Is It Perimenopause or Iron? Understanding Midlife Fatigue and Low Ferritin

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Most women in their 40s are told their fatigue, brain fog, and low energy are “just hormones,” but iron deficiency is often the missing piece. In this episode, we explain why iron status plays a critical role in energy, focus, and overall performance in midlife.

Family physician DR. TASH MIRANDO joins us to unpack how iron functions as the body’s oxygen transport system, why low ferritin can look like perimenopause, and how to interpret blood tests beyond “normal” ranges. We discuss when nutrition and supplements are enough, when medical treatment is appropriate, and how to build sustainable habits that support long-term health and vitality.

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CHAPTERS

00:00 – Episode Snippet

00:55 – Introducing our guest, Dr. Tash Mirando

07:10 – “Normal” vs optimal iron levels

13:20 – Iron, thyroid, and common deficiencies

19:00 – The six pillars of lifestyle medicine

20:42 – Sponsor Break: Cozy Earth

21:40 - Fuel Your Forties: Heme vs non-heme iron and absorption