Dear Doctor Mama,

I am a 23 year old woman and I always feel tired. I should be a bouncing ball of energy, but at any moment of any day I could easily fall asleep. What can I do to go boost my energy? Right now I do not take any supplements. I am under a significant amount of stress, and if iron is the issue (which it may be), I definitely don’t eat enough meat. Could you recommend supplements/food that could help me? What is the best iron supplement out there (that won’t give me a stomach ache)?

Also, what should I look out for when I combine different supplements? I have a friend who takes ten different vitamins/supplements every morning, and I just wonder if some of them shouldn’t be combined, or if some of them cancel each other out. Thoughts?

Thank you,

Sleepy in Seattle

Carl Nenzen Loven (flickr)

Dear Sleepy,

Many different things can cause fatigue in women your age, and you’re smart to think of iron deficiency as a possible factor.

Even if you’re not clinically anemic, lower-than-normal iron levels can cause tiredness, hair loss, excessive menstrual bleeding (yes, heavy periods can cause iron deficiency and iron deficiency can make your periods heavier, too), shortness of breath, weakness, headaches, and other symptoms.

Don’t discount  stress as a major contributor to your fatigue, either. Chronic stress can lead to sleep deprivation, which in turn leaves you even more stressed than when you started.

Before supplementing with iron, it’s important to get a CBC (complete blood count) and a ferritin level done. This will give your doctor important information about the cause of your fatigue. Besides iron deficiency, vitamin B12 and folate deficiency can also cause anemias that will leave you with the same symptoms.

Other common causes of fatigue in women your age include chronic infections (like Lyme disease) and viral infections like Epstein Barr. Your doctor can screen for these, as well.

If it turns out that you need some extra iron, I recommend Integrative Therapeutics Iron Complex. The formula contains heme iron (the most easily absorbed form) and shouldn’t cause nausea.

The iron in animal products (poultry, beef, fish) is more absorbable than that from plant sources. Eat iron-rich foods with some vitamin C-rich ones like peppers, strawberries, tomatoes, or cantaloupe to enhance your iron absorption.

Regarding your question about supplement combining, I’d recommend working one-on-one with a knowledgeable healthcare provider like a naturopathic doctor.

Hope that helps answer your questions!

Sincerely,

Doctor Mama

Disclaimer: The information contained in this blog is for educational and/or informational purposes only, and is not intended to diagnose, treat, or prevent any condition. If you have any concerns about your own health or that of a family member, you should always consult with a healthcare professional.