As South Africa wraps up Mental Health Awareness Month this week, health experts are drawing attention to a surprising connection, one that links something as simple as iron levels to how we think, feel, and function every day.

According to Sister Karin Davidson, anaemia advocate and head of the Cape Town Infusion Centre, low iron stores can directly affect mood and cognitive performance.

‘So many people don’t realise that iron plays a vital role in producing serotonin, dopamine, and norepinephrine, the neurotransmitters that regulate mood, sleep, focus, and emotional stability,’ she explains.

‘When iron levels drop, these crucial brain chemicals cannot be produced adequately, leading to mental health challenges that are often misdiagnosed or overlooked entirely.’

A growing concern in South Africa and beyond

The World Health Organisation (WHO) reports that anaemia affects around 1.62 billion people worldwide, roughly a quarter of the global population.

In South Africa, the figures are especially alarming. National surveys show that between 29% and 61% of children under five are affected, with one-year-olds being the most vulnerable at 52%.

Family on beach holiday
Picture: Supplied

‘The reality is that babies born to iron-deficient mothers are iron deficient from birth,’ says Sister Davidson. ‘Unless this is corrected, these infants are set up for a life potentially fraught with physical and mental health struggles, and it is so easily tested for and treated.’

Across sub-Saharan Africa, the WHO estimates that 43% of women of reproductive age and 40% of adolescent girls are anaemic. ‘Adolescents are vulnerable to mental health struggles. Add low iron stores into the mix and you have a potentially devastating perfect storm that is so treatable,’ Davidson adds.

‘These aren’t just numbers,’ Davidson stresses. ‘Each represents a person likely struggling with physical and mental symptoms that impact daily functioning, relationships, and quality of life. The tragedy is that with proper screening and treatment, these outcomes are entirely preventable.’

Research continues to highlight the strong link between iron deficiency and mental health challenges across all age groups:

Children and adolescents: ‘Iron deficiency can fundamentally alter how young people experience the world during crucial developmental years,’ Davidson explains. ‘We see young children struggling to function at school or regulate their emotions, teenagers too exhausted to socialise, too foggy to study, and too irritable to maintain healthy relationships.’

Adults: Low iron levels often appear as anxiety, restlessness, low mood, and poor concentration. A 2020 study found that individuals with iron deficiency anaemia faced significantly higher risks of psychiatric disorders. When iron drops, the brain can experience apathy, irritability, and lack of attention.

Older adults: For seniors, symptoms are often mistaken for normal ageing. ‘So many patients and families accept declining mental sharpness, persistent low mood, and crushing fatigue as inevitable parts of ageing,’ says Davidson. ‘When we check iron levels and correct deficiencies, we regularly witness remarkable transformations.’

Additionally, sleep and mental health are deeply intertwined, and iron plays a role there too. ‘Poor sleep and insomnia are common symptoms of low iron stores or anaemia,’ Davidson notes.

‘When iron stores are low, it’s an enormous challenge for patients to get the rest they need. Once their iron deficiencies are addressed and treated, the difference can be life-changing.‘

Sister Davidson warns that iron deficiency is often mistaken for stress, burnout, or depression. ‘People adapt to feeling suboptimal, accepting brain fog and fatigue as normal, when a simple blood test and treatment could transform their lives,’ she says.

Physical symptoms may include:

Persistent fatigue despite rest

Headaches, dizziness, or shortness of breath

Pale skin, cold extremities

Hair loss or brittle nails

Restless legs, insomnia, or heart palpitations

Mental health red flags include:

Low mood or depression

Sudden anxiety

Irritability or mood swings

Brain fog, poor focus, or memory issues

Apathy or emotional detachment

‘Mental health symptoms matter. Fatigue is not normal. Brain fog should not be accepted as part of daily life,’ Davidson concludes.

‘If you’re struggling mentally or emotionally, checking your iron levels could be the key to reclaiming your vitality and wellbeing. Ask your doctor to conduct full iron tests, not just haemoglobin tests.’

The Cape Town Infusion Centre continues to raise awareness and offer treatment for iron deficiency and anaemia, aiming to empower patients and improve their quality of life. For more information or to book a consultation, visit www.capeinfusions.co.za

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Picture: Cape Town Infusion Centre/Supplied