigue of iron deficiency isn’t just “feeling tired” – it’s a genuine drop in how efficiently your cells can generate energy.
Importantly, you don’t need to be clinically anaemic to feel this. Iron deficiency without anaemia – where ferritin (your iron storage marker) is low but haemoglobin hasn’t dropped yet is common and still associated with fatigue [4,5]. This is often the stage where women are told their “bloods are fine” because full blood count looks normal, when ferritin, the more sensitive marker, tells a different story.
Where we’re headed this month
Over the next month we’ll unpack how to actually absorb the iron you eat, how requirements shift across your cycle, pregnancy and perimenopause, how to build a genuinely iron-sufficient plant-based plate, and finally how to put it all together in a day of eating. Plus when it’s time to stop guessing and get a blood test. This week, start simply: an iron-forward breakfast like the Plant based iron rich Smoky Black Beans and Veg on toast, or a red-meat main like Pesto skirt steak with greens risotto or Protein rich turkey curry, are an easy place to begin noticing where iron already shows up in your week.
FAQ:
Q: What are the early signs of iron deficiency? A: Fatigue, breathlessness with activity, difficulty concentrating, pale skin, and reduced exercise tolerance are the most common early signs. Some people also notice brittle nails, hair shedding, or restless legs. Because these overlap with many other conditions, a blood test (ferritin plus full blood count) is the only reliable way to confirm it [4].
Q: Can you be iron deficient without being anaemic? A: Yes. Iron deficiency without anaemia is common, particularly in women with heavy periods, and can still cause fatigue even when a standard full blood count looks “normal.” Ferritin is the more sensitive marker for catching this earlier [4,5].
Q: Why do women need so much more iron than men? A: Regular menstrual blood loss means women of reproductive age lose iron every month that men simply don’t, which is why the Australian Recommended Dietary Intake for women aged 19–50 (18mg/day) is more than double that for men of the same age (8mg/day) [3].
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References:
[1] World Health Organization. (2025). Anaemia [Fact sheet]. https://www.who.int/news-room/fact-sheets/detail/anaemia
[2] Medical Republic. (n.d.). Getting enough iron is a challenge for women. https://www.medicalrepublic.com.au/getting-enough-iron-is-a-challenge-for-women/7036
[3] National Health and Medical Research Council. (2017). Nutrient Reference Values for Australia and New Zealand: Iron. Eat for Health. https://www.eatforhealth.gov.au/sites/default/files/2022-04/n35-iron_0.pdf
[4] Healthdirect Australia. (2024). Iron deficiency. https://www.healthdirect.gov.au/iron-deficiency
[5] Johnson, S., Lang, A., Sturm, M., & O’Brien, S. H. (2016). Iron deficiency without anemia: A common yet under-recognized diagnosis in young women with heavy menstrual bleeding. Journal of Pediatric and Adolescent Gynecology, 29(6). https://pubmed.ncbi.nlm.nih.gov/27262832/
