Although the women in the study didn't have anemia, they did have borderline levels of ferritin (the protein that stores iron in the body).
For the study, a daily dose of 80 milligrams of iron (as iron sulfate) or placebo was administered to almost 200 women for 12 weeks. This treatment was associated with a 48% decrease in fatigue scores (compared to a decrease of 29% in the placebo group). It also increased haemoglobin levels and ferritin levels.
That's quite a high dose of iron considering these women didn't have outright anemia. However, what this suggests is that we should consider revising our definition of iron-deficiency to place more emphasis on ferritin. Especially since iron deficiency (in various parts of the body, like the brain)--as this study demonstrated--can present without anemia (which is an iron deficiency in the blood).
Source: Effect of iron supplementation on fatigue in nonanemic menstruating women with low ferritin: a randomized controlled trial
Other posts related to fatigue:
- Even Mild Dehydration Affects Mood
- Dark Chocolate Enhances Physical Endurance
- Dehydration Affects Alertness
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