Low Iron Symptoms in Women: Subtle Signs Your Body Is Asking for Help
- Samantha Pieterse
- 5 days ago
- 17 min read
Most women are very good at pushing through.
Pushing through tired days. Pushing through busy seasons. Pushing through feeling a little “off.” For most women, life doesn’t leave much room to investigate every small change. Over time, pushing through becomes the default. We start adjusting our lives around how we feel, rather than asking why we feel that way.
These subtle symptoms are easy to ignore, often because they develop gradually.
Low iron is one of those things that happens in the background, sometimes for years, before you realise. Often, because the signs are easy to explain away.
This article is about recognising the hints, understanding why they’re important, and understanding what you can do about them.
If you’ve ever thought, “This is probably just how things are right now,” this is for you.
Feeling Exhausted All the Time? What Low Iron Can Look Like in Women
There’s a big difference between having a busy season and feeling like your energy never quite comes back.
Many women describe it as running on reserve. You’re functioning, but everything feels harder than it should. Because low iron gradually gets worse, it’s easy to assume it’s stress, poor sleep, or hormones.
This is where understanding low iron can give some context to what your body might be telling you.
What “Low Iron” Means
Iron is like a little taxi your body uses to carry oxygen around. When iron levels drop, oxygen delivery becomes less efficient, which can affect how your body and brain function. This is also why two women with similar lifestyles can feel very different, even if nothing obvious has changed.
Low Iron vs Iron Deficiency Anaemia, Explained Simply
Low iron and iron deficiency anaemia are related, but they’re not the same thing.
Low iron means your body’s iron stores are running low. Iron deficiency anaemia happens later, when those low stores start affecting your red blood cells. In other words, you might not feel anaemic, but still feel the effects of low iron. Most women start noticing changes well before anaemia develops, which is why waiting for a more serious diagnosis isn’t always helpful.
Understanding this difference matters because it explains why you might experience symptoms even when you’ve been told your blood count looks fine.
Can Your Iron Be Low Even if Your Blood Count Looks Normal?
Yes, and this is one of the most confusing parts for women.
A standard blood count looks at red blood cells, not iron stores. It’s entirely possible for your haemoglobin to sit in the normal range while your iron reserves are already depleted. This is often where women feel dismissed. You know something isn’t right, but the numbers don’t seem to back it up.
Later in this article, we’ll look at which blood tests could give you a better idea of why you’re not feeling great
For now, the take-home message is this: feeling persistently exhausted doesn’t always mean you just need to sleep more. Sometimes it means your body is working harder than it should.
If you’re feeling constantly run down and wondering whether iron could be playing a role, book an appointment with Mums & Bums to talk it through.
We can help test the right bloods to see if iron deficiency might be what's wrong.
Common Low Iron Symptoms Women Often Brush Off
This is usually the stage where women start adapting.
You might drink more coffee. Go to bed earlier. Push through meetings, school runs, workouts, or weekends, all while telling yourself you just need a reset. Because nothing feels dramatic enough to justify having a check-up.
Constant Tiredness That Sleep Doesn’t Fix
This isn’t the kind of tiredness that improves after a good night’s sleep or a quiet weekend. It’s more like never feeling fully recharged. You wake up tired, get through the day tired, and start the next day in the same place. Many women describe it as running on half a battery, no matter what they do.
Because life is busy and exhaustion is common, this symptom is often the easiest one to miss, even when you've felt this way for months.
Feeling Short of Breath, Light-Headed, or Faint
Some women notice they get winded more easily than they used to. Walking up stairs feels harder. Carrying groceries feels heavier. Standing up too quickly leaves them feeling woozy.
Feeling this way is often subtle and short-lived, which makes it easy to blame it on being unfit or dehydrated. On their own, these symptoms don’t feel alarming. Over time, though, they can start adding up.
A Racing Heart Or A Strange Fluttering Feeling
A fast heartbeat or a fluttering sensation can be unsettling, especially when it seems to come out of nowhere.
Many women notice it when lying down or during simple activities that never used to cause it. It’s common to assume anxiety is the cause, particularly if everything else in life feels busy or overwhelming.
While stress can certainly affect the heart rate, low iron can also play a role, and this symptom is often overlooked because it doesn’t fit the usual picture.
Brain Fog, Poor Focus, and Headaches
Difficulty concentrating or feeling mentally slower than usual are things I often hear women complain about.
You might feel forgetful or struggle to follow conversations. Headaches can creep in too, sometimes frequently, sometimes unpredictably. Because these changes are hard to measure and easy to rationalise, they’re often put down to hormones or just not drinking enough water.
Subtle Signs of Low Iron You Might Not Link to Iron at All
This is where many women pause mid-sentence and think, “Wait… I thought that was just me.”
Low iron isn't always something you’d immediately label a health issue. Often, women adapt to, or simply accept, small or unexplained changes.
Pale Skin or Pale Inner Eyelids
Skin tone can be tricky to judge. Many women don’t notice anything until someone else points it out, or until they see photos and realise they look more washed out than usual.
The inside of the lower eyelids can give you a helpful hint, but it’s not something most people check regularly. Because this sign isn’t obvious day-to-day, it’s often missed.
Hair thinning, shedding, or slow regrowth
Hair changes are one of the most frustrating signs for women, and one of the easiest to blame on postpartum or ageing.
You might notice more hair in the shower, a thinner ponytail, or that regrowth seems slower than it used to be. These changes are often subtle and slow, making it difficult to link them to an underlying cause.
Brittle or Ridged Nails
Nails can start to develop ridges or break more easily than before. For some women, they simply stop growing the way they used to.
Because nail changes feel cosmetic rather than medical, they’re often brushed off, even though they can be part of a bigger picture. Additionally, many women have their nails done monthly, and so you might not notice any changes at all.
Always Feeling Cold
Feeling colder than everyone else is something many women joke about.
Cold hands, cold feet, needing extra layers when others are comfortable. It’s easy to assume it’s just part of being a woman, especially if it’s been happening as long as you can remember.
Restless Legs, Especially At Night
That uncomfortable urge to move your legs when you’re trying to relax or fall asleep is another sign many women don’t think to mention.
It can interfere with sleep, contribute to overall fatigue, and still not feel “medical enough” to bring up during an appointment.
A Heavy Feeling In The Arms or Body
Some women describe a heaviness in their arms, legs, or whole body, almost like everything takes more effort than it should.
It’s not pain or weakness in the obvious sense. More of a feeling of carrying extra weight through the day. Because it’s hard to describe, many women don’t mention it at all.
Easy Bruising or Bruises That Appear Without a Clear Reason
Some women start noticing bruises they can’t quite explain.
You might find marks on your legs or arms and not remember bumping into anything, or notice that small knocks seem to leave bigger bruises than they used to. Because bruising is common and often harmless, it’s rarely something women bring up unless it feels extreme.
Low iron can affect how well oxygen is delivered to tissues and how resilient small blood vessels are. Over time, this can make bruising more noticeable, even without significant injury.
On its own, easy bruising isn’t a diagnosis. But when it shows up alongside other subtle changes, it can be another small piece of the bigger picture.
Download the symptom checklist (free PDF, no email required).
This is a simple guide to help you notice patterns and know when to seek advice.
If you recognize some of these signs, it may be worth having it checked. Contact Mums & Bums in Rooihuiskraal to discuss how we can help you get back on track.
Why Low Iron Is So Common in Women
Once you start looking at iron levels through a woman’s health lens, the pattern starts emerging. For many women, low iron is caused by how the body uses, loses, and replaces iron across different life stages, often faster than it can keep up.
Heavy Periods and Monthly Blood Loss
Menstruation is one of the most common reasons iron stores slowly decline over time.
The sad thing is that heavy bleeding or bleeding longer than normal while on contraception often becomes normalised, especially if it’s been that way for years.
Additionally, many women don’t realise their periods are heavier than average, or that ongoing monthly blood loss alone can be enough to drain iron stores, even if everything else seems fine. But more on this in the next section.
Pregnancy, After Birth, And Breastfeeding
Pregnancy places extra demands on iron stores, both for the mother and the developing baby. Even when iron levels are checked during pregnancy, stores can still be left low after birth. Iron levels are often monitored during pregnancy check-ups, but iron stores can still become depleted, especially as pregnancy progresses and after birth.
After delivery, recovery, sleep deprivation, and breastfeeding can make it harder for iron levels to bounce back quickly. Because attention shifts to the baby, many women don’t realise how depleted their own reserves may still be months later. After delivery, recovery, blood loss, and sleep deprivation can all make it harder for iron levels to bounce back, which is why early support, such as a postnatal check-up, can be helpful for many moms.
Low Iron, Even With “Normal” Periods
Not all women with low iron have heavy periods.
Some lose smaller amounts of blood but do so consistently over many years. Others have underlying absorption issues or increased needs that aren’t immediately obvious. This is why you may still have low iron even if you feel your cycles are fairly ordinary.
It’s also why comparing yourself to friends or family isn’t always helpful. Iron needs and losses vary from person to person.
Diet, Iron Absorption, and Why Food Alone Isn’t Always Enough
Diet plays a role, but it’s rarely the whole story.
Iron from food isn’t absorbed equally, and factors like gut health, other nutrients, and even how foods are combined can affect how much iron the body actually takes in. Women who eat little red meat, follow vegetarian or plant-forward diets, or have digestive issues may struggle to keep iron stores topped up through food alone.
Even with a balanced diet, replacing iron lost through menstruation or pregnancy can be slower than many women expect.
Heavy Periods and Low Iron, What’s the Connection?
Did you know? Most women lose about 2–3 tablespoons of blood during a normal menstrual period, which is less than a quarter of a cup in total. With very heavy or prolonged periods, blood loss can be three to four times higher, sometimes reaching around one-third of a cup or more per cycle.
When that amount of blood is lost month after month, iron stores often become depleted, even if everything else appears normal.
Many women are told their periods are “just heavy” or that it’s something they have to live with. Over time, heavy bleeding can start to feel like a personal baseline rather than something worth questioning. But heavy periods and low iron are closely linked, and the connection is often underestimated.
Signs your period may be draining your iron stores
Heavy bleeding doesn’t always mean dramatic flooding or clots, although it can. For some women, it looks more subtle.
You might notice you’re changing pads or tampons more often than friends. Bleeding lasts longer than a few days. You need double protection to get through the day or night. Or your period leaves you feeling wiped out every single month.
Because periods are regular, the iron loss is regular too, and that slow, ongoing depletion is easy to miss.
How Heavy Bleeding Affects Iron Over Time
Iron stores don’t usually drop overnight.
Each cycle means a small loss, but month after month, that loss adds up. The body tries to compensate, but eventually iron reserves start to run low, especially if they’re not being fully replaced.
This is why some women feel fine for years and then gradually start noticing changes. Nothing dramatic has happened, but the balance has quietly shifted.
When Heavy Periods Need Checking Out
Heavy periods are common, but they’re not something you have to simply tolerate.
If bleeding interferes with daily life, work, sleep, or leaves you feeling consistently run down, have it checked out. Heavy periods can have many causes, and identifying them matters, not just for comfort, but for long-term health.
Looking into heavy can help you understand what your body is doing and whether extra support is needed.
How Low Iron Is Diagnosed
For many women, the hardest part of dealing with low iron isn’t the symptoms. It’s the uncertainty. You feel off. You finally get blood tests done. Then you’re handed a report full of numbers and ranges, with very little explanation of what they actually mean for how you feel.
Understanding how iron is checked helps take some of that anxiety out of the process.
The Blood Tests Doctors Use To Check Iron
Iron status isn’t measured with just one number.
Healthcare professionals usually look at a combination of blood tests to understand what’s going on. These can include markers that show how many red blood cells you have, as well as tests that give clues about how much iron your body has available and stored.
This is why two people can have very different experiences, even if they’ve both “had iron checked.” It depends on which tests were done and how they’re interpreted together.
Ferritin Explained in Everyday Language
Ferritin is a protein that reflects how much iron your body has stored away for future use. You can think of it as your iron reserve tank. When ferritin levels are healthy, your body has a buffer to draw from. When ferritin drops, that buffer shrinks, even if everything else still looks okay.
Ferritin is often the piece that explains why women feel unwell despite being told their iron is normal.
Do You Need To Fast Before An Iron Blood Test?
In most cases, fasting isn’t required for iron studies, but this may depend on the specific tests ordered and the lab performing them.
If fasting is needed, you’ll usually be told beforehand. When in doubt, ask to make sure you know exactly what to expect and avoid unnecessary stress.
If you’d like to test your iron or if you’ve had blood tests done and aren’t sure what they mean, contact Mums & Bums or book online to go through them in plain language.
Should You Take Iron Supplements?
For many women, iron supplements feel like the obvious next step. If iron is low, take iron. Simple. In reality, it’s a bit more nuanced, and understanding that nuance can save a lot of frustration.
When Supplements Help and When They Don’t
Iron supplements can be very helpful when iron stores are low, and the cause is ongoing iron loss or increased need. In these situations, they help rebuild reserves while the body catches up.
Where supplements fall short is when the underlying reason for iron loss hasn’t been addressed. If heavy bleeding continues, absorption is poor, or iron needs remain high, supplements may improve blood results without fully resolving how you feel.
This is why some women take iron for months and still feel only marginally better, or feel better briefly and then slip back again.
Common Side Effects Like Constipation And Nausea
Side effects are a major reason women stop taking iron.
Constipation, nausea, bloating, and stomach discomfort are common, especially with higher doses or certain forms of iron. These effects can make it hard to stick with treatment long enough to see real improvement.
Because of this, many women assume iron “just doesn’t agree with them,” when in fact adjusting timing, dose, or formulation can make a big difference.
Why Treating the Cause is Just as Important as Taking Iron
Iron supplements can replenish stores, but they don’t explain why those stores dropped in the first place.
If heavy periods, recent pregnancy, dietary gaps, or absorption issues aren’t recognised, iron levels may keep falling once supplements stop. Treating the cause alongside iron replacement is what leads to lasting improvement, not just better numbers on a lab report.
This is also why iron management looks different from one woman to the next.
During pregnancy and after birth, iron needs increase for both mom and baby.
If you were anemic during pregnancy, your baby may also need iron support, which we cover in more detail in our guide to multivitamins for babies.
How Long Do Iron Supplements Take to Work?
One of the most common questions women ask after starting iron is simple and completely reasonable.
“How long until I feel better?”
The answer depends on where iron levels started, how low stores were, and what’s driving the deficiency, but there are some general patterns most women experience.
When Women Usually Start Feeling Better
Some women notice small improvements within a few weeks. Energy may feel more stable, the constant edge of exhaustion eases, or everyday tasks feel slightly less effortful.
These early changes are often subtle rather than dramatic. It’s not usually a sudden return to full energy, more a gradual sense that things aren’t quite as heavy as they were before.
How Long Does It Take to Rebuild Iron Stores
Rebuilding iron stores takes time.
Even when symptoms begin to improve, iron reserves can take several months to recover, sometimes longer if iron loss is ongoing. This is why iron is often continued well beyond the point where you start feeling better.
Stopping too early can mean stores never fully recover, which is one reason low iron has a tendency to return.
Why Symptoms Can Improve Before Blood Levels Do
Feeling better doesn’t always line up perfectly with blood test results.
As iron availability improves, the body can function more efficiently, even while reserves are still being rebuilt. This can create a gap where symptoms ease before numbers fully normalise.
This is also why follow-up blood tests are often recommended, even if you’re already starting to feel like yourself again.
Choosing an Iron Supplement: What Women Should Know
Standing in front of a shelf of iron supplements can feel surprisingly stressful.
Different names, different doses, different promises. It’s easy to assume there must be one option that’s clearly better than the rest, but iron supplementation isn’t one size fits all.
Different Forms of Iron And Absorption
Iron supplements come in different forms, and they’re absorbed differently by different people.
Some forms are absorbed more easily but may be harder on the stomach. Others are gentler but absorbed more slowly. The right choice often depends on how low iron stores are, how sensitive your gut is, and how consistently you’re able to take the supplement.
This is why one woman can do well on a supplement that another struggles with.
Iron Supplements and Constipation
Constipation is one of the most common complaints with iron, and it’s often the reason women stop taking it altogether.
Iron can slow gut movement and cause bloating or discomfort, particularly at higher doses. For some women, changing the form of iron, adjusting the dose, or spacing it differently can make supplementation far more tolerable.
If side effects are severe or persistent, it’s a sign that something needs adjusting, not that iron supplementation has failed entirely.
Why There’s No Single “Best” Iron for Everyone
The best iron supplement is the one your body can absorb and that you can tolerate long enough to rebuild stores.
What works well for one woman may be completely wrong for another. That’s why advice around iron needs to take symptoms, blood results, and lifestyle into account, rather than relying on blanket recommendations.
Personalising the approach is what leads to steady improvement rather than repeated stops and starts.
If you’re unsure which type of iron is right for you, or you’ve had trouble tolerating supplements before, you can book a consultation with Mums & Bums in Centurion and we’ll walk you through it.
When Low Iron Symptoms Shouldn’t Be Ignored
Low iron often develops slowly, which is why many women live with it for a long time before seeking help. That said, there are moments where it’s worth taking things a step further because your body is telling you it needs more support.
Red Flags That Need Medical Review
Some signs should always prompt a proper check, especially if they’re new, worsening, or interfering with daily life.
This includes feeling faint, breathless at rest, having chest discomfort, or struggling to get through normal activities that used to feel manageable. These aren’t things to push through or self-manage indefinitely.
Getting clarity early helps rule out other causes and prevents iron levels from slipping further.
Ongoing Symptoms Despite Supplements
If you’ve been taking iron consistently and still don’t feel much better, that’s important information.
Sometimes the dose, form, or timing isn’t right. Other times, iron loss is continuing in the background, or absorption isn’t happening as expected. In these cases, simply staying on the same supplement without reassessing often leads to frustration rather than progress.
Persistent symptoms are a sign to reassess, not a sign that you’ve failed treatment.
Iron Levels That Keep Dropping
When iron levels improve briefly and then fall again, it usually means something is being missed.
Repeated drops can point to ongoing blood loss, increased needs, or absorption issues that haven’t been addressed yet. The cause of the low iron levels needs to be identified, not only to correct them but also to prevent the cycle from repeating.
This is where a more personalised plan is important.
Low Iron in Women, Listening to What Your Body Is Telling You
Low iron is often a collection of small changes that slowly become part of daily life. Feeling a bit flatter than usual. Needing more effort to get through things that once felt easy. Adjusting, compensating, and carrying on because that’s what women tend to do.
What matters is knowing that these changes aren’t something you have to ignore or simply live with. Paying attention doesn’t mean something is seriously wrong. It means you’re responding to your body with curiosity rather than criticism.
Understanding how low iron levels can affect women helps restore a sense of control. It helps you decide when to watch and wait, when to ask questions, and when it’s worth getting support.
If reading this has helped you make sense of things you couldn’t quite explain before, that alone is a meaningful first step.
Contact Mums & Bums in Rooihuiskraal if:
You need help managing your iron levels, or you have a few questions about how you're feeling. We're always there to guide you.
Frequently Asked Questions About Low Iron in Women
What are the most common low iron symptoms in women?
Low iron symptoms in women commonly include ongoing tiredness, shortness of breath, light-headedness, headaches, poor concentration, hair thinning, feeling cold, and heart palpitations. Symptoms can develop gradually and are often dismissed as stress or hormones.
Can you have low iron without being anaemic?
Yes. Many women have low iron stores without being anaemic. This often shows up as low ferritin levels while haemoglobin remains in the normal range, which means symptoms can be present even when a full blood count looks normal.
What causes low iron in women?
The most common causes of low iron in women include heavy periods, pregnancy, after birth, breastfeeding, ongoing monthly blood loss, and difficulty absorbing iron from food. Some women also develop low iron despite having what they consider normal periods.
Can heavy periods cause iron deficiency?
Yes. Heavy or prolonged periods are one of the leading causes of iron deficiency in women. Losing blood each month means losing iron, and over time, this can slowly deplete iron stores if they are not fully replaced.
What blood tests check iron levels?
Iron levels are usually assessed using a combination of blood tests, including haemoglobin and ferritin. Ferritin is especially important because it reflects iron stores and can explain symptoms even when haemoglobin levels appear normal.
What is ferritin, and why is it important?
Ferritin is a protein that stores iron in the body. Low ferritin means iron reserves are low, even if other blood results look normal. In women, low ferritin is often linked to fatigue and reduced energy before anaemia develops.
Do I need to fast before an iron blood test?
In most cases, fasting is not required for iron studies. However, this can vary depending on the specific tests ordered and the laboratory, so it’s best to confirm beforehand if you’re unsure.
How long does it take to feel better after starting iron supplements?
Some women notice improvement within a few weeks, but rebuilding iron stores usually takes several months. Symptoms can start improving before blood levels fully normalise, which is why follow-up testing is often recommended.
Why do iron supplements cause constipation?
Iron supplements can slow digestion and irritate the gut, which may lead to constipation, nausea, or bloating. Adjusting the type of iron, dose, or timing can often reduce side effects.
When should low iron symptoms be checked by a doctor?
Low iron symptoms should be checked if they persist, worsen, interfere with daily life, don’t improve with supplements, or if iron levels keep dropping. Feeling faint, breathless at rest, or unwell despite treatment should always be assessed.
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