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 well-being of millions of people: from overstimulated toddlers to anxious teenagers, overwhelmed young adults, depressed postpartum 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 health burden
According to the World Health Organization, anaemia affects approximately one quarter of the world’s population –1.62 billion people. Among South African children under 5, the prevalence ranges from 29% to 61% in national surveys, with 1-year-olds particularly vulnerable at 52%. This leaves little doubt that a huge sector of our population – from birth and beyond – is at risk.
“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 Sr 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 Sr 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 study 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 heartbreaking is that so many patients and families accept declining mental sharpness, persistent low mood and crushing fatigue as inevitable parts of ageing,” says Sr Davidson. “When we check iron levels and correct deficiencies, we regularly witness remarkable transformations.”
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 Sr 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 Sr 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 Sr Davidson. “If you’re struggling mentally or emotionally, checking your iron levels could be the key to reclaiming your vitality and well-being. 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. Visit www.capeinfusions.co.za for more information.
