New Delhi: Mental health is not about one, but several factors. From internal to external, from biological to environmental, even nutrition influences psychological well-being. Researchers say that although nutrition is one of the overlooked factors, it continues to be relevant enough to make a lot of difference. And now, there is evidence that suggests that iron deficiency, which is a common occurrence in women, is likely to take a toll on mental health and raise the risk of depression and anxiety in the long run.

How does iron deficiency affect mental health?

According to Dr. Stephanie Weinberg Levin, a psychiatrist affiliated with Michigan Medicine and the VA Ann Arbor Healthcare System, iron deficiency—even without anemia—can contribute to worsening mental health symptoms. Despite this, many healthcare professionals and patients remain unaware of the connection between low iron levels and mental health outcomes.

During her fellowship in integrative psychiatry, Dr. Levin, along with Dr. Theresa Gattari, reviewed existing research on the subject. They found that individuals with low ferritin levels (a marker of stored iron in the body) were more likely to experience symptoms of depression, anxiety, fatigue, and even psychotic disorders. Ferritin testing, rather than a standard iron or hemoglobin test, provides a more accurate assessment of the body’s iron reserves.
Iron is essential for the synthesis of neurotransmitters such as serotonin, dopamine, and norepinephrine, key chemicals responsible for mood regulation. When iron levels are low, the body may struggle to produce these neurotransmitters efficiently, potentially worsening mental health symptoms.

Large population studies have shown a strong correlation between iron deficiency and higher rates of depression, anxiety, and sleep disorders. One study even noted that people with iron deficiency anemia were more likely to report a history of depressive episodes or mental fatigue. Smaller studies also found that lower iron levels were linked to more severe psychosis symptoms during the first episode of the disorder.

Can anaemia supplements help?

Supplementing iron has shown promising results. In several clinical trials, individuals with low iron levels who received iron supplements reported improvements in mood, cognitive performance, and fatigue, even in the absence of full-blown anemia. In one study, individuals with ferritin levels below 100 ng/mL saw significant symptom improvement, although the traditional threshold for deficiency is often 30 ng/mL.

Dr. Levin recommends ferritin testing, especially for individuals at higher risk of deficiency, such as pregnant women, young children, women with heavy periods, frequent blood donors, cancer patients, and those with digestive issues or heart failure. She advises that mental health professionals and primary care providers consider iron status when treating patients with mood or energy- complaints.

There is no universal agreement on the ideal ferritin level for mental health support, but aiming for around 100 ng/mL and retesting every 4–6 weeks is a good starting point. Importantly, iron supplements should only be taken under medical supervision, as excess intake can be harmful, especially to young children. In conclusion, iron may be a missing piece in the mental health puzzle. While more research is needed, identifying and treating iron deficiency could offer a safe and cost-effective strategy to improve mental well-being.