A few times a year, I head to the blood bank near my home to donate blood—a small act of civic duty that costs little more than time. On my most recent visit, though, I was turned away after the routine screening. My iron levels were too low.
While the decision was made to protect my health, it raised a more pressing question: why was my iron low in the first place? As it turns out, my experience was not isolated or unique. Iron deficiency is one of the most common nutritional concerns globally, particularly among women. A 2023 World Health Organisation study found that over 30 percent of women aged 15 to 49 are affected by anaemia.
“Iron is essential for producing haemoglobin, which allows red blood cells to carry oxygen throughout the body,” explains Singapore-based accredited dietitian and nutritionist Annabelle Johnson. “It also plays an important role in supporting immune function.”
For women, the need is even greater—regular menstrual blood loss means higher daily iron requirements, with demands increasing further during life stages like pregnancy. Johnson, who is also a certified personal trainer, sees the effects of iron intake play out beyond blood work alone.
“Nutrition directly influences energy, strength, recovery and overall performance,” she says. “And it works in reverse—how someone trains shapes what their body needs.” Even outside of major milestones like pregnancy or decisions to donate blood, iron remains a crucial factor in women’s health—one that often impacts our energy levels, focus and overall wellbeing.
Here, Johnson shares her insight on why iron is absolutely essential for women’s health, and how we can work towards improving this crucial aspect of our wellbeing.
Why do so many women overlook low iron until it starts affecting their daily life?
The early symptoms of low iron are often so subtle and gradual that they’re easy to dismiss. We’ve been conditioned to normalise feeling tired, run-down, or unmotivated as byproducts of a busy lifestyle. For women who are constantly balancing the demands of work and family, there is a tendency to simply ‘push through’. As a result, low iron often goes unnoticed until the exhaustion becomes much more pronounced.
What are some of the most common signs of low iron that women tend to dismiss?
Beyond the classic symptoms, like persistent fatigue, pale skin, and dizziness, there are ‘quieter’ signs that women tend to dismiss. I often hear patients mention feeling unusually cold, struggling to concentrate, or noticing their workout performance isn’t what it used to be. While it’s easy to write these off one by one, together they point toward a bigger picture of iron deficiency.
How can inadequate iron intake impact our overall wellbeing?
When iron levels are low, the body’s ability to deliver oxygen to its tissues is compromised. This has a domino effect on energy, leading to persistent fatigue and a noticeable drop in physical capacity. It also impacts cognitive function, affecting focus, memory, and mental clarity. This can even manifest as irritability or a lack of motivation. Ultimately, when you’re physically and mentally depleted in this way, it takes a significant toll on your overall wellbeing and quality of life.
For women who exercise regularly, how does iron status affect performance, endurance, and recovery?
Iron is essential for endurance, but staying active actually puts more pressure on your iron stores. Between sweat and the impact of exercise—known as foot-strike hemolysis—active women lose iron faster than they might realise. If your levels are low, your workouts will start to feel harder than they should. You’ll notice a drop in intensity or feel like you’re hitting a wall despite consistent training. Recovery also slows down significantly because your muscles aren’t getting the oxygen they need to repair, which can make progress feel frustratingly slow.
View this post on Instagram
What are some of the best food sources of iron, and how can women improve iron absorption through their diet?
Iron comes in two forms: heme iron from animal sources and non-heme iron from plant foods. While heme iron is more readily absorbed by the body, both play a vital role in our overall intake. To hit your targets, look to lean red meat, chicken thighs, and liver, alongside plant-based staples like legumes, tofu, tempeh, dark leafy greens, and fortified wholegrains.
You can maximise absorption by pairing iron-rich foods with vitamin C-heavy ingredients like tomatoes or berries. Interestingly, even cooking in cast iron can provide a subtle boost. Also, be mindful of ‘inhibitors’, such as polyphenols and tannins found in tea and coffee. Having these away from meals ensures these ‘inhibitors’ don’t interfere with your iron absorption.
Are there certain groups of women who should be especially mindful of their iron levels?
Yes, there are several groups that need to be more mindful. This includes women with heavy menstrual periods, endurance athletes, and pregnant women, all of whom have significantly higher iron requirements.
Women following vegetarian or vegan diets also need to be more intentional. That said, it is absolutely possible to maintain healthy levels on a plant-based diet; it just requires a bit more planning.
What’s one practical piece of advice you’d give women who want to be more proactive about maintaining healthy iron levels?
Make it a conscious habit to include iron-rich foods at most meals, and always pair them with fruits or vegetables to boost absorption. If you start noticing persistent fatigue or a dip in your usual performance, don’t wait; it’s always worth speaking to a healthcare professional and checking your levels early.
