Understanding Ferritin and Its Impact on Perimenopausal Health

Written and edited by Sarah Bonza MD, MPH, FAAFP, DipABLM, NBC-HWC

Woman in perimenopause vibrant with energy

As a board-certified family physician and menopause and lifestyle medicine specialist, I have dedicated my career to helping women reclaim their vitality. Recently, I experienced a personal health challenge that underscored the importance of understanding ferritin levels and their impact on overall well-being. I want to share my journey with you, hoping it will empower you to advocate for your health.

What is Ferritin?

Ferritin is a blood protein that stores iron inside your cells. It acts as a reserve, releasing iron when your body needs it. Iron is crucial for making healthy red blood cells, which carry oxygen from your lungs to the rest of your body. Ferritin levels reflect the amount of stored iron in your body, making it a vital marker for assessing iron status.

Preferred Ferritin Levels for Women

For women, especially those who are menstruating, the preferred ferritin level is around 100 ng/mL. This is because menstrual blood loss can significantly deplete iron stores, putting women at risk for ferritin deficiency. Despite this, many healthcare providers focus primarily on hemoglobin levels when assessing iron status, often overlooking the importance of ferritin [1].

Lab testing ferritin in perimenopause

Perimenopause and Ferritin Levels

Women in perimenopause are particularly at risk for low ferritin levels. During this phase, menstrual cycles can become closer together and heavier due to fluctuating and often high estrogen levels. This increased blood loss can further deplete iron stores, making it essential to monitor and manage ferritin levels proactively.

Symptoms and Diagnosis

I experienced persistent fatigue, headaches, and numbness in my hands and feet. As someone who typically walks at a fast pace, I found myself slowing down, which was concerning. As a result of months long unexplained fatigue, I also had weight gain. Despite normal thyroid studies and blood counts, my fatigue persisted. It wasn’t until my ferritin level was tested that I discovered it was critically low at 14 ng/mL.

Treatment for Low Ferritin

Treating low ferritin, even in the absence of anemia, is essential for restoring energy levels and overall health. Here are the steps I took:

• Oral Iron Supplementation: I started with an oral form of iron that is better absorbed and gentler on the gastrointestinal tract. While this helped, I still needed to pursue iron infusion.
• Iron Infusions: I then received iron infusions, typically administered weekly for five sessions. Many women, including myself, start to feel better after the third infusion. However, it’s important to monitor for potential adverse effects, such as allergic reactions and decreased phosphorus levels. I supplemented with phosphorus during my infusions to mitigate this risk.

Iron infusions in perimenopause

Importance of Ferritin Testing

My experience highlights the need for comprehensive iron studies, including ferritin levels, especially for women with symptoms of fatigue and other related issues. Low ferritin can significantly impact energy levels, even if hemoglobin levels are normal. Therefore, it’s crucial for women to advocate for their health and request ferritin testing if they suspect iron deficiency.

Comprehensive Ferritin Boosting Protocol

Iron rich plant-based diet in perimenopause

To support women in managing their iron levels, I have developed the Comprehensive Ferritin Boosting Protocol, which includes:

• Preferred Iron Supplement: Enhanced gastrointestinal absorption to ensure optimal iron intake.
• Dietary Recommendations: Focused on iron-rich foods and vitamin C to enhance absorption.
• 7-Day Vegetarian High Iron Recipe Plan: Includes breakfast, lunch, dinner, and two snacks each day, along with a shopping list and nutrition information.
• Lifestyle Recommendations: Tips on sleep, stress management, and detoxification to support overall health.
• Bonus Healthy Habits E-book: Helps you start making wellness goals and track your progress.

Are You Experiencing Symptoms?

If you are experiencing symptoms like fatigue, headaches, or numbness, consider discussing ferritin testing with your healthcare provider. By advocating for comprehensive iron studies, you can take proactive steps toward better health and well-being.

I invite you to purchase the Comprehensive Ferritin Boosting Protocol to help you boost your iron levels and improve your energy.. This protocol includes my preferred iron supplement, dietary and lifestyle recommendations, a 7-day vegetarian high-iron recipe book with a shopping list and nutrition information, and a bonus Healthy Habits E-book to help you start making wellness goals.

REFERENCES
[1] Iron deficiency without anaemia: a diagnosis that matters — PMC — NCBI (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8002799/)