There is a tiredness that sleep does not touch. You wake unrested, climb stairs breathless, feel cold when others do not, and put it down to being fifty. Sometimes that is all it is. Sometimes it is iron, and for a gluten-free woman in midlife the odds are higher than for most.
Why this group
Two things draw iron down at once. Celiac disease damages the part of the small intestine where iron is absorbed, and iron deficiency is one of the most common findings at diagnosis and can persist while the gut heals (Halfdanarson, Litzow and Murray, 2007). Perimenopause, meanwhile, often brings heavier or more frequent periods for a few years before they stop, and each one costs iron.
Add a gluten-free diet built on refined starches, which are not fortified with iron the way wheat flour products are in the United States, and the everyday top-up quietly disappears.
What food can do
Food matters most for keeping iron steady once it is in a normal range. Two forms exist. Heme iron from meat, poultry, and fish is absorbed well. Non-heme iron from lentils, beans, spinach, pumpkin seeds, and tofu is absorbed less well, but absorption roughly doubles when vitamin C is eaten in the same meal.
So: lentils with a squeeze of lemon. Spinach with tomatoes. Beans with peppers. A small portion of red meat once or twice a week if you eat it. Pumpkin seeds on almost anything.
And two things reduce absorption when taken with the meal: tea and coffee, and calcium-rich foods or supplements. Have the tea an hour after lunch rather than with it.
What food cannot do
Food cannot correct a real deficiency in any reasonable time, and this post cannot tell you whether you have one. Fatigue has many causes, thyroid function and vitamin B12 among them, and the only way to know is a blood test ordered by your healthcare provider. Ferritin, the storage measure, is the one to ask about specifically, because haemoglobin can be normal while stores are low.
Do not start an iron supplement on your own; too much iron causes its own problems and the right dose and form depend on the result.
The conversation to have
“I have celiac disease, I am in perimenopause, and I am tired in a way sleep does not fix. Could we check ferritin, B12, and thyroid?” That sentence is the most useful thing in this post. Take it to your next appointment.
Iron-aware meals, built in. The free 5-Day Gluten-Free Reset pairs lentils and greens with vitamin C at every dinner. Nothing to count, nothing to weigh. Get the free guide.
From a celiac herbalist and food educator.
References
Halfdanarson TR, Litzow MR, Murray JA. Hematologic manifestations of celiac disease. Blood. 2007;109(2):412–421.
Hurrell R, Egli I. Iron bioavailability and dietary reference values. American Journal of Clinical Nutrition. 2010;91(5):1461S–1467S.
Vici G, Belli L, Biondi M, Polzonetti V. Gluten free diet and nutrient deficiencies: A review. Clinical Nutrition. 2016;35(6):1236–1241.
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This content is for educational purposes only and is not intended to diagnose, treat, cure, or prevent any disease. Gil Gavrilovic is a Holistic Health Practitioner and Herbalist and is not state-licensed, state-certified, or state-registered as a Colorado health-care professional. Always consult your healthcare provider before making changes to your health routine.
