Iron deficiency is one of the most common nutritional deficiencies, and low iron stores can affect your energy, focus, hair, and exercise tolerance long before they show up as full anemia. Many people live with low iron for months or years, putting their symptoms down to a busy life — when a simple assessment could point to a treatable cause.

Signs & Symptoms of Low Iron

Iron deficiency often develops gradually. Symptoms that may be associated with low iron or low ferritin include:

• Persistent fatigue that sleep doesn’t fix
• Brain fog and difficulty concentrating
• Increased hair shedding
• Shortness of breath or a racing heart with light activity
• Pale skin, brittle nails, or headaches
• Cold hands and feet
• Restless legs, especially at night
• Reduced exercise tolerance or slow recovery
• Unusual cravings, such as chewing ice

Because these symptoms are non-specific, low iron is often overlooked or attributed to stress. Bloodwork is the reliable way to know.

What Causes Iron Deficiency?

• Heavy or prolonged menstrual periods
• Pregnancy and the postpartum period
• Low dietary intake, including some plant-based diets without careful planning
• Malabsorption conditions such as celiac disease, IBD, or after gastric bypass
• Gastrointestinal blood loss
• Frequent blood donation
• Endurance athletes with higher iron turnover

Ferritin vs. Hemoglobin: What They Actually Tell You

This is the distinction that matters most — and the one that most often gets missed.

Because ferritin falls first, you can have completely normal hemoglobin — so you’re not “anemic” on paper — while your stored iron, and your energy, is running on empty. This is known as iron deficiency without anemia, and it’s exactly what hemoglobin-only testing tends to miss. Checking ferritin alongside hemoglobin gives a far earlier and fuller picture, which is why we look at both.

Why Low Iron Is So Often Missed

Standard testing sometimes checks only hemoglobin, and ferritin can sit within a lab’s “normal” range while still being low enough to cause symptoms. If you’ve been told your iron is “normal” but still feel unwell, it can be worth looking specifically at ferritin and a full iron panel.

How We Assess Your Iron

Assessment starts with bloodwork — typically serum ferritin, a complete blood count (including hemoglobin), and a full iron panel. Our on-site naturopathic doctor reviews your results alongside your symptoms and history, and can arrange lab testing if you don’t have recent results. From there, you’ll get a clear picture of whether your iron is low and what your options are.

How Iron Deficiency Is Treated

Treatment depends on how low your iron is, why it’s low, and how you’ve responded to previous approaches. Dietary changes and oral iron work well for some people, but oral iron is poorly absorbed for many and can cause nausea, cramping, or constipation. When oral iron isn’t tolerated, isn’t absorbed, or your stores are significantly depleted, IV iron delivers a full dose directly into the bloodstream and bypasses the digestive system entirely.

Learn more about our IV Iron Therapy in Vancouver →

Frequently Asked Questions

What’s the difference between ferritin and hemoglobin?

Hemoglobin measures the iron actively carrying oxygen in your blood right now, and it’s what standard tests use to diagnose anemia. Ferritin measures your stored iron. Ferritin drops first — often long before hemoglobin — so checking ferritin can catch low iron much earlier. You can have normal hemoglobin and still have low ferritin and symptoms, which is why we look at both.

What ferritin level is considered low?

It varies by person and by lab, but many practitioners consider ferritin below about 30 µg/L to indicate iron deficiency, and some people have symptoms at higher levels. A number on its own doesn’t tell the whole story — interpretation depends on your symptoms, health history, and the rest of your iron panel, which is why we review it together at your assessment.

Can low iron cause hair loss?

Low iron and low ferritin are associated with increased hair shedding in some people, and restoring iron levels may help in those cases. Hair loss has many possible causes, though, so it’s worth assessing iron alongside the bigger picture rather than assuming it’s the only factor.

My doctor said my iron is normal but I still feel exhausted — why?

Standard testing sometimes checks only hemoglobin, which can look normal even when your iron stores are low. Ferritin can also sit at the bottom of the “normal” range while still being low enough to cause symptoms. If this sounds familiar, it can be worth reviewing your ferritin and full iron panel specifically.

Oral iron or IV iron — which do I need?

Many people do well with dietary changes and oral iron. IV iron tends to be considered when oral iron isn’t tolerated or absorbed, when levels are significantly depleted, or when there’s an ongoing cause of loss. Our naturopath will help you decide what’s appropriate based on your labs and history.

Do I need a referral or existing bloodwork?

No referral is needed. If you have recent bloodwork showing your iron or ferritin, bring it — it saves time. If you don’t, our naturopath can arrange testing. A brief intake assessment is part of every first appointment.

Is treatment covered by extended health benefits?

When iron treatment is ordered or supervised by a naturopathic doctor, it’s often eligible for reimbursement under extended health plans in Canada. Coverage varies by plan, so we recommend confirming with your insurer. We provide the documentation your provider requires.

Where are you located?

We’re at 445 W 6th Ave in Vancouver, in the Mount Pleasant / Fairview area, steps from the Olympic Village SkyTrain station. Street parking is available nearby.