Tired All the Time? It May Be Your Iron — Even If You're 'Not Anaemic'
One of the most common and most missed causes of fatigue in women is low iron stores — which can leave you exhausted long before a standard anaemia test turns abnormal.
Nutritional deficiencies are a frequent, treatable cause of symptoms that are often put down to a busy life. Iron deficiency is the clearest example. Many women are tested only for haemoglobin — which can remain normal even when iron stores (measured by ferritin) are seriously depleted. The result is fatigue, hair shedding, brittle nails, breathlessness on exertion, poor concentration, and restless legs, all while being told the blood test is 'fine'.
Vitamin B12 and folate deficiencies can cause similar fatigue and brain fog, along with tingling, balance problems, and low mood — and are more common in those following plant-based diets or with absorption issues. Coeliac disease, an immune reaction to gluten, often presents without classic digestive symptoms at all, instead showing up as fatigue, iron deficiency, or unexplained infertility, and is frequently mistaken for IBS.
What unites these conditions is how reversible they are once identified. Asking for ferritin — not just haemoglobin — and for B12, folate, and a coeliac screen where relevant, can be the difference between months of unexplained exhaustion and a clear, treatable answer.
- 01Fatigue, hair shedding, or brittle nails despite 'normal' blood tests
- 02Breathlessness on exertion, poor concentration, or restless legs
- 03Tingling, numbness, or balance problems (possible B12 deficiency)
- 04Bloating, fatigue, or iron deficiency that could suggest coeliac disease
If you feel persistently exhausted, it is reasonable to ask specifically for your ferritin level, alongside B12 and folate. Heavy periods are a common, correctable cause of iron loss worth addressing.