A new clinical trial suggests that some women can take iron supplements to relieve their inexplicable fatigue even if they are not anemic. The study was conducted on women who had symptoms of chronic fatigue and relatively low levels of stored iron in their bodies. However, they had not reached the level of iron deficiency anemia and still had enough oxygen-carrying red blood cells. Whether iron supplementation can help drive away fatigue in women who are not anemic is not yet clear. Researchers in Switzerland randomized 200 women who were constantly and inexplicably tired into two groups, one taking 80 mg of iron a day and the other a control group (who were given tablets that looked the same but had no active ingredient.) After more than 12 weeks, both groups showed improvement in their symptoms. But the group of women taking the iron progressed better, and the researchers published the results in the Canadian Medical Association Journal. On average, the women who supplemented with extra iron saw their scores on the standardized measure of fatigue drop by almost half, with scores ranging from 13-25. The standardized measure of fatigue scores ranged from 0-40. In contrast, the control group’s scores dropped by 29 percent, with scores ranging from 16-25. According to the study’s lead researcher, Dr. Paul Vaucher, a doctoral candidate at the University of Geneva in Switzerland, the study found that if a woman has persistent fatigue that is not due to a health-related cause, she needs to be suspected of possibly having low iron. Doctors often test for iron deficiency by measuring blood hemoglobin, a protein in blood cells that carries oxygen. But typically, when a person has iron-deficiency anemia, hemoglobin levels don’t drop until the later stages of iron deficiency. In this experiment, Vaucher’s group measured the women’s blood levels of ferritin, one of the markers of iron storage in the body. Doctors may or may not perform this test when detecting iron deficiency, and Vaucher says it’s wise to measure ferritin when women have unexplained fatigue.” This indicator can tell if iron levels are too low, even if the woman doesn’t have anemia.” Vaucher said in an e-mail. All of the women in the study had ferritin levels below 20ug/L, which is lower than the lower limit. Because the women in the control group also improved, the effects of iron supplementation were not as pronounced. They totaled a 3.5-point reduction in fatigue scores.” It looks like there were some small differences.” So says Dr. Christine Gerbstadt, a spokeswoman for the Department of Nutrition, who was not involved in the study. But she said in an interview that the advantage of iron supplements was still statistically significant, and that doctors should be aware of it.Gerbstadt noted that fatigue is complex and subjective, and that the women in the control group’s fatigue improved for some reason. For example, some may have started to sleep more and take better care of themselves. So if you’re habitually tired, is taking iron actually worth it? Gerbstadt warns people should first see a doctor to find out what’s causing the fatigue. She says a range of problems, from depression to sleep disorders to physical problems, can cause fatigue, and Gerbstadt says, “It may or may not be the iron.” Vaucher agrees. Vaucher, whose program is sponsored by a French manufacturer of pharmaceuticals and nutraceuticals, agrees.” We know that fatigue is related to many treatable diseases,” he says.” Once doctors have ruled out other causes, iron deficiency is going to be the only thing to consider.” Importantly, iron supplements have side effects, like constipation, diarrhea and nausea. In this study, 35 percent of those taking iron supplements were reported to have experienced at least one side effect, although 25 percent of the control group also reacted with side effects. In general, experts recommend that women of childbearing age take 18 mg of iron a day, but not more than 40 mg. (If you are truly iron deficient, your doctor may recommend a larger dose.) Iron deficiency occurs less frequently in men and postmenopausal women. This current study only included women who were still menstruating (menstruation increases the chances of low iron), so these findings don’t apply to men or women who are menopausal. To prevent iron deficiency, experts recommend a balanced diet that includes iron-rich foods like beef, poultry, iron-rich grains, beans, and spinach. Consuming foods rich in vitamin C can also help you absorb the iron in your food.