Spring blues and fatigue: It will not go away

Hematologist Anastasia Arseneva

By spring, many people are experiencing problems with their appearance: hair loss, dry skin. Plus a collapse, irritability, insomnia, lack of mind. We usually attribute all this to the fatigue that has accumulated after the winter, and to the berries, and we wait for the summer: fresh vegetables and fruits, sunshine, holidays – we will be as good as new! However the hematologist Anastasia Arsenova assures: not everything is so simple. The reported problems will not go away on their own if the cause is a lack of iron. And 30 million women in Russia experience it – sit down, if you stand up – that is, almost every second (it rarely happens to men). Anastasia talks about the problem not only to patients, but also to readers of her blog for seven years – after she experienced anemia during pregnancy and realized that there are too many women who are “just tired”. And recently, the Komsomolskaya Pravda publishing house published her book Iron Argument. The whole truth about anemia, suggested by experts for mandatory reading.


– Anastasia, what happens to us in the spring and what does the iron have to do with it?

– The human body is not adapted to the winter cold and temperature fluctuations that are typical for most of the territory of Russia and tries to save energy. So in the winter, I want to lie down under a blanket more than I want to walk. By spring, the energy level is depleted, hence fatigue, loss of strength. But people with iron deficiency feel particularly acute spring weight of life. After all, they are constantly living in an energy-saving mode, which the brain “activates” when there is a lack of iron. The main function of iron in hemoglobin is to hold and carry oxygen through the blood, a person will die of hypoxia, so the brain goes out. Over time, a habit of moving less is created and the state of chronic fatigue ceases to worry. This is how we live. In addition, iron deficiency disrupts the production of the hormone of happiness endorphins and when the weather is gloomy outside, people with iron deficiency, even without anemia, are covered by spleen and depression.

– Iron deficiency without anemia? How can you not notice if your hemoglobin is checked when you have a complete blood count?

Low hemoglobin is really easy to detect. However, hemoglobin does not decrease immediately, but last, when the body’s iron is extremely low. The fact is that this trace element is needed not only for hemoglobin, but also for muscles, nervous system, immunity and skin. That is, iron deficiency anemia is the final stage of exhaustion. It is preceded by latent insufficiency, also called iron deficiency anemia. This happens when hemoglobin is still normal, but there is no longer enough iron for other organs and systems to work. Because of this, a person experiences chronic fatigue that does not go away, no matter how much rest it is, as well as lack of energy, when there is no strength to do something, the motivation is zero, life is not joy.


– Among the events in the book you even mention the craving for sweets and extra pounds. Does iron deficiency affect our habits?

Yes, iron deficiency greatly prevents a person from changing habits to healthier ones, as it increases the craving for unhealthy foods. It also reduces physical endurance. That is, you go to the gym as before, but you do not have the strength to do it, so you decide to take a break until better times. Adding to the problem is the tendency of women to diet regularly to lose weight. By reducing calories, you also reduce your iron intake, so in three months you run out of reserves so much that, along with (or instead of) a good form of iron, you will have hair loss, dry skin, loss of strength and other problems.


Do they die of iron deficiency?

In most cases, the diagnosis is not fatal. But if other conditions accumulate – for example, Covid, there is a risk to life. There were cases where the elderly tolerated the coronavirus quite easily, but then died not due to lung damage, but due to anemia, which was detected accidentally and very late.

– Sounds scary. How is a hidden deficit revealed?

– Using a blood test for serum ferritin – shows how much iron is in the body. The analysis is performed according to the compulsory medical insurance in a regular clinic as prescribed by a doctor. You can get it yourself in a commercial laboratory, it is cheap. Pay attention to the interpretation of the result: the lower limit of the rule is the “living wage” for the body. That is, he lives, but badly. For good health, you need an optimal level of ferritin, so that there is not only enough iron, but also stock. And it is individual for everyone and depends on whether the weight is normal, whether the person has high physical activity, whether he is at risk.

– In the “Iron Argument” you describe in detail how to read the results of the analysis, to take a test for self-determination of the points of iron deficiency. How long does it take to heal?

– Treatment is not always long-term, but it is always medicinal, even if there is no anemia. The duration depends on the depth of iron deficiency. If the hemoglobin is 60, then it takes three months to increase and a few more weeks to replenish iron stores. If ferritin alone is not normal, 8 to 12 weeks may be enough. But when you can not wait – for example, during pregnancy – intravenous drugs are used, which significantly speed up the process. In the past, this was an option for serious cases, now the procedure is safe and offered to everyone to choose.


– 30 million in Russia, about 2 billion in the world – fantastic numbers. What is the reason?

– Yes, the problem is global. And one of the main reasons is the way of life, more specifically malnutrition. Many have a western type diet when the menu is too rich in processed carbohydrates, which provide only calories and a few foods rich in vitamins and minerals. Another reason is that there is no prevention of iron deficiency in our health system. The pediatric community is trying to change that.

– I know you keep a flash mob # I will_give_ferritin for several years. He organized the movement “Moms against iron deficiency”. It helps;

– Patients, reading my blog, my books, go to the doctors themselves and ask to prescribe the necessary analysis, bring relatives and friends. Thus, doctors are encouraged to work with this problem. Public initiatives sometimes work more effectively than the above guidelines.

– If ferritin is normal, how to make sure? Who should monitor this indicator?

– Good ferritin indicates that the diet meets the body’s needs for iron. However, those who are planning a pregnancy or those who are pregnant at an early stage should take a preventive dose of iron or multivitamins to ensure that both the expectant mother and the baby are adequate. Alas, due to anemia, there are problems with pregnancy and the deficiency is transmitted from mother to baby. The second risk group is children under 5 years old, especially those who, for some reason, have a limited diet. Next – women who are going to diet.



Childhood symptoms: fatigue, inability to remember lyrics, headache

Parents rush to delete the child’s school problems for laziness, but in vain

– Do children have the same symptoms? – I’m checking with Anastasia.

– Closer to adolescence – yes. They may complain of fatigue, it is difficult to focus on the lesson. A very typical symptom is a bad memory: he tries to learn a poem, but it does not work out. And parents think they’re just lazy. Girls begin to menstruate and many fall into anemia. Another symptom is frequent headaches, especially in the spring, when it is either hot or cold. Because due to lack of iron, the vascular tone is disturbed. In children under 5 years, when there is active development and maturation of the nervous system, everything is different. If you were born with an iron deficiency, the deficiency will become even more pronounced. Sleep problems, when he falls asleep badly, he often wakes up. Delay in motor development and speech development. Closer to five years – a tendency for ADHD, when it is difficult for a child to concentrate, to sit still. Fortunately, all of this is easily fixed.

Is hematogen still prescribed to children for prevention?

“What we had in our childhood was made from bovine blood and was rich in iron and healthy. Now (the composition was specially checked) the hematogen is made of caramel – in fact, it is a cream with sugar and a little iron is added. So a bowl of lentil soup would be much healthier.



What should be on the menu

In your daily diet you should include:

· Red meat;

chicken or turkey thigh meat;

dark legumes – lentils, beans.

Fresh fruits and vegetables that contain vitamin C (helps absorb iron from food): persimmons, tangerines, oranges, apples, leafy vegetables. Better seasonal, as their nutritional value is higher.

whole grains – buckwheat, corn, millet, brown rice.

bread – whole grains or rye.

Processed foods should be minimized: sugar, industrial sweets, white rice, high quality flour products, low fat dairy products, fast food.

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