Going through bouts of extreme fatigue is an experience you’re likely familiar with if you have endometriosis. An increase in fatigue is often a sign that you’re about to experience a pain flare-up.
This fatigue is the result of a combination of the body trying to eliminate the endometriosis tissue and the inflammation that the diseased tissue produces. And of course, when you are in pain your feelings of fatigue are likely heightened.
But it might not just be your endometriosis that is causing you to feel constantly exhausted.
Iron deficiency often goes hand in hand with endometriosis
This is partly because these conditions can come with heavy, long periods, resulting in increased blood loss – and iron loss – each month. Your body then tries to replenish those lost red blood cells by using what iron you do have stored to make more haemoglobin, which is then used to carry oxygen around your body on red blood cells.
Month on month, more and more iron is taken from your stores, resulting in an eventual iron deficiency, which can be difficult to combat through diet alone.
That’s not the whole story though.
The increased levels of inflammation that accompany endometriosis also play a role in your decreasing iron levels.
When inflammation is present, the body decreases how much iron is absorbed from your diet and any iron supplements you might be taking. It seems a bit cruel of the body to reduce how much iron you absorb as a result of the condition that caused you to become iron deficient in the first place, but it is trying to protect you.
You see, when the body detects that it is inflamed, it assumes this is because of an infection. Iron is the preferred food for all sorts of bacteria and viruses, so in order to prevent those pathogens replicating faster and the infection progressing, your body starves them of iron by not letting it cross the intestinal wall and enter the bloodstream.
And this is where things get even more complicated because that unabsorbed iron has to be removed from the body, so it is passed through the digestive tract and excreted when you have a bowel motion.
Unfortunately though, if you have endometriosis, we know you are more at risk of having an imbalance of gut bacteria, with more of those iron-hungry microbes hanging around. So now that iron that is passing through your digestive tract becomes food for any pathogens in your gut, and as those pathogens replicate they produce more and more of an inflammatory substance called lipopolysaccharides, which then leaks through your intestinal wall and ends up in your pelvic cavity where it – you guessed it – exacerbates your endometrioses.
If you’re feeling like you’re in a no-win situation after reading this, don’t despair! There is so much we can do to help your body start absorbing more iron again, rebalance your digestive microbiome and reduce the inflammation caused by the endometriosis.
Let us know in the comments what your experience with iron deficiency and endometriosis has been. And if you have managed to resolve your iron deficiency, we would love to hear about that too to give hope to others who may be in the same situation.