--- title: "Why Am I So Tired All the Time? The Hidden Iron Connection" entity: "blog" canonical_url: "https://www.onnalomd.com/blog/why-am-i-so-tired-all-the-time-the-hidden-iron-connection" markdown_url: "https://www.onnalomd.com/llms/blog/why-am-i-so-tired-all-the-time-the-hidden-iron-connection" lastmod: "2026-06-19T22:06:00.000Z" --- ## Are You Sleeping Enough but Still Exhausted? Do you wake up tired, rely on caffeine to get through the day, struggle with brain fog, and wonder why your energy never seems to fully recover? Maybe you've been told your labs are "normal." Maybe you assume it's stress, getting older, perimenopause, or simply having too much on your plate. As a functional medicine physician, I hear this every day from smart, successful women who are balancing careers, families, responsibilities, and everyone else's needs before their own. What surprises many women is that one of the most overlooked causes of fatigue may be something surprisingly simple: low iron. In this episode of Reclaiming Vitality, I sat down with acupuncturist, herbalist, and Traditional Chinese Medicine practitioner Jen Cherawaty RAc. to discuss why iron deficiency is so common in women and how addressing it can dramatically improve energy, focus, mood, sleep, and overall vitality. In this episode, you'll learn: ✓ Common signs and symptoms of low iron women often miss ✓ The connection between ferritin, fatigue, brain fog, and burnout ✓ Why iron deficiency can mimic perimenopause symptoms ✓ How to naturally support iron ✓ What can improve iron absorption ✓ How to choose an iron supplement that's easier on digestion ✓ Jen's favorite iron smoothie recipe for boosting energy naturally ✓ How acupuncture and Chinese herbal medicine support iron deficiency and blood building ### Why Are So Many Women Low in Iron? Women are uniquely vulnerable to iron depletion. Every month, menstruation causes blood loss. Add pregnancy, breastfeeding, stress, poor digestion, restrictive diets, intense exercise, and busy lifestyles, and it's easy to see how iron stores become depleted over time. The problem is that many women normalize exhaustion. They assume: - "I'm just busy." - "This is what motherhood feels like." - "It's probably my hormones." - "I just need more coffee." But when iron levels are low, every cell in your body receives less oxygen. Over time, this can affect nearly every aspect of how you feel. ### Symptoms of Low Iron Women Often Miss Low iron stores can contribute to symptoms such as: - Brain fog - Poor concentration - Hair loss - Brittle nails - Feeling cold - Anxiety - Heart palpitations - Restless legs - Poor exercise recovery - Dizziness when standing - Low motivation - Difficulty sleeping - Chronic fatigue What makes this particularly confusing is that many of these symptoms overlap with perimenopause, burnout, thyroid dysfunction, and chronic stress. Sometimes, women may spend years chasing answers without realizing that low iron is contributing to the problem. ### Why Ferritin Matters Ferritin measures your stored iron reserves. Many women are told their complete blood count (CBC) looks normal, but ferritin is never checked. Yet ferritin is often the marker that helps explain persistent fatigue, poor resilience, and low energy. - Mild Iron Deficiency: Ferritin 30–50: - Moderate Deficiency: Ferritin 15–30: - Significant Deficiency: Ferritin <15 or anemia Other labs worth checking too are: - CBC - Iron saturation - Serum iron - TIBC - Transferrin saturation - B12 and Folate - hs-CRP (because inflammation can falsely elevate ferritin) If you've been struggling with unexplained exhaustion, discussing ferritin testing with your healthcare provider may be a worthwhile next step. ### Foods That Naturally Support Healthy Iron Levels Iron-rich foods include: Animal Sources (Heme Iron) - Beef - Bison - Lamb - Liver - Dark poultry - Seafood Plant Sources (Non-Heme Iron) - Lentils - Black beans - Pumpkin seeds - Spinach - Quinoa - Tofu - Blackstrap molasses - Spirulina Jen also shared a simple iron-supportive smoothie that combines: - Blueberries - Blackstrap molasses - Spinach - Pumpkin seeds - Hemp hearts - Vitamin C-rich fruit (lemon, orange) - Protein powder ### Tips to Improve Iron Absorption It's not just about how much iron you consume. It's also about how much your body can absorbs. To improve absorption: - Pair iron-rich foods with vitamin C - Ensure adequate B12 and folate - Support healthy digestion - Avoid taking iron with coffee, tea, or calcium-rich foods Even small adjustments can significantly improve how effectively your body uses iron. ### Supplementing with Iron Several studies in iron-deficient women found that alternate-day dosing resulted in greater fractional iron absorption than daily dosing. Best Forms of Iron 1. Iron Bisglycinate (often my favorite) Typical elemental iron: 25–30 mg per capsule Pros: - Better tolerated - Less constipation - Less nausea - Good absorption 2. Ferrous Sulfate Typical elemental iron: 65 mg elemental iron per 325 mg tablet Pros: - Most studied - Inexpensive Cons: - More constipation - More nausea and GI upset 3. Heme Iron Pros: - Excellent absorption - Less affected by food - Helpful when ferritin won't rise Cons: - More expensive - Animal-derived ### What Traditional Chinese Medicine Teaches About "Building Blood" In Chinese Medicine, blood is much more than a laboratory value. Blood nourishes: - The brain - The muscles - The uterus - The skin - The eyes - The nervous system When blood is abundant, women often feel: - Calm - Focused - Emotionally resilient - Well rested - Energized - Mentally clear When blood becomes depleted, symptoms can show up throughout the entire body. This perspective aligns beautifully with what we see in functional medicine: true vitality depends on nourishment, not just symptom management. ### Why Acupuncture Can Help Women Recover from Burnout tOne reason I often recommend acupuncture as part of an integrative care plan is because it addresses multiple systems simultaneously. For women struggling with fatigue, hormone imbalance, stress, digestive issues, and low iron, acupuncture may help support: - Nervous system regulation - Sleep quality - Digestion - Stress resilience - Menstrual health - Energy production Many women leave treatment feeling deeply rested, grounded, and restored. T hat experience of deep rest is often something burned-out women haven't felt in years. ### Watch the Full Episode If you've been experiencing fatigue, brain fog, burnout, poor recovery, hair loss, anxiety, or symptoms that have been dismissed as "normal," I encourage you to watch this conversation. #### Our Guest Jen Cherawaty, RAc, RTCMP , is a fertility and women's health-focused acupuncturist, herbalist, and Traditional Chinese Medicine practitioner with more than 20 years of experience helping women optimize hormones, improve fertility, recover postpartum, navigate perimenopause and menopause, reduce stress, improve digestion, and restore vitality. Through [Blossom Acupuncture](https://www.blossomacupuncture.ca/), she combines Traditional Chinese Medicine with evidence-based functional medicine to help women address the root causes of their health concerns. [https://www.instagram.com/jencherewaty.rac.rtcmp/ ](https://www.instagram.com/jencherewaty.rac.rtcmp/) ### Are You Sleeping Enough but Still Exhausted? Do you wake up tired, rely on caffeine to get through the day, struggle with brain fog, and wonder why your energy never seems to fully recover? Maybe you've been told your labs are "normal." Maybe you assume it's stress, getting older, perimenopause, or simply having too much on your plate. As a functional medicine physician, I hear this every day from smart, successful women who are balancing careers, families, responsibilities, and everyone else's needs before their own. What surprises many women is that one of the most overlooked causes of fatigue may be something surprisingly simple: low iron. In this episode of Reclaiming Vitality, I sat down with acupuncturist, herbalist, and Traditional Chinese Medicine practitioner Jen Cherawaty RAc. to discuss why iron deficiency is so common in women and how addressing it can dramatically improve energy, focus, mood, sleep, and overall vitality. In this episode, you'll learn: ✓ Common signs and symptoms of low iron women often miss ✓ The connection between ferritin, fatigue, brain fog, and burnout ✓ Why iron deficiency can mimic perimenopause symptoms ✓ How to naturally support iron ✓ What can improve iron absorption ✓ How to choose an iron supplement that's easier on digestion ✓ Jen's favorite iron smoothie recipe for boosting energy naturally ✓ How acupuncture and Chinese herbal medicine support iron deficiency and blood building ### Why Are So Many Women Low in Iron? Women are uniquely vulnerable to iron depletion. Every month, menstruation causes blood loss. Add pregnancy, breastfeeding, stress, poor digestion, restrictive diets, intense exercise, and busy lifestyles, and it's easy to see how iron stores become depleted over time. The problem is that many women normalize exhaustion. They assume: - "I'm just busy." - "This is what motherhood feels like." - "It's probably my hormones." - "I just need more coffee." But when iron levels are low, every cell in your body receives less oxygen. Over time, this can affect nearly every aspect of how you feel. ### Symptoms of Low Iron Women Often Miss Low iron stores can contribute to symptoms such as: - Brain fog - Poor concentration - Hair loss - Brittle nails - Feeling cold - Anxiety - Heart palpitations - Restless legs - Poor exercise recovery - Dizziness when standing - Low motivation - Difficulty sleeping - Chronic fatigue What makes this particularly confusing is that many of these symptoms overlap with perimenopause, burnout, thyroid dysfunction, and chronic stress. Sometimes, women may spend years chasing answers without realizing that low iron is contributing to the problem. ### Why Ferritin Matters Ferritin measures your stored iron reserves. Many women are told their complete blood count (CBC) looks normal, but ferritin is never checked. Yet ferritin is often the marker that helps explain persistent fatigue, poor resilience, and low energy. - Mild Iron Deficiency: Ferritin 30–50: - Moderate Deficiency: Ferritin 15–30: - Significant Deficiency: Ferritin <15 or anemia Other labs worth checking too are: - CBC - Iron saturation - Serum iron - TIBC - Transferrin saturation - B12 and Folate - hs-CRP (because inflammation can falsely elevate ferritin) If you've been struggling with unexplained exhaustion, discussing ferritin testing with your healthcare provider may be a worthwhile next step. ### Foods That Naturally Support Healthy Iron Levels Iron-rich foods include: Animal Sources (Heme Iron) - Beef - Bison - Lamb - Liver - Dark poultry - Seafood Plant Sources (Non-Heme Iron) - Lentils - Black beans - Pumpkin seeds - Spinach - Quinoa - Tofu - Blackstrap molasses - Spirulina Jen also shared a simple iron-supportive smoothie that combines: - Blueberries - Blackstrap molasses - Spinach - Pumpkin seeds - Hemp hearts - Vitamin C-rich fruit (lemon, orange) - Protein powder ### Tips to Improve Iron Absorption It's not just about how much iron you consume. It's also about how much your body can absorbs. To improve absorption: - Pair iron-rich foods with vitamin C - Ensure adequate B12 and folate - Support healthy digestion - Avoid taking iron with coffee, tea, or calcium-rich foods Even small adjustments can significantly improve how effectively your body uses iron. ### Supplementing with Iron Several studies in iron-deficient women found that alternate-day dosing resulted in greater fractional iron absorption than daily dosing. Best Forms of Iron 1. Iron Bisglycinate (often my favorite) Typical elemental iron: 25–30 mg per capsule Pros: - Better tolerated - Less constipation - Less nausea - Good absorption 2. Ferrous Sulfate Typical elemental iron: 65 mg elemental iron per 325 mg tablet Pros: - Most studied - Inexpensive Cons: - More constipation - More nausea and GI upset 3. Heme Iron Pros: - Excellent absorption - Less affected by food - Helpful when ferritin won't rise Cons: - More expensive - Animal-derived ### What Traditional Chinese Medicine Teaches About "Building Blood" In Chinese Medicine, blood is much more than a laboratory value. Blood nourishes: - The brain - The muscles - The uterus - The skin - The eyes - The nervous system When blood is abundant, women often feel: - Calm - Focused - Emotionally resilient - Well rested - Energized - Mentally clear When blood becomes depleted, symptoms can show up throughout the entire body. This perspective aligns beautifully with what we see in functional medicine: true vitality depends on nourishment, not just symptom management. ### Why Acupuncture Can Help Women Recover from Burnout tOne reason I often recommend acupuncture as part of an integrative care plan is because it addresses multiple systems simultaneously. For women struggling with fatigue, hormone imbalance, stress, digestive issues, and low iron, acupuncture may help support: - Nervous system regulation - Sleep quality - Digestion - Stress resilience - Menstrual health - Energy production Many women leave treatment feeling deeply rested, grounded, and restored. T hat experience of deep rest is often something burned-out women haven't felt in years. ### Watch the Full Episode If you've been experiencing fatigue, brain fog, burnout, poor recovery, hair loss, anxiety, or symptoms that have been dismissed as "normal," I encourage you to watch this conversation. #### Our Guest Jen Cherawaty, RAc, RTCMP , is a fertility and women's health-focused acupuncturist, herbalist, and Traditional Chinese Medicine practitioner with more than 20 years of experience helping women optimize hormones, improve fertility, recover postpartum, navigate perimenopause and menopause, reduce stress, improve digestion, and restore vitality. Through [Blossom Acupuncture](https://www.blossomacupuncture.ca/), she combines Traditional Chinese Medicine with evidence-based functional medicine to help women address the root causes of their health concerns. [https://www.instagram.com/jencherewaty.rac.rtcmp/ ](https://www.instagram.com/jencherewaty.rac.rtcmp/) ## Your health won’t wait—why should you? Let’s get to the root of what’s getting you stuck. Schedule Your Discovery Call Today Get actionable tips delivered to your inbox so you can start using right away to feel more energized and improve your overall health. Get It Here References: 1. Auerbach M, DeLoughery TG, Tirnauer JS. Iron Deficiency in Adults: A Review. JAMA. 2025;333(5):421-432. doi:10.1001/jama.2024.27574 2. Voelker R. What Is Iron Deficiency? JAMA. 2025;333(5):405. doi:10.1001/jama.2024.28604 3. Firquet A, Kirschner W, Bitzer J. Forty to Fifty-Five-Year-Old Women and Iron Deficiency: Clinical Considerations and Quality of Life. Gynecol Endocrinol. 2017;33(7):503-509. doi:10.1080/09513590.2017.1284780 4. Luo J, Wang X, Yuan L, Guo L. Iron Deficiency, a Risk Factor of Thyroid Disorders in Reproductive-Age and Pregnant Women: A Systematic Review and Meta-Analysis. Front Endocrinol (Lausanne). 2021;12:629831. doi:10.3389/fendo.2021.629831 5. Camaschella C. Iron-Deficiency Anemia. N Engl J Med. 2015;372(19):1832-1843. doi:10.1056/NEJMra1401038 6. da Silva Lopes K, Yamaji N, Rahman MO, et al. Nutrition-Specific Interventions for Preventing and Controlling Anaemia Throughout the Life Cycle: An Overview of Systematic Reviews. Cochrane Database Syst Rev. 2021;9(9):CD013092. doi:10.1002/14651858.CD013092.pub2 5. Hurrell R, Egli I. Iron Absorption: Factors, Limitations, and Improvement Methods. Nutrients. 2024;16(2):245. doi:10.3390/nu16020245 Disclaimer: This information is for educational purposes only and is not intended as medical advice. Consult a qualified healthcare professional before making any health-related decisions. Individual results may vary.