How often do you check your iron?
If you’re a menstruating woman, the answer should be: at least once a year. And not just a quick glance at your hemoglobin — I’m talking about a full iron panel that includes ferritin, transferrin saturation, and inflammation markers.
Why? Because iron deficiency is incredibly common, often missed, and deeply tied to how you feel — from energy to mood to period health. In fact, it’s one of the top deficiencies I uncover through blood work in my naturopathic practice.
And truthfully, it’s something I’ve struggled with personally too. Between heavy periods, underlying gut inflammation, poor absorption, and inconsistent supplementation, maintaining optimal iron levels hasn’t been easy — and I know I’m not alone. I’ll be sharing more about my own results and what I’ve learned in a follow-up post.
Ok, let’s dive in and break down what to test, why it matters, and how your monthly cycle (and your symptoms) might be trying to tell you something!
The Iron Balancing Act: Why Women Are More at Risk
The average person maintains a net iron balance of zero — meaning the iron you absorb from food is roughly equal to the amount your body uses for daily functions like making red blood cells, supporting thyroid function, transporting oxygen, and regulating metabolism.
But once you add in blood loss from a period every month — or frequent intense exercise — it’s easy to fall behind. Over time, this can create a slow and steady decline in your iron stores.
And here’s the frustrating part: low iron can actually cause heavier periods… and heavier periods can further deplete iron. It’s a vicious cycle.
It's Not Just Hemoglobin — Here’s What to Actually Test
Many people think checking a CBC or basic hemoglobin is enough. But by the time hemoglobin drops, you’re already quite depleted.
Instead, we should be looking at a full iron panel, including:
• Ferritin – your stored iron. This is the most important marker for early detection
• Serum Iron – how much iron is circulating at that moment
• Total Iron-Binding Capacity (TIBC) – how well your blood can carry iron
• Transferrin Saturation – the percentage of transferrin that is saturated with iron
• CRP or ESR – markers of inflammation, which can falsely elevate ferritin levels
This full picture helps determine not just if you have enough iron, but whether your body is using and absorbing it effectively.
It’s Not Just a “Woman’s Issue” — But Here’s Why It’s More Common in Women
I’ve had men in my practice say,
“My mom was always low in iron — maybe it runs in the family?”
And while genetics influence many things, iron deficiency is usually environmental, not inherited. Most men don’t menstruate and therefore don’t lose iron monthly, which helps them maintain adequate stores.
However, iron testing can be relevant for men too — especially if there’s heavy exercise, a vegan or vegetarian diet, or digestive issues that impair absorption.
Still, menstruating women remain the highest-risk group — and unfortunately, many go years without proper testing.
Updated Guidelines: Ferritin Targets Have Finally Shifted
For years, the standard “normal” range for ferritin was far too low. But in 2024 Ontario's guidelines were updated, aligning more closely with what many naturopathic doctors have been recommending all along.
Here’s what we look for now:
• Below 30 – low, and often associated with fatigue, brain fog, and hair loss
• 30–50 – borderline; you’ll likely benefit from supplementation
• 50+ – optimal target for menstruating women
• 80+ – often needed for athletic performance or when recovering from deficiency
If your ferritin is under 50 — especially if you have symptoms — it’s worth a closer look.
But Wait... Ferritin Can Be Misleading
Ferritin is also an acute phase reactant — meaning it rises with inflammation. If you have an underlying infection, autoimmune condition, or high stress, it might falsely appear “normal” or even elevated.
That’s why I always recommend testing inflammation markers (like CRP or ESR) alongside your iron panel — especially if your symptoms don’t match your labs.
Final Thoughts
If you’ve ever been told your iron is “fine,” but you’re still dealing with:
• Fatigue or burnout
• Brain fog or poor memory
• Shortness of breath with exertion
• Hair thinning
• Heavy periods
...it might be time to dig deeper. A full iron panel, run annually, is one of the simplest ways to get insight into your energy, hormones, and menstrual health.
In Part 2, I’ll share my personal iron results as a naturopathic doctor — and what they revealed about my own energy and health!
If it’s been more than a year since you last checked your iron—or if you’ve never had a full panel done—it’s time. Whether you're feeling off or just want a deeper understanding of your health, blood work is one of the most powerful tools we have.
As a naturopathic doctor, I help women and men interpret their lab results, connect the dots with their symptoms, and build a plan that actually supports long-term energy, hormone balance, and period health.
Book in for a visit or a blood work review—and let’s make sure you’re not being overlooked. You deserve to feel well-informed, supported, and confident when it comes to your health. I'm here to help you advocate for exactly that.
Disclaimer: Any information is for informational purposes only and is not intended to be used in place of professional medical advice. Always seek the advice of a qualified health care practitioner with any questions or health concerns you may have and before starting any new treatments (including supplements).
