Running on Empty: How Iron (and Ferritin) Fuel Your Body's Engine
Anna Harrelson • April 11, 2025
Why you might feel exhausted, foggy, or stuck—and what your "normal" labs might be missing.

You’re not crazy.
You’re not lazy.
And no, you’re not just "getting older."
If you’re dragging through your days, feeling foggy, heavy, or worn out—but your labs are "normal"—you’re not alone. One of the most overlooked causes I find in my practice is suboptimal ferritin levels.
Let’s break it down—with science, a little wit, and a whole lot of hope.
Your Body: A High-Performance Machine
Imagine your body like a beautifully engineered, high-performance car.
- Hormones are your spark plugs.
- Micronutrients are your engine oil.
- Proteins are your gears and pulleys.
Without the right balance of all these building blocks, the engine sputters. It doesn’t matter how good the outside looks—if you're low on fuel or missing key fluids, you’re not getting out of the driveway.
And iron —stored as ferritin—is a huge part of that fuel system.
What Is Ferritin, and Why Should You Care?
Ferritin is your body's iron storage protein. It’s like your gas tank. Not your current speed, not your miles per gallon—your actual reserve of fuel.
- Iron is essential for carrying oxygen to every cell in your body.
- It's crucial for energy production (ATP) in your mitochondria.
- It supports your thyroid, neurotransmitter function, hair growth, immune system, and even mood.
If you’re low on ferritin, you might still show "normal" hemoglobin or hematocrit—so traditional screening won’t catch it until you’re running on fumes.
Symptoms of suboptimal ferritin can include:
- Fatigue and poor exercise tolerance
- Brain fog or poor concentration
- Mood swings or low mood
- Headaches
- Hair shedding
- Shortness of breath with minimal exertion
- Restless legs or poor sleep
Sound familiar?
But My Labs Say I'm Normal...
Here's the kicker: most lab ranges are designed to flag anemia — not optimal function.
You could have a ferritin of 12 and be told "everything looks fine" — but feel absolutely awful.
For most women, especially those who are still menstruating or recently stopped, ferritin levels under 40–60 ng/mL can cause symptoms. Many functional and integrative medicine specialists aim for 70–100+ ng/mL to support optimal energy, cognition, and hair health.
Low-normal is not optimal.
When your engine light is blinking, topping off the tank halfway doesn’t cut it.
Why You Might Be Low
- Menstruation: Every period can deplete iron stores, especially if cycles were heavy.
- Pregnancy and postpartum: Even years later, many women never rebuild their iron stores.
- Gut health issues: Poor absorption due to low stomach acid, celiac disease, or IBS.
- Dietary patterns: Plant-based diets can be low in easily absorbed heme iron.
- Chronic inflammation: Inflammatory signals can "hide" your iron from circulation.
Food First, But Realistic
Yes, food matters. Red meat, poultry, seafood, lentils, spinach, and pumpkin seeds all contribute iron.
But rebuilding storage? That’s a bigger lift.
Think of dietary iron like filling up your gas tank 10–15% at a time. Helpful, but slow if you're starting on empty. Sometimes you need a boost.
That’s where targeted supplementation can help—whether it’s gentle oral iron (like iron bisglycinate) or occasional intravenous iron if needed.
And by the way, ever wonder why "senior" vitamins have no iron? Because postmenopausal women typically don’t lose blood monthly.
We don’t want too much iron. But we also can’t function with too little. Balance is everything.
Final Thoughts
If you’re feeling run down, foggy, achy, or unlike yourself—it’s not "all in your head."
Your body is whispering (or screaming) for better support. And sometimes the missing piece isn’t fancy. It’s basic, foundational, and fixable.
Ferritin matters.
Iron matters.
You matter.
At Wondercreek Health, I believe in digging deeper, connecting the dots, and helping you rebuild the strong, steady foundation your body deserves.
Because you weren’t designed to run on empty.
Iron-Rich Foods to Boost Your Levels
- Beef, lamb, liver (heme iron is best absorbed)
- Dark poultry (chicken thighs, turkey)
- Shellfish (clams, oysters, mussels)
- Lentils and chickpeas
- Spinach and swiss chard
- Pumpkin seeds and cashews
- Fortified cereals and oatmeal
- Tofu and tempeh
Ferritin Target Chart
Ferritin Level
What It Means
<15 ng/mL
Severe deficiency
15–40 ng/mL
Low stores (symptoms likely)
40–60 ng/mL
Borderline (may still have symptoms)
70–100+ ng/mL
Optimal for energy, cognition, hair health
Individual needs vary—always interpret ferritin in the context of your full health picture!
When to Suspect Low Iron
- Feeling tired despite good sleep
- Exercise feels harder than it used to
- Brain fog or poor memory
- Unexplained hair thinning
- Pale skin or brittle nails
- Frequent headaches
- Restless legs or poor sleep
- Shortness of breath climbing stairs
If you’re nodding along to several of these, it’s worth a closer look at your ferritin levels.
WonderCreek Health Blog

You know how people say, "Just drink some water and take a magnesium supplement" like it’s the answer to everything? Well… they’re not totally wrong. But like most good advice, the devil is in the details. Magnesium is one of the most essential minerals in the body, involved in over 300 enzymatic reactions , yet it remains one of the most commonly overlooked deficiencies in midlife women. And no, your annual bloodwork probably didn’t catch it. So What Does Magnesium Actually Do? Think of magnesium as a multitasking background assistant—it keeps the lights on and the gears turning across nearly every body system: Brain & Mood: Regulates GABA and NMDA receptors, supporting calm, focus, and resilience against anxiety and overstimulation. Muscles: Prevents cramping and twitching, supports strength and recovery, and reduces restless legs. Sleep: Plays a role in melatonin production and nervous system regulation. Bowel Function: Helps pull water into the colon to prevent constipation. Cardiovascular Health: Regulates blood pressure and helps with vasodilation. Hormone Balance: Assists in estrogen metabolism and combats insulin resistance. In short: if you’re exhausted, bloated, moody, foggy, tense, or irregular in your gut or cycle—magnesium deserves a spot on your radar. Why Is Magnesium So Important in Midlife? Estrogen and progesterone both influence magnesium levels. As hormone levels decline or fluctuate during perimenopause and menopause, so does your ability to retain and utilize magnesium. Add to that: Chronic stress (which depletes magnesium) Modern diets (often low in magnesium-rich whole foods) Medications like PPIs, diuretics, or certain antibiotics High caffeine, sugar, or alcohol intake (all increase magnesium excretion) And suddenly, a " borderline magnesium issue " becomes a perfect storm. Why Your Blood Test Might Not Show It Serum magnesium tests only reflect ~1% of total body magnesium. Most magnesium is stored in bone and tissue. So it’s very possible to have "normal labs" and still be clinically deficient. In practice, we go by symptoms, risk factors, and therapeutic response. Common Signs of Suboptimal Magnesium Trouble falling or staying asleep Anxiety or nervous system overactivation Fatigue or burnout that doesn’t resolve with rest Muscle cramps, spasms, or eye twitches Constipation Menstrual migraines or tension headaches Joint stiffness or tightness Sugar cravings or blood sugar crashes Best Food Sources of Magnesium Magnesium-rich foods include: Dark leafy greens (spinach, chard) Nuts and seeds (especially pumpkin seeds and almonds) Avocados Legumes Dark chocolate (yes, really!) Whole grains like quinoa and oats That said, many of us still fall short even with a healthy diet, especially during high-stress seasons or if absorption is impaired. Supplements: Which Type of Magnesium Is Best? Not all magnesium is created equal. Here are the forms we most often recommend: Magnesium Glycinate: Best for sleep, anxiety, and muscle relaxation. Gentle on the stomach.** Magnesium Citrate: Useful for constipation, but can cause loose stools at higher doses. Magnesium Threonate: May support cognitive function and brain health. Magnesium Malate: Good for energy and muscle pain, often used in fibromyalgia. We generally avoid magnesium oxide unless constipation is the only concern, as it’s poorly absorbed. **Mag Glycinate is generally my go to recommendation and what we take at our house Also, BLENDS can be good- but generally more expensive Dosing & Timing Most women benefit from 200–400 mg daily, depending on needs. Take it in the evening if you're targeting sleep or relaxation. Divide doses if taking more than 300 mg (e.g. AM + PM). Always start low and go slow, especially with citrate forms to avoid urgent bathroom visits. Final Thoughts If magnesium had better marketing, it would be a top-tier wellness darling. But because it’s quiet, essential, and boring on paper, we tend to overlook it. Yet for so many midlife women, magnesium is the missing link that helps all the other systems and strategies finally click. So if you're doing "everything right" and still feel off? It might be time to start taking magnesium!

"Is Ozempic safe?" "Do I have to be diabetic to use it?" "Will I regain weight if I stop?" "I eat well, lift weights, sleep, take hormones—and I still can't lose weight. What's going on?" These are some of the most common questions I hear from women in midlife. And they’re incredibly valid. For decades, the conversation around weight and health has been riddled with shame, assumptions, and surface-level advice. But we’re finally shifting into a new era—one that recognizes obesity as a chronic, complex disease, not a personal failure. One that looks at metabolism through the lens of hormones, inflammation, genetics, stress, and brain chemistry, not just calories in and out. And at the center of this shift is an exciting class of medications known as GLP-1 receptor agonists. What Are GLP-1 Medications? GLP-1 stands for glucagon-like peptide-1, a hormone your body naturally produces in the gut. It helps regulate blood sugar, insulin, and satiety (your sense of fullness). GLP-1s also slow gastric emptying and signal your brain to reduce appetite. Medications like semaglutide (Ozempic, Wegovy), liraglutide (Saxenda, Victoza), and tirzepatide (Mounjaro) mimic this hormone and have been revolutionary for treating type 2 diabetes—and more recently, for metabolic syndrome and obesity. These drugs are not stimulants or fad diet tools. They are hormone-based medications with powerful metabolic and anti-inflammatory effects. Why Are GLP-1s So Relevant for Midlife Women? Midlife is a time of massive hormonal transition. Estrogen, progesterone, and testosterone levels shift dramatically in perimenopause and menopause. This impacts insulin sensitivity, body composition, lipid metabolism, sleep, inflammation, and brain function. Even women who have optimized their lifestyle—dialing in nutrition, strength training, sleep, and hormone therapy—may find themselves stuck. GLP-1 medications can be the missing piece for women who: Have insulin resistance or prediabetes that isn’t budging with lifestyle alone Carry weight disproportionately in the visceral (abdominal) area Are at increased cardiovascular risk due to family history, labs, or existing conditions Are experiencing significant inflammation or joint pain related to metabolic dysfunction Have a history of PCOS or gestational diabetes Are postmenopausal and noticing rapid changes in weight or metabolism These medications work synergistically with hormone therapy and can reduce inflammation, improve insulin sensitivity, and help shift body composition. For some women, they are as life-changing as starting estrogen. It’s Not Just About Weight Loss GLP-1s are being studied for NAFLD (fatty liver), cardiovascular protection, neurodegenerative disease, PCOS, and even addiction and mood regulation. The benefits go far beyond the scale. That said, when stubborn weight is a major barrier to living fully—whether due to physical discomfort, comorbidities, or psychological toll—helping a woman reduce weight safely and effectively can open the door to movement, joy, and hope. So, Who Should Consider a GLP-1? I don’t believe in prescribing these meds as a first-line for someone who hasn’t addressed the basics. That’s not judgment—it’s strategy. If you haven’t worked on: Blood sugar balance through real food Resistance training and daily movement Addressing sleep and circadian rhythms Managing stress and nervous system regulation Optimizing hormones, micronutrients, and gut health … then you’re not giving yourself the best shot at lasting change. But if you have done the work and still feel like your body is working against you—or you have serious metabolic risk factors— then GLP-1 therapy might be a wise and evidence-based next step. Some women use it briefly to reset. Others may need it long-term, just like hormone therapy. It’s not a crutch. It’s a tool. And for the right woman, it can be life-changing. Common Questions I Hear "Will I gain the weight back if I stop?" Maybe—but not always. If the lifestyle foundations are in place, many women maintain progress even after discontinuing. But some women have chronic conditions that benefit from ongoing use. That’s not failure—that’s biology. "Are there side effects?" Yes. The most common are nausea, constipation, or bloating early on. Starting slow, staying hydrated, and eating smaller portions helps. Rare but serious risks exist, including pancreatitis. A good clinician will walk you through these carefully. "Will I lose muscle?" You can—unless you’re strength training and eating enough protein. We talk a lot about this at Wondercreek. Protecting lean muscle is critical. "Is this forever?" Not necessarily. Some women use these meds to reduce inflammation, restore insulin sensitivity, and break a cycle. Others stay on them longer due to underlying metabolic dysfunction. Every plan is individualized. Final Thoughts GLP-1 medications aren’t for everyone. But they are not cheating, shameful, or lazy. They’re a legitimate, science-based treatment for a serious, chronic condition. In my practice, we focus on healthspan—not just lifespans. That means preserving function, preventing disease, and helping you feel energized, sharp, and resilient for as long as possible. For some women, GLP-1 therapy is one of the most powerful tools we have to get there.