Iron levels and vaginal symptoms

An iron and a hammer sit in a pile of iron shavings. The hammer is leaning on the iron.

Got vagina problems and haven’t checked your iron levels lately? Put it on your to-do list.

Low iron is associated with vaginal symptoms and poor immunity. We see it a lot in patients: vaginal symptoms, ongoing infections, with low iron. It’s an important element to investigate because it’s so critical for your immune system and energy production – iron carries oxygen to all cells.

Low iron maybe not the only thing going on, but if you’re working on underlying issues and are hitting a wall, check your iron and ferritin levels and make sure they are not just within range, but optimal.

Do not accept suboptimal “within range” iron levels – running on the smell of an oily rag is not the same as running on a full tank. Both might get you someplace, but the ride will be smoother and you’ll go for waaay longer feeling good if your tank is full.


  1. Do you have a poor vaginal microbiome?
  2. Are you pale?
  3. Are you sensitive to the cold?
  4. Are you tired all the time?
  5. Do you puff or get tired walking up stairs or up hills?
  6. Is your hair falling out?
  7. Do you get colds more often than other people?
  8. Are you anxious all the time?
  9. Do you have heavy periods?
  10. Have your periods recently gotten heavier?
  11. Do you avoid red meat generally due to preference/taste?
  12. Are you a vegetarian? Vegan?
  13. Do you have a history of disordered eating?


You can’t tell how your iron is going without a test, and you shouldn’t supplement without a test – you don’t want to have too much iron, as that’s dangerous, though in all truth, if you’re getting regular periods, you’re probably not low.

However, safety first, kids! Book in online or with your doctor for iron studies that include:

  • Iron
  • Ferritin (want to see 50-100 ug/L (ng/mL)
  • Transferrin and Iron-binding Capacity (TIBC)


Ferritin levels reflect the body’s overall stores of iron. Ferritin holds iron in the cell until the body signals it’s time to release it. Then, transferrin picks it up and delivers it to its destination.

Ferritin is a great indicator of how much iron is being released into your body and a better measure than just iron by itself. You could have plenty of iron, but not much ferritin or transferrin, making the iron useless.

Over 100 ug/L (ng/mL) indicates hemochromatosis (a dangerous condition), while under 50 means you’ll likely be suffering symptoms.

Your test results may fit between the lab’s reference ranges, but that is not what is optimal. Check for over 50 and under 100, and if you fall below, get some advice, supplement or start eating more red meat and vegies high in iron.

  • Quercetin, zinc and slippery elm all block the intestinal absorption of iron, so take at a different time to iron supplements or food sources of iron.
  • Lactoferrin is a great source of iron that doesn’t come with the same intestinal issues that other iron supplements, but there are differences between apolactoferrin and bovine lactoferrin – apolactoferrin will bind to iron in your digestive tract, while bovine lactoferrin already includes iron attached. If you’re having apolactoferrin, have it with iron-containing foods to boost absorption.
  • Lactoferrin is also an immune booster, so if you’re low in iron and lacking robust immunity, lactoferrin is a great choice. 
  • Take iron on an empty stomach – it needs an acidic environment to aid absorption, and food can dilute your stomach acid.
  • Absorption enhancers include vitamin C​1,2​ and lysine​3​, but in particular, orange juice. Take any iron supplement with vitamin C (if it’s not already included in the supplement) or orange juice​4–7​.
  • Bacteria steal iron! If you’re low in iron and have chronic problems, especially in the digestive tract, after reading all the safety information and understanding what you’re doing, try a good gut biofilm treatment such as InterFase Plus (with supportive treatments) to weed out the iron thieves. Especially useful if you have had long-running iron-deficient anaemia for no apparent cause (i.e. if you eat red meat, but are still always low).


Transferrin levels reflect how much iron is being transported around the body. When the dog whistle for iron occurs, transferrin picks up its homie ferritin, and they start hauling iron around.TIBC is another way to talk about how much transferrin the blood has in it.


If you live in a country with free healthcare, schedule a visit with your GP and ask for a full blood checkup including iron studies. Iron studies mean not just iron, but the full panel that includes other iron absorption markers.

If you live in the USA, you can get a ferritin and iron test through your GP or from an online testing provider where you pay online and drop into the lab nearest to you and get the blood drawn.

If you’re squeamish about needles, think about your vagina and try to push through! But, if it’s all too much, see a practitioner such as a holistic naturopath or nutritionist who can look at you (eyes, mouth, nails, diet, symptoms) and see if you’re likely to be low in iron and work from there. 


  1. 1.
    Lynch SR, Cook JD. INTERACTION OF VITAMIN C AND IRON*. Annals of the New York Academy of Sciences. Published online December 1980:32-44. doi:10.1111/j.1749-6632.1980.tb21325.x
  2. 2.
    Li N, Zhao G, Wu W, et al. The Efficacy and Safety of Vitamin C for Iron Supplementation in Adult Patients With Iron Deficiency Anemia. JAMA Netw Open. Published online November 2, 2020:e2023644. doi:10.1001/jamanetworkopen.2020.23644
  3. 3.
    Rushton DH. Nutritional factors and hair loss. Clinical and Experimental Dermatology. Published online July 2002:396-404. doi:10.1046/j.1365-2230.2002.01076.x
  4. 4.
    Shah M, Griffin IJ, Lifschitz CH, Abrams SA. Effect of Orange and Apple Juices on Iron Absorption in Children. Arch Pediatr Adolesc Med. Published online December 1, 2003:1232. doi:10.1001/archpedi.157.12.1232
  5. 5.
    von Siebenthal HK, Moretti D, Zimmermann MB, Stoffel NU. Effect of dietary factors and time of day on iron absorption from oral iron supplements in iron deficient women. American J Hematol. Published online June 26, 2023:1356-1363. doi:10.1002/ajh.26987
  6. 6.
    Balay KS, Hawthorne KM, Hicks PD, et al. Orange But Not Apple Juice Enhances Ferrous Fumarate Absorption in Small Children. Journal of Pediatric Gastroenterology & Nutrition. Published online May 2010:545-550. doi:10.1097/mpg.0b013e3181b1848f
  7. 7.
    Powers JM, Auerbach M. When taking iron, a glass of orange juice a day keeps anemia away. American J Hematol. Published online July 4, 2023:1354-1355. doi:10.1002/ajh.27017

Jessica Lloyd - Vulvovaginal Specialist Naturopathic Practitioner, BHSc(N)

Jessica is a degree-qualified naturopath (BHSc) specialising in vulvovaginal health and disease, based in Melbourne, Australia.

Jessica is the owner and lead naturopath of My Vagina, and is a member of the:

  • International Society for the Study of Vulvovaginal Disease (ISSVD)
  • International Society for the Study of Women's Sexual Health (ISSWSH)
  • National Vulvodynia Association (NVA) Australia
  • New Zealand Vulvovaginal Society (ANZVS)
  • Australian Traditional Medicine Society (ATMS)