Iron mind: The link between this vital mineral and mental health

With iron deficiency and anaemia identified as conditions that affect the mental wellbeing of millions of people, a new connection is emerging that challenges how we understand and address mental health issues,

“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.”

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Health Impact

According to the World Health Organisation (WHO), anaemia affects approximately one quarter of the world’s population –1.62 billion people – while across sub-Saharan Africa, 43% of reproductive age women suffer from anaemia, while approximately 40% 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 treatable,” adds Sister Davidson. 

“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.”

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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.” 

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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. 

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Warning Signs

“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.”