Iron Deficiency and Maternal Mental Health

Something I want every mother to know - whether she's pregnant, postpartum, or years after her last baby:

Having low iron increases the risk of depression and anxiety.

Every week in my online clinic, I meet mothers struggling with depression and/or anxiety. Some have been pushing through, others have been prescribed antidepressants with little to no improvement, and many feel lost and unsure of what to do next.

Some ask if there are ‘antidepressant’ herbs I can prescribe, while others suspect there must be an underlying cause - hence why they’ve booked their appointment!

Most (but not all) have visited their doctor, hoping blood tests would reveal something. Yet more often than not, they’re told, “Everything is fine.”

Once we dig deeper with more thorough testing, we often discover that 99.5% of these mamas have low iron levels.

When I say low iron, I may be referring to low ferritin (her iron stores), low or low/normal haemoglobin (the oxygen-carrying molecule in her red blood cells), and/or high transferrin (which tells us how 'hungry' the body is for iron). There are other blood markers I also look at for confirmation.

Meet ‘Genevieve’

Genevieve is 14 months postpartum with her first baby and still breastfeeding. She came to me feeling super tired, no matter how much sleep she got. She struggled with brain fog and forgetfulness, which stressed her out. Her patience was wearing thin, and she often felt irritable.

She wanted to exercise for the feel-good buzz but had no motivation or energy to do so. Her mood felt generally “blah”, with some days she felt “really down”.

She also noticed she got rattled easily over small changes and felt more anxious than usual - especially when making decisions. She was concerned about ongoing hair loss and had experienced “three horrendous periods” since they returned at 10 months postpartum.

She hadn’t had any blood work done since pregnancy and only took her prenatal/breastfeeding multivitamin on the days she remembered.

She was concerned she may have postpartum depression. As it’s not in my scope to diagnose, we set about investigating potential contributing factors that could be behind her symptoms.

HER BLOOD TESTS REVEALED:

• Low haemoglobin (122) optimal is closer to 135

• Very low ferritin (19) optimal is 70+

• Raised transferrin (3.3) optimal is 2-2.5

These markers confirmed that she was low in iron and her body was hungry for more. I explained how this was likely contributing to her symptoms. We created a plan using supplements, food, and digestive support to restore her iron levels - while addressing a few other areas too.

What’s the link between iron and mental health?

Put simply, our body needs adequate iron for many functions - one of the most important being neurotransmitter production 🧠

Iron is essential for producing serotonin, dopamine, and norepinephrine - the chemical messengers that regulate our mood, emotions, anxiety levels, and sleep patterns.

Even if you're bone-tired, you might still struggle to sleep (so unfair, right?). That’s because when low iron triggers anxiety, your nervous system shifts into ‘fight or flight’ mode.

This increases cortisol, which in turn suppresses melatonin, your sleep hormone.

Having low iron doesn’t just cause fatigue. It affects your entire body, including your mood, memory, and ability to handle stress.

Key points:

• Iron is crucial for neurotransmitter function. Low iron disrupts pathways that regulate mood, concentration, and anxiety levels.

• Iron deficiency has been linked to depression and anxiety.

• Low iron is associated with low serotonin levels, a key player in depression.

• Iron influences the balance between glutamate (a stimulating neurotransmitter) and GABA (a calming one). Disruptions can trigger emotional and psychological issues.

• Low postpartum ferritin is associated with an increased risk of postpartum depression. I see this a lot.

• Your thyroid depends on iron. Low iron affects thyroid hormone production, which can also contribute to depression and anxiety.
  

  
  COMMON SYMPTOMS OF LOW IRON

  
  If you're feeling off, having low moods and/or feeling more anxious than usual, your iron levels might be playing a role.
  
  Other signs of low iron can include: constant fatigue, ongoing hair loss (beyond normal postpartum shedding), bruising easily, excessive yawning (I call this ‘air hunger’), shortness of breath or rapid heartbeat from minimal exertion (feeling really unfit), headaches, weakened immune function, heavy periods.
  
  It’s important to understand how you came to be iron deficient in the first place. For many mums, it can be the cumulative effects of pregnancy, birth and breastfeeding. For others, it can be related to poor iron intake in diet, poor quality supplements, poor gut health (affecting the absorption of iron), or perhaps a greater loss of iron through heavy menstrual cycles.
  
  If you suspect low iron, I can certainly help! 🙋🏼‍♀️ Book a consultation with me to get clear, individualised guidance on restoring your iron levels and supporting your mental health.

  Read more about iron:

  Iron Deficiency Anaemia and Postpartum Haemorrhage
  Is Low Iron Affecting Your Thyroid Health?
  What You Need to Know About Iron Absorption From Food and Supplements
  Postpartum Hair Loss: What’s Normal and What’s Not