LIFESTYLE NEWS - As Mental Health Awareness Month comes to an end in South Africa, a connection is emerging that challenges how we understand and address mental health issues.
Iron deficiency and anaemia – treatable and preventable conditions – affect the mental wellbeing of millions of people, from over-stimulated toddlers to anxious teenagers, overwhelmed young adults, depressed post-partum women and forgetful seniors.
“So many people don’t realise that iron plays a vital role in producing serotonin, dopamine, and norepinephrine, the neurotransmitters that regulate mood, sleep, focus, and emotional stability,” says Sister Karin Davidson, anaemia advocate and head of the Cape Town Infusion Centre.
“When iron levels drop, these crucial brain chemicals cannot be produced adequately, leading to mental health challenges that are often misdiagnosed or overlooked entirely.”
The burden in South Africa and Africa
According to the World Health Organisation (WHO), anaemia affects approximately one quarter of the world’s population –1.62 billion people. Among South African children under five, the prevalence ranges from 29 to 61 percent in national surveys, with one-year-olds particularly vulnerable at 52 percent1.
This leaves little doubt that a huge sector of our population – from birth and beyond – is at risk.
“The reality is that babies born to iron deficient mothers are iron deficient from birth, and unless this is corrected, these infants are set up for a life potentially fraught with physical and mental health struggles – and it is so easily tested for and treated,” says Sister Davidson.
According to WHO, across sub-Saharan Africa, 43 percent of reproductive age women suffer from anaemia, while approximately 40 percent of adolescent girls are affected. “Adolescents are vulnerable to mental health struggles. Add low iron stores into the mix and you have a potentially devastating perfect storm that is so treatable,” she adds.
“These aren’t just numbers. Each represents a person likely struggling with physical and mental symptoms that impact daily functioning, relationships, and quality of life. The tragedy is that with proper screening and treatment, these outcomes are entirely preventable,” says Sister Davidson.
The mental health connection
Research has established compelling evidence linking iron deficiency to mental health challenges across all ages.
Children and adolescents: “Iron deficiency can fundamentally alter how young people experience the world during crucial developmental years,” explains Sister Davidson. “We see young children struggling to function at school or regulate their emotions, teenagers too exhausted to socialise, too foggy to study, and too irritable to maintain healthy relationships, all because their brains are deficient in the iron stores needed to function optimally.”
Adults: Research shows iron deficiency often presents with low mood, anxiety, restlessness, and difficulty concentrating. A 2020 study2 found individuals with iron deficiency anaemia experienced significantly elevated risks of psychiatric disorders. The mechanism is clear: when iron levels drop, patients can experience apathy, drowsiness, irritability, and lack of attention due to impaired brain functioning.
Older adults: Older adults with low iron stores and/or anaemia face a unique set of challenges that are often overlooked and attributed to their age. “What’s heart breaking is that so many patients and families accept declining mental sharpness, persistent low mood, and crushing fatigue as inevitable parts of ageing,” says Sister Davidson. “When we check iron levels and correct deficiencies, we regularly witness remarkable transformations.”
Research has established compelling evidence linking iron deficiency to mental health challenges across all ages.
The sleep connection
Poor sleep and insomnia are common symptoms of low iron stores and/or anaemia – and it is widely understood that impaired sleep can have a negative effect on overall mental wellness and the likes of ADHD, anxiety and depression.
“We know that sleep is crucial for people with diagnosed mental health disorders and when iron stores are low, it’s an enormous challenge for patients to get the sleep they need. Once their iron deficiencies are addressed and treated, the difference can be life changing,” says Sister Davidson.
Warning signs often normalised
“The most heartbreaking aspect of iron deficiency is how easily its symptoms can be mistaken for other conditions or dismissed as stress,” warns Sister Davidson. “People adapt to feeling suboptimal, accepting brain fog and fatigue as normal, when a simple blood test and treatment could transform their lives.”
Physical symptoms:
- Persistent fatigue despite adequate rest
- Headaches, dizziness, shortness of breath
- Pale skin, cold hands and feet
- Hair loss, brittle nails, increased bruising
- Insomnia, restless legs, heart palpitations
Mental health red flags:
- Depression or persistent low mood
- Anxiety seemingly from nowhere
- Irritability and mood swings
- Brain fog and memory problems
- ADHD-like symptoms
- Apathy or loss of interest in activities
- Emotional dysregulation
“Mental health symptoms matter. Fatigue is not normal. Brain fog should not be accepted as part of daily life,” concludes Sister Davidson. "If you're struggling mentally or emotionally, checking your iron levels could be the key to reclaiming your vitality and wellbeing. Ask your doctor to conduct full iron tests, not just haemoglobin tests.”
The Cape Town Infusion Centre is committed to managing iron deficiency and anaemia, to empowering patients, and to improving lives. Please contact them if you would like any further information.
Sr Karin Davidson is an Inflammatory Bowel Disease Nurse Specialist. She heads up the Cape Town Infusion Centre in Mowbray, Cape Town. She has worked extensively in both paediatric and adult IBD and has trained numerous health care professionals around South Africa in the areas of IBD and anaemia patient care. Karin has been involved with the formation of IBD Africa and The Autoimmune Alliance of South Africa, both non-profit organisations involved in patient advocacy and education. She has lectured both locally and internationally to doctors, HCP’s, patients, and funders on all aspects of IBD care, anaemia and patient blood management.
Sources:
1. MDPI Int. J. Environ. Res. Public Health, 2021; Curationis, 2014.
2. BMC Psychiatry, 2020 – link here
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