By Joan Haynes, NMD

Fatigue can have many causes, but a fairly easy cause to figure out and treat involves iron. Iron deficiency is an under-recognized cause of fatigue and can be missed on standard lab work.

Symptoms which may be linked to iron depletion are:

• Fatigue
• Poor work productivity
• Poor attention and memory
• Sore tongue
• Poor condition of skin or nails
• Hair loss
• Restless leg syndrome
• Cracks on the corners of mouth
• Pica – cravings for non-foods such as ice or even dirt

Iron does some important things in the body:

• Carries oxygen to tissues
• Needed in the mitochondria which makes energy
• Helps synthesis of thyroid hormone
• Converts tyrosine to dopamine (one of our feel good neurotransmitters)
• Important in immune function

Testing

Most clinics order a CBC (Complete Blood Count) which will pick up the advanced form of iron deficiency anemia with a low hematocrit and/or hemoglobin (the color and volume of your red blood cells). But an earlier form of low iron levels can be detected with a serum ferritin test. The “normal” range for serum ferritin is broad, from 8 – 250 ng/mL, but hair loss, fatigue and other symptoms can occur when the number gets below 90.

Uncover the Cause of the Low Iron

Besides just identifying the problem, we need to discover and address the causes of the iron deficiency. It could be the patient just doesn’t eat enough iron-rich foods, but it could be something more serious. For example: heavy menstrual bleeding, low stomach acid, celiac disease, low B-12 and folate levels, hidden bleeding in the colon (a potential sign of colon cancer), small intestinal bacterial overgrowth (SIBO), chronic disease, inflammation, high lead levels and more.

Iron Supplements

Many people complain about gastrointestinal symptoms when taking supplemental iron, usually the ferrous sulfate form. But there are easier forms to absorb. At Boise Natural Health Clinic we use iron bis-glycinate with Vitamin C, between meals. It can take months for iron levels to come back up.

Iron absorption is inhibited by:

Low stomach acid, acid blocking medication, H. pylori infection, coffee, tea, soy products, wheat bran, wheat gluten, oat, nuts, casein, egg white, whey protein, some herbal teas.

Iron absorption is enhanced by:

Hydrochloric acid and vitamin C

Caution is advised with iron supplementation can be toxic, it is the leading cause of poisoning in children. In general, men and non-menstruating women should not take iron supplements or even a multi with iron in it unless they test low.

If you are suffering with any of the above symptoms, come in for a visit with and we’ll do a thorough health history and run labs to discover if iron deficiency, or something else, could be contributing to you not feeling well.

Joan Haynes, NMD

Did you know that 75% of Americans are chronically dehydrated?   

Here are 5 warning signs and symptoms of chronic dehydration, and tips on optimizing your water intake so you can feel your best all year long.  

1. Fatigue
   Dehydration is the number one cause of daytime fatigue. Dehydration of the tissues causes enzymatic activity to slow down (slowing the metabolism.)
2. Constipation
   When chewed food enters the colon, the body absorbs excess water via the colon walls, allowing the stool to form properly. In chronic dehydration, the body sacrifices the ideal consistency of the stool in order to give water to more vital parts of the body. The result: hard dried out stool that is difficult to pass.
3. Excess weight
   Thirst is often confused with hunger. One glass of water shut down midnight hunger pangs for almost 100% of the dieters studied in a University of Washington study.
4. Pain
   Pain can be a localized sign of dehydration. Headaches are commonly caused by lack of adequate water. Preliminary research indicates that 8-10 eight-ounce glasses of water a day (half of that coming from food and drinks other than plain water) could significantly ease back and joint pain for up to 80% of sufferers.
5. Brain-fog
   A mere 2% drop in body water can trigger fuzzy short-term memory, trouble with basic math, and difficulty focusing on the computer screen or on a printed page. Obvious signs of dehydration include dry mouth, crinkled skin, excessive thirst, or absence of urination for over 6 hours. These are more serious symptoms and need to be corrected immediately.

Tips to Optimize Water Intake

1. How much is enough?
   Thirst is not always a reliable indicator, so it’s good to keep track. Experts disagree on the exact amount of water each person needs. A commonly used calculation is to divide your weight in pounds by two, then convert this figure to ounces, and drink that many ounces of water daily. Example: 150 pounds/2 = 75 ounces of water per day. A simpler version is the 8-10 (8 oz) glasses per day rule. Learn to read your body’s signs, be willing to experiment, and you will find the right amount for yourself.
2. What counts?
   Contrary to popular belief, caffeine is only a mild diuretic so a cup or two of coffee and/or tea can count toward your total fluid intake. Avoid energy drinks that often have huge amounts of caffeine and sugar. Alcohol subtracts from your daily fluid total, as it is a diuretic and will cause dehydration. In general, filtered or spring water is best but if you are having trouble getting it down, consider using some diluted fruit juice or lemon slices to add some flavor.
3. What are the best times to drink?
   Good times to drink water are on rising, at least 1/2 hour before meals and 2-3 hours after. If you don’t like waking at night to urinate, stop drinking after 6 pm.  It is recommended by some health experts that you not drink much water with meals as it is thought to dilute the digestive juices.
4. When is more needed?
   You need more if the temperature is hot or if you exercise. A general rule is to add an extra 2 glasses per day for every 5°F over 85°F if you are at rest, and more if you exercise.
5. What about electrolytes?
   Adding electrolytes is important with exercise, in hot weather, and if you have become dehydrated. Electrolytes increase water absorption, and replace vital minerals lost in sweating. Instead of Gatorade, consider a healthier version called Recharge available in natural food stores. Coconut water is a good (although expensive) option. Another option is to eat salty snacks on heavy exercise days.  Some people hydrate regularly, but still feel thirsty and dehydrated and adding electrolytes work wonders for them.  

Here is my own favorite way to get myself to drink water regularly and to rehydrate if I’ve gotten low:

This tasty drink goes down much easier than water, rehydrates me quickly, relieving muscle tension and headache, and increasing my energy and alertness.

In a quart mason jar or large glass, fill it 80-90% of the way with filtered water.

Fill the remaining 10-20% with Simply Lemonade (or another grocery store lemonade with real lemons and real sugar – you can use other brands or other juices, the little bit of sugar is important to absorb the water more quickly, so don’t use just lemon juice for best effect.)

Add 1/8 – ¼ teaspoon salt (I prefer Celtic sea salt or an electrolyte supplement).   

I find that adding a (reusable) straw and ice in warm weather helps me drink more.