A 40-year-old woman experienced a significant change in her personality and energy levels, initially suspecting early menopause. Rachelle Smith, a stunt performer from Wales, found herself too exhausted to engage in her usual physical activities, including sports and gym workouts. Her social life suffered as she began canceling plans, and even daily tasks became arduous, leading her to take daytime naps and focus solely on getting home to sleep.
Beyond fatigue, Smith experienced aching joints, irregular periods, difficulty concentrating, and memory lapses, which prompted her to turn down work. Her assumption of perimenopause was based on her mother's experience with early menopause. However, a friend's suggestion to take an at-home blood test revealed a different cause: severe deficiencies in iron and vitamin D, with low vitamin B12 levels.
"I really underestimated how much nutrition can impact your life," Smith said. "That's why I assumed it was a hormonal problem; I didn't think a vitamin deficiency could cause such extreme symptoms."
These deficiencies are not uncommon. Approximately one in three women experience iron deficiency during their lives, often due to heavy menstrual bleeding. Severe iron deficiency can lead to anemia, reducing the blood's oxygen-carrying capacity and straining the heart. Iron and vitamin D deficiencies can share symptoms like fatigue, muscle weakness, and low mood. Some research suggests a link between heavy perimenopausal bleeding and iron deficiency anemia, and low vitamin D levels have also been associated with fatigue and mood disturbances.
Smith discovered that her vegan diet, while rich in plant-based iron, made absorption more challenging for her body. To combat this, she focused on increasing her intake of vitamin C-rich foods, such as red peppers and oranges, to enhance iron absorption. While diet can help, correcting iron deficiency often requires supplements because the body tightly regulates iron absorption. Even with increased dietary intake, supplements are frequently necessary, especially if blood loss from heavy periods or digestive issues contributes to the deficiency.
Smith opted for oral spray supplements for iron and vitamin D, as she had difficulty swallowing pills. Vitamin sprays are absorbed through the mucous membranes in the mouth, potentially bypassing parts of the digestive tract, which can be beneficial for individuals with absorption issues. Studies indicate that vitamin D oral sprays are as effective as traditional capsules. However, experts express caution regarding the efficacy of oral iron sprays due to their lower dosage compared to tablets and a lack of robust clinical trials.
Professor Toby Richards, an iron deficiency specialist at the University of East London, recommends a higher oral iron dosage, typically 200 to 300 mg in liquid or tablet form, taken for three to six months, followed by reassessment. He also advises women who do not eat meat to consider a low-dose iron supplement regularly, particularly during their periods, to maintain adequate levels.
Following these dietary adjustments and supplementation, Smith reported feeling like a different person within two weeks. The mental fogginess cleared, and her energy returned, enabling her to resume activities like running and horse riding. She emphasizes the ease of incorporating these changes into her routine and advises others not to overlook the impact of nutrition, especially as they age.
Her improved health has also positively impacted her husband, who had been concerned about her well-being. "Now we've both got our lives back and I feel much more independent, like the woman he married," she stated. Smith expressed relief that her symptoms were not simply a consequence of aging but had a treatable cause.