How much iron does a woman need during menopause?

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Today's topic

Hello, and welcome to my weekly video blog. And today on A.Vogel Talks Menopause, I'm going to talk about how much iron do you need during the menopause.

Now, this is something that crops up regularly and for those of you who've been watching a lot of my videos, you'll know that I regularly recommend that you get your iron levels checked. So I thought today that I would go into it just a little bit more to look at potential problems, potential side effects, and why it's so important to get things checked out.

Can menopause cause low iron?

Now, what causes low iron in the menopause? Basically, the number one is heavy periods on the run-up to the menopause. If you're already a little bit low, and a lot of us are just because of our general diet and lifestyle, you only need a couple of really heavy bleeds, and that can tip you over the edge as far as iron levels go.

It's also even years later, so if you've had a run-up to the menopause where you've had heavy bleeds, you maybe didn't realise you were low in iron, so as time goes by, you can end up getting slightly lower and lower, and at that point symptoms can start to kick in.

So don't think that this just has to do with if you are having heavy periods at this moment in time. It could be that maybe even three-four years ago, you were having the heavy periods. It can also be due to digestive problems. We need strong stomach acid in order to help with the absorption of iron.

One of the problems in the menopause is a lot of women get digestive problems, especially stomach ones. They get indigestion or what they think might be gastric reflux, and they end up on what's called proton pump inhibitors which end up suppressing stomach acid.

So if you are one of these ladies, then really double-checking your iron levels at this point is really important. The third reason is diet itself. Are you getting enough iron in your diet? Especially if you're vegetarian or vegan, it can become a lot easier to get low in iron. So that's another major issue here.

What is the normal iron level for a woman?

So how much iron do you need? If you're having reasonably regular periods, the recommended dose is about 18 milligrams per day. After the menopause, it does go down and it's roughly about eight milligrams per day.

How do you know if you are iron deficient?

So what are the common symptoms of low iron? This is where it gets really confusing because a lot of low iron symptoms are menopause symptoms as well, and it can be very difficult to distinguish between the two of them.

So the common ones are fatigue and just feeling generally weak. You know that you can't rustle up the energy to do anything. It can be hair loss, thinning hair, and very brittle nails. It can be pale, dull skin. You can get cold hands and cold feet.

Even if you're getting hot flushes and sweats, if you find that your hands and feet tend to be cold all the time, that can be a good indication. It can be dizziness, that's another factor. You can get, not particularly common, but you can get a swollen tongue or a tingly tongue. And you can also get tingling in the legs and a fast or irregular heartbeat.

So as you can see, these symptoms can be mistaken for menopausal anxiety and basic just low oestrogen symptoms.

What to do if think you have low iron

So what do you need to do if you're suffering from any of these issues, and you're not quite sure if it's low iron or the menopause?

Get your iron levels tested

The first thing to do is get it checked by your doctor. Please don't just run out and buy iron supplements because you can overdose on iron, and this is not a good idea. So please just get your iron levels checked out by your doctor.

The important thing is to ask for both tests. Now, what that basically means is you have a blood level of iron, and normally, the doctor will take a blood sample, but you also need to get your stored iron levels checked which is called ferritin.

You can get a blood test done and your iron levels will look perfect, but if your stored iron levels are very low, this can still be a contributory factor to a lot of symptoms. So just ask the doctor for both the blood and the stored levels of iron to be tested.

Take an iron supplement if you doctor recommends it

If you are low in iron and you need to take an iron supplement, all I would say here is look at the natural ones if you can. The reason being is that majority of iron tablets that are prescribed are sort of heavy-duty ones. They can constipate you. They can make your stools black.

And our digestion can slow down anyway, so the last thing you want to be doing is slowing things down even further. There are lots of lovely gentle iron tonics. I tend to recommend liquid ones because they're far better absorbed. They are made of a completely different type of iron to the doctor's iron tablets.

These are much more easily absorbed and you need to take a lower dose in order to get as good as, if not better, results. So ask at your local health food for a liquid iron tonic. Most of these contain other ingredients as well, either vitamins and minerals, or herbs, so they will give you a lovely little general boost, as well as helping with your iron levels.

Eat more iron-rich foods

Look at your diet as well. Make sure that you are eating plenty of iron-rich foods, so that's your dark green leafy veg, things like pumpkin seeds. If you're not vegetarian then go for good quality red meat and just have a really good varied diet. If you are vegetarian or vegan, then you do need to be extra careful.  Just make sure that you're getting plenty of plant-based high-iron foods into your daily diet.

Boost your vitamin C intake

Look for vitamin C as well. This is really important because vitamin C helps to absorb iron in the body, so if you're not getting a lot of really good fresh fruit and veg, then taking a nice vitamin C supplement is really going to be beneficial for you as well.

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Is it necessary to take an iron supplement after menopause?

Do you need iron after the menopause? Again, it depends. As I said earlier, you could be through the menopause, but still struggling from low iron because you had heavy periods a few years ago. So just double-check, if you're getting these symptoms, go and get a doctor's checkup. If you're okay, then it's very unlikely that you need an iron supplement as long as you're getting a good quality diet.

A little word of advice

Now, the one thing as I mentioned before, please don't just nip out and get yourself an iron tonic because you can overdose on it, and you know, even me, I am fallible sometimes. A number of years ago, I was feeling a bit rundown, I thought, "Well, maybe a little iron tonic will do me good."

Not long afterwards, I had a general health test, and my iron levels came back a bit too high. And they had to be double-checked later on just to make sure that there wasn't any other issues going on because some health issues can incorporate high iron levels. Too much iron can give you things like fatigue, joint pain, an irregular heartbeat, which is a bit strange because that's the exact symptoms that you can get with low iron.

So the only thing I would say today is just be careful with this one, always double-check, and don't self-medicate. So hopefully that's given you a few good tips. And I will see you next week for another edition of A.Vogel Talks Menopause.