Wednesday, 9 February 2011

Iron Ladies

first published in 2009

There is a difference between being tired and fatigue. Everybody is getting tired at the end of the day, and once in a while we still are in the mornings after a too short night of sleep. We may feel like an afternoon nap, or a lie in – that’s all rather normal. 

Why so tired?
With fatigue I mean feeling constantly worn down. Being tired even when the night was long enough; the feeling that although the sleep was deep and dreamless one hasn’t slept at all. One is able to get through the daily tasks, even finds a laugh when chatting with the girls, but there is always this feeling of having to push through; there is no natural flow, one is clumsy and forgetful and creativity has left the brain.

So one is checking the calendar and is somewhat relieved to see that it is ‘the week before’. Thank God, it’s just one of those months, and there will be payback time: When this will be over the sun usually is shining a bit brighter, even. But not this time! So the search continues: Well, a lot of people have a cold: I may come down with something; it’s almost spring: This change of seasonal climate is stressful on the body and one is worn down by central heating and lack of oxygen. 

I need a pill!
The re-installed power walking sessions, however and the garden work are not helping, in contrary: Instead of a rosy, fresh air complexion I look grey like an old bed sheet, the hair is lifeless, and I only have to look at food for it to appear on my thighs. The head clouds are getting bigger and the workload that lies ahead becomes ever more overwhelming: One already has to think about summer holidays and it’s only those few month to squeeze everything in – the garden, Easter, some travels to see family, preparing the BBQ place to be ready for the May Bank Holidays, sport definitely needs picking up and sh... the windows and the garden fence need painting, and all I want to do is to sit in my armchair with biscuits and tea and stare at the wall – even choosing a movie from the DVD collection is too much of a decision. It would be so great to have a pill to make it all go away. Well, maybe there is one: 

Iron is needed to build the haemoglobin in the red blood cells, and that is the stuff which is transporting the oxygen that we breathe in, into to cells of the body where it gets burnt and turned into energy, so that the cell can do its job.

How it works
The burning process is using the same principles like a fireplace. In order to heat a room or cook some food two things are needed: a fuel like gas or coal and oxygen. Trying to light the fuel in a vacuum won’t work as the oxygen is missing; there has to be oxygen to turn the fuel into energy. This can easily be observed when extinguishing a candle with a candle snuffer. As soon as it is put over the candle, the flame uses the leftovers of the oxygen and then just stops burning.

This mechanism explains where the lack of energy comes from when iron is missing in the body. Iron means oxygen and if it is missing our fire has gone out or is about to, hence the body wants to save the meagre remains for vital organs, goes into energy saving mode and tries to put us to sleep. Additionally it signals for help. Once in a while it might make the heart work hard in the hope to get more blood pumped and hence more oxygen supplied - one then can feel the beat scarily loud and clear, or it may ask for fuel, meaning food, sometimes in the shape of weird cravings. Well, and since the body won’t waste energy to keep skin and hair nice, one might become rather flaky and ‘beige’. Although the typical pale complexion of an anaemic will come at a later stage.

Oh, what a bad combination: Wanting nothing more than hanging around and eating. So why on earth do we lose iron? It’s something really rather solid, how does it leave the body? 

When things go wrong
The iron lives in the red blood cells, which when everything goes right, live around 3-4 months and then get recycled and rebuild, if something goes wrong the iron gets lost. There are five main mechanisms involved in the iron trade where things can go wrong:
  • the body is not able to build enough red blood cells to replace the dying ones  – then something is usually wrong with the bone marrow,
  • the body is not able to absorb the iron that it gets delivered with the food – then something is wrong with the intestines, similar to celiac disease,

  • the body is in need for more iron, like during pregnancy,

  • the body is losing a huge amount of blood, like during an accident or operation, or

  • the body is losing small amounts of blood, like during menstruation.
Regarding the first two, one would not just feel a bit off whack but rather sick. The underlying condition would cause further symptoms and doctors will take care of the situation. Additionally the symptom would probably appear rather quickly. The same is true for pregnancy during which iron levels should be monitored and balance out. 

Balanced Diet
Well, when losing a large amount of blood the iron levels are usually the least of ones problems; this period thing however is very, very sneaky! Every month one is losing just a tad bit of iron, and although a lot of information sources are claiming that with a balanced diet one should have replaced the missing bits by the end of the cycle, I personally cannot confirm that. ‘Balanced’ for health people usually means ‘utterly healthy’.

In my book ‘balanced’ reads as ‘mostly being a good girl, but liking my coffees and teas and dairies’ – and those are all things that inhibit iron to be consumed by the body. Meaning that one can eat as much as one likes, but the body can’t use it because a lot of Chemistry goes on between the iron and the foods and hence it is passed straight through the intestines and does not get digested as it should be. Additionally iron from food sources comes in all sorts if chemical compounds and the body is rather specific about which ones it wants. Just nibbling a rusty nail as suggested by some urban myths won’t do the trick. 

A warning!
Well, and then of course one has to give a warning that too much iron can be harmful, and even if some additional intake is indicated it may upset the stomach or cause indigestion. Hence I am taking this little pill before I go to sleep when my stomach is not entirely empty, but there is enough time between food and iron intake to not have the two interfere with each other. 

My experience
I stumbled across iron a good two decades ago. I was young, I was healthy and I was tired down to depression. At that time I was researching vitamins to find out if they could have a positive impact on my allergies (which some of them have), and when I read the list of symptoms for iron deficiency I thought I had a mirror held to my face.

So I gave it a shot, didn’t have any side effects except of a bit of indigestion for a couple of days until the body got used to it, and felt an improvement instantly. After two days my energy came back and within a week I was my old self again.

I took a six week course as advised on the pack and then a couple of years later I ran into the same trap. It happens so slowly that one doesn’t realise it. Other conditions like sleep deprivation due too much partying, work or a cold can have a similar effect and hide the real cause. Again I took the pills  with the same outcome: Instant relief!

I then checked with my GP, got off the drug for a month, had the blood levels measured which were in the lower third of the range – so nothing bothersome or unusual – but I already felt the lack again. He then confirmed that should I feel like needing it, I could take this low dose continuously without causing any harm. He as well told me that some people react to lower levels earlier than others, something that I found confirmed in the book ‘Well-being for Women’ by Helen Lawrence (Geddes & Grosset, 2004, p.18)

Regarding the duration of the course it seems that my body is telling me when enough is enough. I tend to all of a sudden forget taking them, so I am stopping intake altogether until the next time when I am wondering why I am so tired and if I might have caught a cold... 

Will I ever learn?
This time round I was so proud to have survived Christmas well and thought that this would give me a brilliant head start into summer. Ha, I’d wished! Mid January I started feeling a bit drained, beginning February I had my holidays when I usually slip horribly food wise – what is ok as I am preparing for it – and after that I crushed. I didn’t realise what was going on until mid March when the downhill trend became more and more obvious. Within these six weeks my weight went up about 3 kg adding an additional 21,000 calories to my diet which I now have to get rid of again. If somebody however would have dared saying a word about my biscuit consumption, I would have gathered the last of my strength and would have gone for a kill. There was no control whatsoever. Now three days in I am back to my normal diet without any problems, liking my salt less bread, the eggs and bananas.

Well apparently I am an iron lady in many ways!

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