Dr Libby on the importance of iron in our overall health

Do you constantly feel tired and exhausted no matter how much you sleep or rest? Have you been blaming it on stress or a busy life? The answer may be simpler than you think.

This week, Francesca and Louise are joined by nutritional biochemist and author of Fix Iron First, Dr. Libby, to discuss the vital role iron plays in our energy levels and overall health, and why more women need to tackle this earlier. Listen as they cover everything from the stages of deficiency and causes, to testing, treatment, and how to get the ideal levels.

See omnystudio.com/listener for privacy information.

Episode Transcript

Speaker 1 (00:10):
Hi, I'm Francesca Rudkin and I'm Louise Area and this
is season five of our New Zealand Herald podcasts, The
Little Things.

Speaker 2 (00:16):
It is great to have you with us again, and
if you're new to The Little Things, welcome. This is
the podcast where we chat with experts about all the
little things that can make a big difference in your life.

Speaker 1 (00:25):
We've got a.

Speaker 2 (00:25):
Special focus on women in the midlife season, but honestly,
the tips and the insights that we share often hit
home for people of all ages and stages. So we're
really excited to be bringing you another season packed with
conversations on everything from health and fitness, to fashion and
finance and more. Basically, if it matters in this stage
of life, were here for it and for you.

Speaker 1 (00:46):
Now. Something that's been on my mind as we hit
into season five is just how valuable it has been
over the seasons to get a better idea of what's
sort of going under the surface in our bodies. I mean,
that's kind of why we started this podcast. But I
don't need to know heaps, but I want to know
enough because I'm the one flying this particular plane. Our
bodies are incredible. They do a lot on autopilot for us.

(01:06):
You know, we've got systems working constantly to keep everything good,
but I kind of want to know more about how
I can give it a nudge if it needs it,
or how do I know what's my body telling me
when I'm doing too much. So I thought I had
a fairly good handle on things like iron, but learning
more about it and how to access it and how

(01:27):
I might be eccidentally sabotaging it really surprised me. And
when you start layering it in with the gather information
we've been gathering about gut house and hormones, it starts
to make a lot more sense.

Speaker 2 (01:39):
Because, Lou, we talk a lot about how important is
to keep our bodies moving, to keep our mind's agile,
to look after ourselves and others, But the truth is
that we can't We can't really do any of this
if we're not feeling up to it. And how often
do we say and how often do we have our
friends just say I'm just so tired, I'm just exhausted,
I am so tired. And that kind of fatigu isn't

(02:00):
always about sleep, you know, It's not like we might
be having disruptive sleep sometimes it's our bodies trying to
work without the vital minerals that they need to function.
And one of the big ones across all stages of life,
it's on.

Speaker 1 (02:13):
As it turns out, as it turns out something we
probably already knew, but it's just dropped off a little bit.
We don't talk about it as much as we used to,
and like, I'll be honest, I just thought when I
stopped getting a period that iron stores or being iron
deefficient would not be a thing in my life. But
apparently it probably it's an issue for everybody.

Speaker 2 (02:32):
We tend to think it's for women who've got periods,
but actually everybody needs to be aware of what's going
on with our iron, whether you're a teenage boy or
you know a middle aged woman.

Speaker 1 (02:40):
And look, there is so much advice flying around out
there about what to do in middle age and menopause
and all that sort of thing. If there's something out
there that is really easy and easy fix a blood
test and a supplement, I'm here for it. Do you
get your iron tested?

Speaker 3 (02:57):
Well?

Speaker 1 (02:57):
As you know, I'm pretty a vested blood tests so
ever since I used to have to have them every
week for chemotherapy and then I have to wait for
the results and I just I just hated it. I
still hate it. So no, I don't. Okay, No, I
totally understand that, but I will. I will. I of
course have brought in my AUNT test. Yeah.

Speaker 2 (03:15):
I thought, Wow, we're going to talk on and we've
got a pretty amazing guest with us today, so it
only makes sense. I know, I'm talus that I bring
in my tests, that they are a month or so old.
But interestingly it doesn't fluctuate that much. But I'm really
interested to talk about because there's not just issues with
not having enough. I think you can have too much.

Speaker 1 (03:33):
And I'm worried. I'm in that. I'm sort of worried.
That's me anyway, it's not worried about me. Well, we'll
see what she says, shall we.

Speaker 2 (03:42):
Okay, to explain iron's impact on our quality of life,
we are talking today to doctor Libby. She's an internationally
acclaimed nutritional biochemist, author, and speaker. You are likely to
have come across her before it's She has thirteen best
selling books that aimed simplify the science of health. Doctor
Libby is also the founder of bio blends her new
book called Fixed Iron First, The One Thing That Changes Everything,
is another example of how she can explain and educate

(04:04):
us about our biochemistry in a way that we can
all understand. Doctor Libby, thank you so much for your time.

Speaker 1 (04:10):
Welcome.

Speaker 4 (04:11):
Oh, it's a joy to be here with you both.
Thank you very much for having me.

Speaker 1 (04:15):
Let's just start at the beginning. Why do we need iron?

Speaker 4 (04:21):
So iron is crucial for so many processes inside of us.
But one of the big ones, of course, is it's
involvement in hemoglobin and therefore oxygen delivery to every single
cell in our body. I love people to imagine that
our body is made up of about fifty trillion tiny
little circles and which is a cells, and inside those
cells are little tiny cities that need oxygen to be

(04:43):
able to conduct their operations. So iron is crucial for that,
which is why iron deficiency there's almost nothing that doesn't
touch and it's a big concern. It is the most
common nutritional deficiency globally, including in New Zealand, and it
particularly affects women across the menstruation years. Pregnant women teenage
girls is a growing group of concern and endurance athletes,

(05:05):
and also children and toddlers. So there's a lot of
people who are affected by it, and I feel it's
being missed or I think sometimes even ignored at the moment,
and I want to bring it.

Speaker 3 (05:15):
Back to the top of the conversation. Pile love it.

Speaker 2 (05:18):
So, what are the stages of iron deficiency, because you
could be deplete, deficient or have anemia, right.

Speaker 3 (05:25):
Yes, so spot on.

Speaker 4 (05:27):
So there are four stages technically, but the beginning of it,
we don't really notice symptoms. So it's just when blood
levels start to change a little bit. Then we get
to a point of what's called iron depletion and we
might start to notice some symptoms there. So energy is
the first thing that usually changes. And I'll just pause

(05:47):
there actually because I feel that it's so easy right
now to just write off lousy energy to a busy
life or stress or just you know, dealing with all
of the things, and of course it can be those things.
But when the fatigue is ongoing, so when it lasts
for more than two weeks, when it's not when your
energy is not restored from a good quality sleep, then

(06:09):
that's when you want to start to investigate it and
find out what might have changed. So iron depletion comes first, then,
as you mentioned Francesca, iron deficiency comes next, and then
iron deficiency anemia. So anemia is essentially where there are
no longer enough red blood cells, or the number of
red blood cells you do have are too small to

(06:29):
be able to do all of their critical work, which
primarily is delivery of oxygen to all of your tissues.

Speaker 1 (06:35):
So do you think that we are picking up issues
with iron once people are anemic, or are we getting
better at picking it up before then?

Speaker 4 (06:44):
I think some people. I think the divide is greater
luise right now. So I think there are some people
who have become really health conscious, and they might be
people who proactively have a blood test once a year,
and iron is something they might measure to keep track
of to see if they are at a decent level
or if it has been depleted in some way, and
then they might act to rectify that. But there's certainly

(07:05):
a large group of the population who don't necessarily know
that it's a really important test to have, and therefore
if we're not aware of it, we can't correct any
level of depletion or deficiency or anemia. So too many
people are found at the bottom of the cliff and
they're at a point where they need an infusion. And
we're very fortunate that we have access to such life

(07:26):
saving technology, such life saving medicine.

Speaker 3 (07:30):
But my concern is.

Speaker 4 (07:31):
I've met a lot of women over the years who
just use infusions as their way of managing not eating
enough dietary iron. So they'll wait till they are at
that absolute rock bottom, go get an infusion, and then
just keep living the way they've been living without addressing
why they keep becoming deficient. That's not a good plan
in my opinion, because you spend too much time either
depleted deficient before you hit that anemia point where the infusion.

Speaker 3 (07:54):
Is actually essential.

Speaker 4 (07:56):
So so much better to just maintain those lovely robust
level in the first place, because can it.

Speaker 1 (08:01):
Have long term damage if you don't address.

Speaker 4 (08:04):
It, So certainly in infancy it can. So it's so
crucial for the development cognitive development in children, their growth,
their development. We understand that some of the symptoms in
young children is picky eating or a poor appetite, even
lousy sleep, and a tendency to irritability and agitation.

Speaker 3 (08:24):
In their little natures.

Speaker 4 (08:25):
So that's a big concern because the iron deficiency can
have a lasting impact if it's not picked up in
childhood and addressed in women. Though here's my concern. I
feel that so often it unfolds for us in our
teenage years when menstruation begins, because our iron requirements accelerate
their once menstruation begins, and if it's not known or

(08:46):
not addressed, then we then live with it. And because
iron is needed for the production of neurotransmitters like dopamine
and gabba, so we need dopamine for motivation and energy.
We need gabba the chill pill, it's the one of
the relaxation neurotransmitters. We need iron to be able to
produce serotonin, so over time there can be compromises in

(09:09):
some of those neurotransmitter production. In the production of some
of those neurotransmitters, anxiety is actually a symptom of iron deficiency,
and at the moment in our culture, there's a tendency
to go primarily down a psychological road, and that's the
right road for some people, absolutely, But what concerns me
is that sometimes iron deficiency is being missed in people

(09:30):
who experience anxiety. And I have a phrase I use
in my work. The road in is the road out.
So whatever's created the dysfunction, we want to address it.
And if iron deficiency is creating the anxiety, then addressing
the ion deficiency is what will alleviate that in that person.
So we also the longer term effects also not necessarily
a just on mood. They can be on thyroid function.

(09:52):
So the thyroid gland literally requires iron to be able
to produce its hormones, and it's also Signe's also essential
for the conversion of inactive thyroid hormone T four into
active thyroid hormone T three, which is the one that
drives our metabolism and helps to regulate our temperature. So yes,

(10:12):
long term there are really major consequences of living with
iron deficiency. And I feel that right now there's this
tendency amongst women to sort of say, oh, well, I'm
iron deficient and so it's my best friend, and so
aren't we all, and we're not necessarily acting to address it,
and that's a big concern.

Speaker 1 (10:30):
So one of the things that came up as you
were explaining that about teenage girls in particular once they
reach intuation is that in an otherwise healthy sort of girl.
You are probably not going to get to go go
for a full black plat count every year to your GP, right,
that's right. So it would only be picked up once
there are other symptoms, so they would be likely to

(10:52):
be at that further deficient sort of stage.

Speaker 3 (10:55):
Usually, yes, always very much.

Speaker 4 (10:58):
And so when the tailface is an indicator, it can
be an indicator of iron deficiency some degree of it.
So it's noticing that when that starts to happen for
a young girl, and that's coupled with fatigue, they're sort
of two of the first telltale signs. There can also
be changes in her mood or her temperament, but certainly

(11:20):
because our requirement once we start to menstrum eight is
eighteen miligrams per day, which is significant, we can eat enough,
but we need to be very focused on eating enough.
And my worry is that at the moment, there's a
tendency for teenage girls, and I'm generalizing obviously to be
very easily influenced by things they're seeing on social media,

(11:40):
for example, and they might admire someone who they've never met,
and that person might eat in a plant based way,
and so without any education, that teenage girl adopts that
way of eating, but she's not focused on ensuring she's
getting enough iron. With that way of eating, you can
do it, but as I said, you need to be
very educated and very focused on doing that. So right

(12:02):
at a time where her iron requirements have increased, her
tendency with her food choices might be to decrease the
amount of iron she's consuming. So if there's that pattern
going on, the fatigue, the pale face, maybe some mood changes,
and that real a tendency towards that picky eating or
dietary restriction, then they're red flags even without a blood test.

Speaker 1 (12:24):
I think that's really interesting.

Speaker 2 (12:25):
I've definitely got a teenager at home and we've gone
down a psychological route to deal with some issues. But
the more things to say, I'm going we're just ticking
every box here, and that's really important to know because
that is something else that I need to follow up
on and get the blood test. I mean, it is
relatively easy to diagnose.

Speaker 4 (12:41):
It's a blood test, right, Yes, it is, and it's
a very straightforward blood test. And because it is the
most common nutritional deficiency in the world, it is I
feel that it's something that we all want to have
awareness of and monitor Now that doesn't mean that everyone
needs to have blood tests regularly to check it. But
if you have that tendency to restrict your eating in

(13:02):
some way, because there's still very sadly a tendency for
too many women to restrict in some way. I don't
meet a lot of women who eat for robust, healthy
I don't meet many women who eat for fantastic energy
or for satiety with that sort of mindset. So often
it's still in some way or another impact to buy

(13:24):
restriction or trying to control body shape and size or
reduce body shape and size. So coffee is not lunch.
It's really hard to It's sort of hard enough to
eat enough iron to meet your requirements when you're what
I call a good meat and potatoes kind of eater.
So when you're eating for robust health and society, it's

(13:45):
virtually impossible to eat enough iron through food if you're
restricting in some way or skipping meals or having coffee
for lunch.

Speaker 1 (13:52):
And as you say, there are times in your life
where the requirement's larger. So a menstruating women, pregnant women,
you seed eight what did you say? Eighteen? What was
your number to hit.

Speaker 4 (14:03):
Eighteen melograms per day for menstruation and twenty seven melograms
per day across pregnancy.

Speaker 2 (14:09):
We sort of spoke there about symptoms that you might
see in a teenage girl. What if we're talking about
it a woman and maybe in particular somebody who is
between sort of the ages of forty and sixty sort
of heading into midlife.

Speaker 4 (14:25):
Yes, so once menstruation ceases, our requirements decrease significantly, so
they go from eighteen melograms per day down to eight
miligrams per day. It's actually a time where some women
find POSTMENOPAUSALI is a time when some women find out
they have hemochromatosis, which is an iron overload disorder. It's
a genetic condition and across the menstruation is because of

(14:49):
the blood loss, iron doesn't necessarily accumulate, and then once
menstruation ceases, some women do find out that they have hemochromatosis.
It's only a very small group in the population, but
it's very much worth mentioning that requirements fall away once
menstruation ceases. But as far as women sort of from

(15:09):
forty onwards going through and going through perimenopause, actually I
have some concerns right now that there's a tendency for
us kind of between about the ages of thirty eight
and fifty five. Any new symptom we experience, we blame
it on perimenopause. And when and I'm not denying that

(15:32):
it's not playing a role, of course it is. This
is not an are conversation. This is a very much
an and conversation.

Speaker 3 (15:37):
But when we.

Speaker 4 (15:38):
Say that something is because of perimenopause, what we're essentially
saying is we're blaming it. We're attributing those symptoms on
changing hormones. And that might be the case, but the
trouble with that is it might be due to iron deficiency.
The symptoms we're experiencing might be due to insulin resistance.

(15:58):
It might be due to fat liver. It might be
due to our thyroid not working as well as it
once did. And so we can miss biochemically or nutritionally
what's sitting there in the background by thinking it must
just be hormonal because of my age. And like I
said a moment ago, if we're not aware of something,
then we don't address it. So when the symptoms of

(16:19):
iron deficiency, an underactive thyroid and symptoms we're currently attributing
to perimenopause. There's a lot of overlap, and that's where
I am a fan of testing, because that's where the
insights can actually come and we can work on what
we're actually experiencing in our bodies.

Speaker 2 (16:35):
It's so good to hear you say that, because I
think we've mentioned this on every podcast we've done that
has covered off menopause or perimenopause. We've said, hey, look,
don't take it for granted that a symptom is perimenopause
or menopause. It's really important to still bring it up
with your doctor and get it checked out. And you know,
because we just sort of, you know, get on and

(16:56):
live with it, don't we when we sort of put
it on the list of symptoms.

Speaker 3 (17:01):
Frans And sorry, Louise.

Speaker 1 (17:03):
So I know so many women I had medical menopause
from chemotherapy, so I didn't have erratic periods. They just
winked there gone. But in peerim menopause, of course, there
can be huge amounts of blood loss through and erratic
periods and having periods more than once a month. So
you know, I think that peering menopause stages should must

(17:24):
be a risk a high risk for low iron.

Speaker 4 (17:27):
Yes, spot on, Louise, and thank you for raising that.
It is because, as you say, the pattern of blood
loss can significantly change. So for some women it doesn't.
It sort of just peters out. I've done lots of
interviews with women who have all had very different perimenopause
or transitions, and as you say, for some, the bleeding
becomes far more regular, and for some it becomes incredibly heavy.

(17:50):
They women can experience flooding, that is, you know, deeply
concerning some worry about going to work. I remember a
group of school teachers I interviewed describing situations where they've
had to hide in cupboards because they've suddenly got their
periods and the flooding and they don't want the students
to see. And so it can be almost traumatic and
traumatic at times for some women because of how heavy

(18:13):
that blood loss is. But you're right, it very much
then creates a state. If the iron deficient state isn't
already there, it can create that because of all of
that blood loss. So it is a time where we
need to be even more mindful of iron. And it's
interesting because iron deficiency can actually drive heavier periods until
we become in that fully anemic state, the iron deficiency

(18:36):
anemia more severe state, and that's when the body can
sometimes shut down menstruation in an effort to conserve the blood.
But a lot of women will experience heavier periods when
they are actually iron deficient.

Speaker 2 (18:49):
You're listening to the Little Things, and our guest on
the podcast today is doctor Libby discussing her new book
Affects Iron First. Will be back shortly. Welcome back, doctor Levy.
Why could our iron levels be low? There's various different

(19:11):
reasons for it, isn't it. It's not that we might
just not be eating enough iron.

Speaker 3 (19:15):
That's right. I think that is really important to highlight those.

Speaker 4 (19:17):
The first one, Francesca, is that we might not be
eating enough because I feel that we blow We can
blow over that too easily. And I remember speaking to
a lady who she said, I used to just have
coffee and banana bread for breakfast, and when she found
out she was iron deficient, she thought, right, well, I've
got to get rid of the coffee because caffeine can
inter sorry, the polyphenols in tea coffee can disrupt iron absorption.

(19:40):
And she started having either mussels or sardines for breakfast,
which I know is not everybody's cup of tea. But
my point is she made a real effort to increase
her dietary iron intake and had a great outcome from that.
So lack of dietary and take can certainly be a
contributing factor. Poor absorption, of course, comes next. The science

(20:01):
of iron absorption is actually so fascinating and I.

Speaker 3 (20:05):
Could probably talk to you underwater about that for the.

Speaker 4 (20:07):
Next two hours, but we won't bore your listeners with
me carrying on about that. But essentially, if you can
imagine that, for there are different types of iron hem
iron non hem iron, and then there's also a newer
form that's been used in good quality supplements called ferretin iron.
But first let's just talk firstly about the non hem iron.

(20:30):
And this is also the type of iron that's often
in synthetic based nutritional iron supplements. They're often bound to
a salt or a keolate, and so when we pop
that into our mouth and it lands in our stomach,
the acid, actually the acid in the stomach actually breaks
apart the iron itself from what it's bound to, and

(20:51):
then the iron reaches our digestive system and reaches the
outside of a gut cell. And on the outside of
a gut cell is a truck or a transporter. It
has a silly name that's abbreviated to DMT one, and
this type of iron has to hop on the back
of that truck to be taken inside the cell. But
the problem with that is that floods the gut cell

(21:12):
with a lot of what's called free iron, and free
iron can be very inflammatory. It can drive oxidative stress
and also drive some of the symptoms we associate with
some of those old school ion supplements, which is typically
constipation or nausea, certainly gut related symptoms. That type of
iron then needs copper, a copper related enzyme to get
it out the back door of the gut cell and

(21:33):
into the blood so it can go off and do
all of its crucial work. So there are a lot
of points in that absorption process where things can go wrong.
It's also another one reason why vitamin C is incredibly important.
We need vitamin C to absorb that non hem ion.
Calcium also blocks the absorption of that non hem ion

(21:53):
because they both use the same truck to get into
the gut cell and then there are other substances just
naturally present in food like fytates oxalates that can and
the tannins for example I mentioned in tan coffee that
can actually block iron absorption. So for some people that's
the key. Really recognizing those iron blockers and having iron

(22:15):
supplements or iron rich meals away from those iron blockers
that can make a difference. And then of course there
can be heavy blood loss, so whether it's from menstruation
as Luise mentioned or it can be it's rare, but
microscopic bleeds from the bow, for example, it can happen
in endurance athletes actually, so where there can be microscopic

(22:35):
bleeds from the bladder or the bowl can be another reason.
So finding out the why is one of the keys
I think in if you are iron deficient, finding out
why you are is very important. But for some it
actually is they're just not eating enough.

Speaker 1 (22:49):
How do we find out that why though beyond the
blood test?

Speaker 4 (22:52):
Yes, So once you have a blood test and find
out you're deficient, you then take steps to address it.
So if that's improving dietary intake or take a supplement,
you then want to retest to see if what you're
doing is actually working, and if it's not, then you
want to pursue further investigations because you've addressed the intake,
so then it might be for another example would be
that someone has undiagnosed Celiact disease. I know a number

(23:15):
of people who they've been my patients over the years
who have actually found out that they have Coeliact disease
because they had iron deficiency that just wouldn't resolve through
dietary change and supplementation. It can also be related to
a gut based infection. So here eco back to pylori.
So the infection we know is related to the development
of summer colses. It can be a parasite type infection

(23:39):
because those infective organisms sequestered the iron for their own use.
They love it to be able to so that they
can thrive. But then the human itself, the total human
misses out.

Speaker 2 (23:50):
It's so fascinating because it's not just about getting the iron,
it's what our body does with it. Then niques, which
is also placed just as much an important part in that.
There's a couple of things that I just want to
bring up on everything you said, mostly to do with Louise,
Doctor Livvy because the first thing Louise did say to
me was can I really not have my coffee with
my eggs?

Speaker 1 (24:11):
It was her biggest issue. Do I have to have
a kiwi fruit on the side?

Speaker 4 (24:15):
That would be so much better, Louise, if you want
to focus on.

Speaker 1 (24:17):
Line, okay, so watch the window with the coffee before.
How long before or after? I mean, I don't drink
a lot of coffee, but I have one coffee in
the morning and that's it.

Speaker 4 (24:27):
Yes, so ideally an hour if you can wait an.

Speaker 2 (24:31):
Hour, okay, Okay, you're getting a nod from our producer
as well. She's going, I can do that. That's fine.
Kiwi fruit. I've just decided I'm having one kiwi fruit
today and that's going to change my life. Is that
All I need is that the copper I need.

Speaker 4 (24:45):
So Kiwi fruits are little superstars as far as whole
foods go, because they don't just they contain vitamins. They
contain such a range of nutrients. Basically, there's an endless
list of nutrients they contain. We know they also have
very favorable impacts on gut bacteria. They can have even
anti inflammatory properties, So they are little superstars when it

(25:06):
comes to an inclusion in a regular way of eating,
absolutely doing a great thing.

Speaker 3 (25:11):
They're franchise, okay, one.

Speaker 1 (25:13):
Or two a day, just getting right down to us, up.

Speaker 3 (25:15):
To you, up to you.

Speaker 1 (25:17):
One's going to be special and they're probably also quite
good if you do have a little bit of a
constipation reaction to your iron supplement as well, because they're
good for that part of things too, aren't they.

Speaker 4 (25:26):
They're wonderful for the bell. Yes contain prebiotics and some fiber.

Speaker 1 (25:31):
So the other good ways of getting our vitamin C
and our vitamin A in that we need.

Speaker 4 (25:35):
So yes, and you mentioned it's beautiful, Francesca, thank you
for mentioning some of these gorgeous what we call cofactor
nutrients that are essential for healthy iron metabolism. So vitamin
A couple of ways we can get vitamin A directly
from things. It's a fat's voluble vitamins, So you'll get
vitamin A directly from things like cod liver oil or
those sardines.

Speaker 3 (25:55):
Again a little superstars.

Speaker 4 (25:57):
Because you're eating the liver of the sardine, the body
will convert beta carotene, which is found in all of
our orange.

Speaker 3 (26:03):
Fruits and vegetables.

Speaker 4 (26:05):
The body can convert that into vitamin A as well,
so and it will do that in an amount that
is usually very healthy for us. So having those carrots
has so many benefits as well. And you can see
that what we're talking about sort of well, I hope
that for listeners it doesn't feel complicated. It's just food,
and sadly, for too many people, the junk has essentially

(26:28):
infiltrated their everyday way of eating, and so just these
stock standard foods like carrot and kiwifruit aren't necessarily being
included on a regular basis, and we miss out on
so many benefits by sidestepping some of these. You know,
you wouldn't call it carrot a superstar really, but it
is because it brings it can bring so much to

(26:48):
our health.

Speaker 1 (26:49):
How would you eat your sadines on toast or just
block them down a lot?

Speaker 4 (26:54):
Yeah, on toast, chop them up and pop them into
an omelet. Some people have it just straight out of
the can and.

Speaker 2 (27:01):
Really sid really good for a mega threes and things,
isn't it exactly?

Speaker 4 (27:05):
Yeah, I've got so many benefits those little stuttings.

Speaker 2 (27:08):
The other thing that you were mentioning is endurance athletes
and we have one in the room. Louise's training for
a trail marathon at present, and I am her coach,
so I was I'm loving it. I'm just putting her
through misery. I was interested in reading about the iron
and exercise, especially around endurance style exercise. What does she
need to keep in mind because the iron isn't just

(27:31):
important as she's going about the exercise, but for recovery
as well, isn't.

Speaker 4 (27:34):
It It is Francesca and Louise, congratulations on even setting
the goal of doing this.

Speaker 3 (27:40):
It's brilliant.

Speaker 1 (27:41):
Thank you.

Speaker 4 (27:43):
So for endurance athletes need to be very mindful of
iron and their iron status because it will directly perfect
impact performance. There's increased iron loss when we train like
an endurance athlete or we are an endurance athlete, so there's.

Speaker 3 (28:00):
Losses through sweating.

Speaker 4 (28:02):
There can be microscopic blood loss from the bowl and
the bladder just through irritation. And also what's called foot
strike homolysis. So if people are training on hard you know,
on tar, on the road, on the footpaths, when you're heal,
when your foot strikes the ground over and over again
with all of that training, it can actually break red
blood cells open. So there are numerous additional ways to

(28:25):
the ways we've already talked about four endurance athletes to
be mindful of and reasons why iron status needs to
be monitored and any deficiency corrected. So estimates are that
if we training for an endurance performance, the iron requirements
can be up to one point time one point seven
times the RDI. So for you, Louise, your RDI is

(28:48):
eight melograms per day, so one point seven times that.
For a woman's across the menstruation years, we're obviously multiplying
eighteen meligrams by one point seven which gets us up
to about thirty meligrams per day, which is significant. Also too,
it's important to mention if someone eats in a vegan
or vegetarian way, we need to multiply their the RDI

(29:09):
for them, whatever age or stage of life they're at,
multiply it by one point eight. So for someone who
eats in a vegan way across the menstruation years, that
requirements up at around thirty two milligrams per day. But
back to that, back to athletes, it can obviously when
we're iron deficient. I'm depleted iron deficient and we are
training it can very much impact oxygen delivery to cells

(29:31):
and then, as you mentioned Francesca, our recovery. So some
studies of there have been many studies done looking obviously
at the importance of iron four women who and men
who train in this way, and both recovery and performance
are so far superior when iron status is robust, so
certainly one to.

Speaker 1 (29:49):
Watch out, all right. I mean, my longer runs are
going to be Saturdays, and my husband and I have
just started copying my appearance and having our stake night
on a Saturday because the kids a leftime. We can
afford to get a really lovely piece of steak. But
I'm probably having a red glass of red wine with that.
I guess that's the same with the coffee. I'll have
the glass of red wine an hour later.

Speaker 3 (30:09):
Do you know that? Well it is.

Speaker 4 (30:11):
But you know, I just want to keep this so
real world good on you and.

Speaker 3 (30:16):
Just relax and enjoy that.

Speaker 4 (30:17):
But yes, you won't be you won't be getting all
of the iron you could be.

Speaker 1 (30:21):
Yeah, yeah, and to be fair, the rest of the week. Yeah,
there isn't a lot of meat in my diet. It's
been like that for a long time. And actually when
I think about it. I have had time, so I've
been an emic. So if we are following a vegetarian diet,
if we're doing things like we're getting our our chickpeas
and our filaf for our hummus and that kind of thing,

(30:45):
and also then tofu timpai, that's the thing if you're
making sure you are supplementing it with a with something
that is rich and iron. Is that okay? Or do
do you just have to think about it a bit more?

Speaker 4 (30:57):
You usually have to think about it a little bit more. Yes,
So absolutely we can meet our requirements. But it's so
things because absorption is interfered with just too easily with
that non hem iroon. So when someone eats vegetarian, all
of their sources of iron is going to be non
hem and because of its decreased bioavailability, that's one reason

(31:19):
why the RDI is multiplied by one point eight. But
also when we eat in a vegetarian or vegan way,
there are more of those iron what we call iron
absorption inhibitors usually present the pytates the oxalates, because they're
present essentially in our vegetables. So that's why the RDI
is increased and you won't necessarily require a supplement if

(31:41):
you do eat in a vegan or vegetarian way, but
it is more common. It is quite common for people
who eat that way to require an iron supplement across
the menstruation, you certainly, or if they're training like an
endurance athlete.

Speaker 1 (31:52):
Yeah, I don't really think that. If people are listening
and they are concerned about particular teenage daughter, then they
you know, so, I totally agree with you. They follow
things like the girl's dinner or whatever it was that
was trendy for a while, just a piece of cheese
and a cracker kind of thing, and a lot of
these girls are really really active. I would be testing them,

(32:14):
but I mean, particularly if they're showing symptoms. I'm thinking
of my daughter who was chronically sleepy. Wasn't she friendships
get through teenage? Yes? Actually still is. Might singer along
for an iron test.

Speaker 2 (32:25):
I hope we'll be doing a group group testing doctor
Lebby's supplements. Not all supplements are equal, and especially in
New Zealand where we do not have good regulation when
it comes to our supplements. If people are listening to
this podcast and they're going, you know what, I've been
thinking about this. I've got a lot of these symptoms

(32:45):
and they're taking those off the list and they just
head to, you know, a local pharmacy or something and
grab an iron supplement off the shelf and tear into it.
Is that going to do anything or do you need
to do a little bit more investigation and do you
need to know you know more about the dose and
the product and the quality of the product and things.

Speaker 4 (33:02):
The latter Francesca, Yes, So they're like everything, there's great
quality things available and lousy quality things available. And then
there's also what I would call bioindividuality, so in other words,
the way your own unique body is going to respond
to something. So our body always gives us feedback when
it's letting us know that something is either wonderful for

(33:23):
it or not so wonderful for it. And certainly gut
related symptoms are one of the very common side effects
of lousy quality iron supplements, so constipation especially, and I've
had many many women over the years say to me,
I would rather be iron deficient than constipated, so they
just don't address their iron deficiency for that reason. So,
as I mentioned, typically the type of iron in most

(33:46):
iron supplements are synthetic, and they will flood the gut
cells with that free iron, which can drive inflammation and
oxidative stress and might necessarily be taken.

Speaker 3 (33:56):
Up into the blood.

Speaker 4 (33:56):
And obviously, for if you can imagine that inside of us,
there what's called the total iron pool, and what we eat,
or the iron we eat or consume through supplements, goes
into that total iron pool. But then also our red
blood cells they only live for one hundred and twenty
days and get a load of this. This is mind blowing,
and I'll relate it back to supplements in two seconds.

(34:18):
But every single second, our body is producing two and
a half million new red blood cells, and inside every
single one of those there's iron. And then they only
live for one hundred and twenty days, but the iron
inside of them is still perfectly good, and the body's
extraordinary and it doesn't waste anything. So it donates the
iron inside the red blood cells back to this total
iron pool, so that iron can then be distributed where

(34:40):
it needs to go. And so the goal of anything
any iron we consume is to get it into this
total iron pool. And as we mentioned, those cofactor nutrients
like copper and vitamin A are very important to be
able to actually get any iron we eat or take
through a supplement in there, so a supplement that contains
those cofactors can be very very helpful for its absorption

(35:01):
as well and for full transparency.

Speaker 3 (35:03):
And you kindly mentioned this in the beginning.

Speaker 4 (35:05):
I have a supplement company called Bioblends, But the difference
is it's all made from food, and we actually have
been I've spent eight years developing an iron supplement and
it uses really groundbreaking technology to extract what's called ferretin
iron from organic peas. And the ferretin iron is so
unique that when we swallow it, ferretin is a protein cage,

(35:27):
and inside that protein cage of thousands of molecules of iron,
and it actually gets through the stomach acid and is
delivered to the gut intact, and a gut cell takes
it in whole through its own unique absorption mechanism could
receptor mediated endocytosis, which no one needs to remember as
such stupid word, but it just essentially takes the ferretin

(35:48):
cage with the iron inside it inside the cell and
the gut cell is not exposed to free iron, so
there's no inflammation or oxidative stress and therefore none of
those gut related side effects, and then it's delivered so
beautifully to the blood. So the clinical trials that have
been done using ferritinin are exceptional into a great difference
and very speedy recovery for women with iron deficiency anemia.

Speaker 1 (36:08):
So I'm so pleased.

Speaker 2 (36:10):
I'm so pleased that you brought up the red blood
cells because my admiration for red blood cells has increased
massively since reading this book. They are just incredible. I mean,
I had no idea that we could recycle iron in
our bodies from old or injured red blood cells. I
found that that whole sort of chapter absolutely fascinating, And

(36:30):
just on.

Speaker 1 (36:31):
That a question I had actually was, so Mayo's husband
donates plasma fortnightly and they test as iron every single
time with a fingerprick test. Is that why don't we
do that?

Speaker 4 (36:43):
So it is less accurate than an actual blood test,
but it's obviously a very quick and efficient way. So
it's the most accurate insight you'll get, is if you
actually go to pathology and have I was going to
say an old fashioned type of blood set, but just
a stock standard type of blood test the fingerpricks are
getting there. They're not as reliable with the information as

(37:06):
the venus.

Speaker 1 (37:06):
Supply, but they would show if someone was really really
low and couldn't give.

Speaker 4 (37:10):
Absolutely yeah, and that's all and so and then that
moment for your husband. That's all they're checking is to
make that it's not through the floor.

Speaker 2 (37:17):
Okay, so we've done our taste, we know that and
we may have an issue with iron. We've found a
good quality supplement. Do we rely on adoptor to tell
us what kind of dose we need and what we
should be taking or a MetroPath so.

Speaker 3 (37:30):
Well, it's one reason I wrote Fix Iron first.

Speaker 1 (37:32):
Or your book There we Go, so that.

Speaker 4 (37:35):
People almost had just an educational tool at home, so
they can look up very in a very straightforward way
what their requirements are.

Speaker 3 (37:42):
There's a list of foods there to show you.

Speaker 4 (37:45):
How many milligrams you get from eating a certain amount
of food and really taking charge of it. So then
when you do get blood tests back, I encourage people
to get copies of their own blood tests so they
can actually see where their levels are at because in
my clinical experience, so ferretin, for example, is our iron
storage a measure of our iron storage, and the normal

(38:06):
range in New Zealm pathology labs for adult women is
twenty to two hundred and twenty micrograms per lieter and
in my clinical experience, and there's certainly literature supporting this,
that bottom number is too low. Once ferretin goes below
about fifty, a lot of women experience symptoms.

Speaker 3 (38:23):
And so when you know you might have.

Speaker 4 (38:25):
Blood tests and your ferretin's twenty two and you told
everything's fine, but usually you won't feel fine when that's
the case, and so pursuing a ferretin that's certainly at
a minimum of fifty, but a lot of women feel
better when it's more like eighty or per some even
feel better when it's at one hundred.

Speaker 3 (38:41):
That's something to be mindful of.

Speaker 4 (38:43):
And the other one to have a look for it
when you do get blood tests done is transferin. So
transferren goes high in iron deficiency and iron deficiency anemia.
And that can sound confusing because you see the letter
H for high on a blood test related to iron.

Speaker 3 (38:57):
And you think, oh, maybe I have too much.

Speaker 4 (38:59):
But not with trans because it's a taxi that drives
iron around, so your body will produce more taxis in
an attempt to pick up more passengers, the passengers.

Speaker 3 (39:08):
Being the iron.

Speaker 4 (39:09):
The body will make more transfer in to try to
get more iron. So elevated transferring is almost like iron hunger.
So that's another indicator that your body is seeking more iron.

Speaker 2 (39:20):
Doctor Lebby, you've written a lot of books about women
in our lifestyle and our lives and things, and we
know that fatigue is such a big issue for women,
especially when they're heading into the middle age. What if
you get your iron tested and you are one hundred
percent sure that this is going to be the answer
to everything, because you take every box and you get
your result back and your iron is absolutely fine. I'm

(39:41):
wondering what else we should be thinking about. And look,
I'm going to be really honest with you. I bought
on my latest test just because I was like, this
is too good an opportunity not to do it. To
be fair, this is a month or two old. But
I have always been sure that a lack of iron
is going to be the answer, and it never is.
My ferretin is turned thirty nine, so I'm worried I've

(40:02):
got too much. I've got too much on. Are you
still menstruating occasionally, very rarely, but I'm not in menopause.

Speaker 3 (40:10):
Yet, okay.

Speaker 4 (40:11):
And do you have any inflammation, any inflammatory type things happening.

Speaker 2 (40:16):
Yes, I've had an issue with a knee, which might
the listeners will be going, oh, do not go on
about the knee again. Yeah, I just had random swelling
of knees.

Speaker 3 (40:24):
Okay.

Speaker 4 (40:25):
So when there's inflammation, it can falsely elevate ferretin. It's
why testing ferretin on its own is never is not
a good idea because if all we test is ferretin,
then we we're not going to know. We don't get
enough of a picture to know what's happening with someone's eye.
And so when there's inflammatory, something inflammatory going on in
the body, whether it's injury or illness, then it can

(40:48):
falsely elevate ferresin. So I'm not suggesting that's the case
for you, but it might be Francesca. So you're your
number of two hundred and thirty nine, your actual ferretin
might be one hundred, for example, it might not actually
be that high.

Speaker 3 (41:00):
Be worth monitoring.

Speaker 2 (41:01):
I feel like we're going to be having mother and
daughter trips to the doctor for some blood test. But
look what else if it is an iron what else
should women just be thinking about when it comes to fatigue?

Speaker 4 (41:11):
So thyroid function, because as we so, lots of things
can contribute to our thyroids starting to underperform. You don't
have to have a thyroid disease like Hashimoto's thyroiditis for
your thyroid to not be performing as well as it
once did. So TSH is a hormone made by the
pituitary gland, and it's the signal that calls out to

(41:33):
the thyroid gland to get it to wake up and
make its hormones. And we can have if our test
results are inside normal ranges, that's wonderful because it means
we don't have a disease. But sometimes those test results
are skewed in one direction, so the thyroid might need
more attention the nutrients the thyroid needs iodine, selenium, iron,
and zinc. The thyroid also loves progesterone, which we make

(41:58):
a lovely big surge of progests thrown after we ovulate.
It doesn't love excess amounts of estrogen. So there can
be a sex hormone picture contributing potentially to what's happening
with the thyroid. For some people, they notice their thyroid
starts to underperform or becomes fully underactive after a virus,
so they might have had glandular fever which is epstein

(42:19):
bar virus, and that's when thyroid, the thyroid starts to
trouble them. And the reason I bring up all of
these different scenarios because it harks back to that idea
I shared earlier about the road in is the road out,
So we want to know what's creating that. So it
can very much be an underperforming thyroid that's driving the fatigue.
It can also be what I can just simply say, burnout,

(42:39):
which is what I call stage three stress. So stage
one stresses where adrenaline elevates. So that was supposed to
be short lived for us as humans, because we only
ever made adrenaline when there was a threat to our
life and we pushes us into that fight or flight response,
and that was supposed to be just momentary. So we
fought the fight or ran away, fully survived, and then

(43:01):
it might have been another three weeks or three months
before we surged adrenaline again to try to save our
own life. Whereas now for a lot of people, the
majority of the adrenaline they produce is due to psychology,
so it comes from thoughts or from everyone block your ears.
Caffeine leads us to produce adrenaline. So whatever it is
that leads us to make adrenaline, it is what I

(43:22):
call stage one stress, and it was supposed to be
short lived, but we tend to do it every day
now and that then creates all sorts of inflammatory compounds
of its own and pushes this into what I refer
to as stage two stress, which is when we then
produce more cortisol because one of its jobs is as
an anti inflammatory, So the cortisol's trying to settle the
inflammation down, and some people stay in that stage two stress,

(43:46):
whereas other people can't withstand that the demand on that
production of cortisol, and then they move into what I
call stage three stress, which is essentially burnout, where the
petuitary is signaling to the adrenals to produce cortisol. The
adrenals can't make enough to meet demands, so then we
start to get conditions of inflammation unfolding. We feel very

(44:07):
stiff in our body. You might wake up in the
morning and feel like you've aged twenty years overnight, so
and all, we can recover from all of that, but
it's knowing what's creating that deep burning fatigue in us
and addressing what's causing it in us.

Speaker 2 (44:20):
Doctor Livy, I want to finish with a great quote
from your book, one of many, and wondering if you
could talk to it. Your health isn't built in grand gestures.
It's shaped by the quiet, consistent choices you make every day.
It's not about being perfect, but about choosing again and
again what truly nourishes and supports you.

Speaker 1 (44:37):
I just love this.

Speaker 3 (44:38):
Thank you. I'm so glad that touched you.

Speaker 4 (44:42):
Got tiry when I put pen to paper writing that
to be honest, because I feel there's a lot of
truth in it, and I would it shows us too
that we don't have to be perfect. So the red
wine with the meat that Louise is relishing, you know,
in her husband's company on a Saturday night, we don't
necessarily need to focus on our own and at that meal,
that's about enjoying the privilege of that meal and the

(45:04):
connection with your husband and relaxing on a Saturday night
after your big training day. So it's my point is
it's what we consistently do that creates our health. It's
not about pursuing perfectionism, but nor is it about not caring.
So there's this beautiful I think beautiful health unfolds in
that space in the middle and related to what we
consistently do.

Speaker 3 (45:24):
And it stems from.

Speaker 4 (45:26):
I think, to having a little bit more awareness of
the wonder of our body of living, a little bit
more in touch with Awe and wonder of essentially the
privilege that we get to be here on earth.

Speaker 1 (45:38):
I love that. And yeah, one of our previous gussle
of a book when kind of you know, had the
same attitude of its gratitude. But it's just being present
to enjoy what's around us and accepting what we can
and can't control. I love it. We read the book
secretly and made our own notes, and I made the
same I made the same kind of thing to make
sure that we included that, because it really is what

(45:58):
it's all about.

Speaker 2 (46:00):
Fact, Doctor Libby, thank you so much for your time.
Cannot thank you enough, appreciate it immensely.

Speaker 3 (46:06):
Thanks, I'm so touched.

Speaker 4 (46:07):
Thank you so much for having them for this wonderful conversation.

Speaker 1 (46:21):
So I thought that I had learned a lot during
the book, but I actually that just added and solidified
everything that she had written about. It's a really good read.
She is excellent at just explaining things in a way
that you can't help but understand.

Speaker 2 (46:37):
Oh no, an incredible communicator, and it was quite interesting.
When we've sort of finished our chat, we were just
sort of saying goodbye, and doctor Libby said, do you
know what, when I was growing up in the seventies
and things, it was really normal to test your iron.
It was just expected we do this. And as she
has sort of implied, we've become fascinated. We jump on

(46:58):
trends of being obsessed. And we've done this with our
protein or our fiber, or getting our magnesium or vitamin
D and all these other things, and sometimes we forget
the basics. And that's what I really like about this book.
I think it's definitely worth having a read to get
your hit around the symptoms. I was actually quite taken
back at the fact that I had not thought about
this for my daughter, who does have to get regular

(47:18):
blood test that absolutely must go in the mix. Quite
a specific situation where but I'm hoping that that might,
you know, for a few other parents out there, they
too might have gone or hang on a minute, maybe
that's something I should be thinking about as well.

Speaker 1 (47:31):
Same with your boys. If they're fascy eats, Well, yeah
it's a moody. It's not just a girl thing. No,
it's just one of those check things like you say.
I think it was just part of our conversation when
were younger. Somehow iron's falling out of vogue.

Speaker 2 (47:42):
Do you remember when I don't know if you did this,
but when when the kids were babies, I was making
chicken of a patai and.

Speaker 1 (47:48):
Things for them. It just stopped. Yeah, I don't know.

Speaker 2 (47:53):
You've had your years worth great not making that anymore.
I don't know why that stopped.

Speaker 1 (47:56):
And I don't know. And I don't remember my midwife
talking aou Actually Proba did, but I don't remember that
conversation and pregnancy either.

Speaker 2 (48:02):
But I also really appreciated doctor Libby then at the
end of our conversation having a talk about fatigue in general,
because for me it always was the fatigue. I'd feel
I would just go, this has to be something. This
fatigue is just so overwhelming. It can't be nothing. It's
got to be on And then I get the aunties
back and it's strangely high. It's always been strangely high.
Actually I'm going to investigate that. But it was nice

(48:25):
to hear who just talk about fatigue in general and
other things that we can if you're in that same
situation as I am. Now you've got a few more
steps to go down to know how to deal with.

Speaker 1 (48:34):
Fatigue, right, and all the syro talk as well, because
I feel like that's coming up in conversation with women
that I know around our age, and again again emphasizing
that not every single perimenopause and menopause symtom should just
be put down to that worth getting things checked out.

Speaker 2 (48:50):
And hey, remember the other thing too is what I
just loved what doctor Libby said at the end. She said,
you know, live your life, be aware of these things,
help yourself out a little bit, but you don't need
to turn your whole life upside down, your whole diet
upside down to get on top of this. Just you know,
if it's get a test and they need a couple
of giving fruit and some sadines and you're off and rolling.

Speaker 1 (49:12):
I really like that attitude very much.

Speaker 2 (49:14):
So look, something that we thought that we would do
this season on the Little Things at the end of
each episode is just mentioned a really small little thing
that lou and I have done during our week, just
to cheer us up a little bit. We're sort of
we're still in winter and it feels like it's been
a long year and sometimes you just need to sort of,
you know, you need a little pick me up, pick

(49:34):
me up. What's your suggestion for the week.

Speaker 1 (49:36):
I had a couple of things, but after this conversation,
I've actually decided to go with the food bag. I
picked up doing the food bag again because I haven't
been doing it for years and I needed something to
take them into a load off thinking about it, and
then I did it, and then I moaned, I said
it was too expensive, and then you reminded me, and
my sister reminded me it's about It's not just about

(49:58):
the food. It's about that, and then I went, wow,
I just can't and so and the reason I thought
about that was, I think there's carrots and everything. I'm
doing quite a heavy vegi one, but they are balanced
me all, so I know what I'm getting. It shows
me what the protein is, It shows me what what
minerals are in there and these carrots, and just about
every single meal.

Speaker 2 (50:18):
I'm just gonna start munching carrots, carrot, mcare me fruit,
and I'm sort of what about your franchisc my. I
got my idea from the New York Times. I did
this recently on another gray, rainy day in Auckland, when
I was a bit fed up. I've done a serotonin playlist,
so I jumped on Spotify. It's called my serotonin list.
It features those songs that it doesn't matter what is
going on in your day or what is going on

(50:39):
in life. When you put those songs on, just reminds you,
I don't know it just everything drops away, reminds you
you can just rock on. Nothing's a problem.

Speaker 1 (50:48):
Love.

Speaker 2 (50:48):
These songs put you in a good mood, so I have.
It's interesting, though, songs are going on and off this
playlist like you wouldn't believe. I'm like, no, that one
doesn't quite motivate me as well as like I thought
it would. So yeah, do a serotonin playlist. Find those
songs that you've always loved, that always put you in
a good mood, that just take you out of yourself,
take you out of your head and make yourself a
playlist that you flick on when you're sitting in really

(51:09):
shitty traffic going why does it take me an hour
to get home?

Speaker 1 (51:13):
That seems like a wonderful IDEO. I'm going to try that.

Speaker 2 (51:17):
Thanks so much for joining us on our new Zealand
Herald podcast series for the Little Things. We hope you
share this podcast with a woman in your life so
that we can all, you know, have a little bit
of energy to get through the day.

Speaker 1 (51:25):
You can follow this podcast on iHeartRadio or wherever you
get your podcasts, and for more on this and other topics,
head to inseet Herald dot co dot inset.

Speaker 2 (51:34):
I'm okay to next time on The Little Things.