20 April 2022 |

Iron deficiency, an increasingly female disorder?

carenza di ferro nelle donne - medico donna con camice e stetoscopio in mano

Frequent headaches, fatigue and a pale or dull complexion are the typical signs of iron deficiency, a particularly common disorder among women of childbearing age. Despite a healthy, balanced diet, it is important to periodically check iron levels, through a simple blood test, especially when the body’s intake needs increase.

The causes of iron deficiency (in scientific terms we talk of sideropenia) in the body may be pathological, related to specific diseases, or physiological, resulting from certain conditions that lead to more iron consumption by the body, or due to dietary habits that reduce iron intake. Sideropenia is an alarm bell that should not be underestimated, as, if not corrected, it can lead to a clinically significant condition called iron deficiency anaemia.

Why are women more at risk of iron deficiency?

Compared to men, women are more likely to develop iron deficiency, particularly in childbearing age, for a number of reasons, including a heavier menstrual cycle (hypermenorrhea) and an increased requirement during pregnancy. This does not however mean that men are “immune” to this problem, indeed they can also develop sideropenia, linked above all to development during adolescence.

Generally, it is estimated that 25% of the world’s population suffers from anaemia, which is especially prevalent among children and pregnant women. In more developed countries, the incidence of iron deficiency anaemia is 3% among adult males and 20% among women, and increases even to 50% among pregnant women, who, as we will see in this article, have a much higher daily iron intake need during the 9 months of pregnancy.

When are women at risk of iron deficiency?

Vitamins and minerals are essential during pregnancy. During pregnancy, iron requirements increase considerably, especially in the last quarter, as the iron is needed not only by the mum-to-be but also to help foetal development. In fact, iron not only aids the production of new red blood cells but is fundamental for the baby to guarantee an appropriate weight at birth and help cognitive development.

A varied, balanced diet is the foundation of a correct daily intake of iron, however in some cases, food alone is not sufficient to maintain normal iron levels in the body; therefore, taking specific iron-based supplements during pregnancy is highly recommended.

In women of childbearing age, iron deficiency is often caused by a heavy menstrual bleeding (hypermenorrhea), which leads to significant blood loss, in some cases more than 35 mL per cycle. This condition results in a high loss of iron, which consequently has to be integrated in the diet. However, we should remember that only 5% of the iron contained in plant foods is absorbed, while this percentage can increase to 20% in meat foods. Therefore, in the cases in which a correct diet is not sufficient to integrate the loss of minerals and correct the condition of sideropenia, it is worth using iron-based food supplements.

At what age can iron deficiency develop, and when should we start to check it?

Monitoring iron levels in the blood is very important at all ages, even for people who do not suffer from anaemia or iron deficiency.

Iron never circulates freely in the blood but has to be bound to proteins to prevent it from binding with other molecules. Free iron is in fact highly reactive and could react with other substances, causing damage to the organism. The proteins to which the iron molecules bind have the function of depositing or transporting it, thus preventing it from becoming “hazardous” for our health.
To check iron levels in the blood, the following values are analysed through simple blood tests:

  • transferrinemia, which measures the amount of transferrin, the protein that carries iron to the organs and tissues where erythropoiesis, the synthesis of red blood cells, occurs;
  • sideremia, which measures the amount of circulating iron bound to the transferrin;
  • transferrin saturation, in adults the optimal situation is when transferrin saturation is between 20 and 50%;
  • serum ferritin, which measures the amount of ferritin, the protein that deposits iron in the liver, muscles and bone marrow.

Furthermore, iron deficiency evaluation continues with the analysis of two other blood test parameters: haemoglobin and haematocrit levels.

Bound to haemoglobin, iron is able to carry oxygen to the tissues and areas where it is needed. This is why it is important for the values of this protein to fall within a specific range:


Haemoglobin levels (Hb)

Man 14–18 g/dL
Woman 12–16 g/dL
Pregnant women 11–14 g/dL

When the haemoglobin level is low, i.e., lower than the values given in the table, there is a diagnosis of iron deficiency anaemia.

Haematocrit levels, on the other hand, are analysed to represent the volume of blood (expressed as a percentage) occupied by red blood cells.

All these laboratory tests are usually carried out when iron deficiency anaemia is suspected, or when there is a condition of asthenia and general malaise, characterised by the typical symptoms of iron deficiency. Whatever the age, the most frequent symptoms are:

  1. Pallor;
  2. Feeling weak;
  3. Irritability;
  4. Dizziness and headaches;
  5. Fatigue;
  6. Cold feet and hands with a tingling sensation;
  7. Speeding up of the heartbeat (tachycardia).

Why take iron during pregnancy?

As explained above, during pregnancy iron intake requirements increase, and without the right dietary support, the risk of a deficiency of this essential nutrient increases.

Foodstuffs rich in iron such as red meat (horse, beef), liver, spleen, green-leaf vegetables, pulses, whole cereals and oily fish can be useful, but in some cases the diet has to be integrated with food supplements to provide the additional organic iron that is typically required during pregnancy.

Iron supplements suitable for pregnancy generally also contain other nutrients to help correct foetal development and ensure normal erythropoiesis (the formation of red blood cells) in both mother and baby. The most important nutrients include:

  • folic acid and folates, which help maternal tissue growth during pregnancy and reduce the risk of the foetus developing neural tube defects;
  • vitamin B6, which helps the proliferation of red and white blood cells;
  • vitamin B12, which contributes to normal red blood cell formation;
  • vitamin C, which helps iron absorption in the intestines,
  • vitamin D, which contributes to normal bone development.

In other words, iron supplements during pregnancy not only help to maintain normal iron levels in both mother and child, but also ensure complete support for the baby’s growth and correct physical and cognitive development.

SiderAL® Folic is a food supplement with Sucrosomial® Iron, vitamin C, vitamin D, vitamin B6, vitamin B12 and folic acid (in the active form Quatrefolic®), which can be prescribed by the doctor from the first three months of pregnancy to treat any deficiencies and support the correct daily intake of this mineral.

Always seek medical advice before taking the product, or in any case before starting to use any supplements during pregnancy.


  • Parisi F., Berti C., Mandò C., Martinelli A., Mazzalli C., Cetin I., Effects of different regimens of iron prophylaxis on maternal iron status and pregnancy outcome: a randomized control trial; J. Matern Fetal Neonatal Med. 2017 Aug;30(15):1787-1792. doi: 10.1080/14767058.2016.1224841.
  • Bothwell H., Iron requirements in pregnancy and strategies to meet them; Am J Clin Nutr. 2000 Jul; doi: 10.1093/ajcn/72.1.257S.

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