I've been a vegan for a good portion of my adult life. From 2016 to 2021, I avoided all animal products and loved them. I started cooking more, I was free from food guilt, and I survived the irresistible boom in vegan products.
My parents had some concerns about the health implications, as headlines touted the risk of developing various deficiencies when adopting a vegan diet. But I was in my mid-twenties, so I was both rebellious and confident. I ate lots of plant-based protein, cooked a lot at home, ate foods rich in fiber and iron, and took trips to Holland & Barrett to buy vitamin D and vitamin B12 supplements. I was doing everything right, so how could I be wrong?
I spent my late teens and early twenties struggling with anorexia and then bulimia, and had a complicated relationship with restrictive behaviors. Perhaps ironically, going vegan was a huge step for me in letting go of many food anxieties and reducing my urges to overeat. As long as you were vegan, you could eat it, no matter how “healthy” it was. And because I wasn't restricting, overeating didn't turn into binge drinking.
But I vowed that the moments I felt myself tense up against the limits of my lifestyle, I would listen. In 2021, that call came in the form of a lockdown fried egg, and I haven't really looked back since. I started eating eggs, then dairy, and eventually meat again. Quitting the vegan lifestyle was primarily a psychological choice.
While doing veganism, I really struggled with my energy levels. I had a period in my early 20s when my iron levels were very low (also due to an eating disorder), so I was aware that this could be a factor. But my lethargy is the result of low-level depression from struggling to find my place in the world in jobs that are too boring or that I don't want too much to do with my interests. I thought it was also true. (I often dismissed it as a hangover.)
Sure, it could be because of my iron levels. But I didn't look too closely because that would be admitting defeat for vegans. I have taken iron supplements before and will take them again if needed.
Then, as I began to transition from vegan to vegetarian to pescatarian and finally to full-fledged meat eater, I felt my energy levels begin to rise. It wasn't a huge leap forward – in a fun twist I developed OCD and the constant panic caused a new round of spicy fatigue – but it was enough to be noteworthy. But is it completely resolved?
The first year after I started eating meat again, I don't remember, but for journalistic reasons, I went to Harley Street for a full body scan and was told I had low iron stores.
This is different from anemia (sometimes known as non-anemic iron deficiency), which is not so severe as to mean there is not enough iron in the blood itself. But that meant that if my iron became depleted for any reason (during my period, not getting enough iron, etc.), I wouldn't have enough to get it back. This is the most common cause of anemia.
Non-anemic iron deficiency is surprisingly common (may be three times more common than iron-deficiency anemia, which affects 2 to 5 percent of adult men and postmenopausal women) and is It may be an under-recognized cause of fatigue in women. . Dr Sue Pavoud, consultant haematologist and president of the British Society of Haematology, says this is an early stage of iron deficiency, in which “iron supply to other cells in the body such as the brain, heart and muscles is reduced, but red blood cells “If there is a shortage,” he explains. Production is maintained so that the body's tissues receive sufficient oxygen. ” If untreated, it can lead to anemia.
However, because it is difficult to recognize (diagnosis relies on a specific combination of tests to eliminate lack of reliability), it is “less recognized by clinicians.”
I remember the Harley Street doctor flatly asking if I was vegan. I said I wasn't (which was true) but sheepishly added that I had been doing that for a long time. As if he had expected this, he sighed and connected my iron deficiency to the symptoms I was experiencing, including fatigue, decreased productivity, and poor memory.
Although there are plant-based sources of iron (called non-heme iron), the only way you can get heme iron is through animal foods. This is important because heme iron is much more easily absorbed and stored by the protein ferritin. So even though I was taking vitamins and minerals during my vegan period, I was depriving myself of something important. Even if you take supplements for a short period of time, the iron supplementation won't last long.
At first I was embarrassed and felt like I had to apologize, but then I started to stand up for myself on behalf of former and current vegans. However, I was reassured that although I still felt like I was running on empty, I was technically fine. My Harley Street doctor told me to focus on getting iron through my diet, as well as start taking appropriate supplements (in pill or liquid form).
After that, I tried really hard. For a while, I took the vitamin supplement Floradix, which stains my teeth and makes me constipated. I took the prescribed ferrous fumarate, which made my constipation worse and my stools darker, but had no other noticeable effects. Eating more meat containing heme iron will improve the absorption of other non-heme iron in your diet (thanks, spinach). I wanted to order a blood test from my GP but thanks to the lockdown there was still a backlog and the process was delayed so I had to trust the process instead.
After a few more months, I thought I was fine when I successfully donated blood and passed the famous iron test (I can't have blood drawn because I risk fainting if it falls below a certain level). However, before long, I felt the feeling of fatigue creeping in again. When I had it checked (by 2022 and 2023, the coronavirus backlog had been cleared), the results were low but normal and no further action was required.
By the beginning of this year, at age 31, I assumed that no matter what I did, low-level fatigue was just a fact of modern life. It wasn't consistent enough to be a major cause for concern, but I would often find myself completely exhausted from the most normal activities. It manifests itself in strange ways. Long runs can be comfortable, but squatting for 5 minutes can make you tired. Once I started moving, I felt like I could keep going, but doing individual tasks ironically felt like I was running a marathon.
I knew it wasn't depression because unlike when I was in my 20s, I could still feel every emotion. I stopped drinking, exercised regularly, and was eating well. The anxiety disorder that dominated my late twenties has now become manageable background noise. But no matter what I did, it just happened out of nowhere and didn't seem to have a pattern. During a visit to my GP, I was prescribed iron supplements, but they had no effect in tablet form, even when taken continuously.
My wife got tired of me complaining and brought home some horrible Floradix that blackened my teeth. I forced her hand in and this time it felt like the supplements were clicking on a light bulb. Despite working long hours and constantly managing a puppy, I had the energy to do endless chores, concentrate to complete tasks with ease, and be able to stand up at the moment I was asked. It felt surreal to know that other people lived like this too.
Dr. Pavor says that a vegetarian diet “can have short-term and long-term effects on iron stores if you don't take iron supplements.” Although an iron-rich diet helps maintain good iron stores, it is not possible to correct established iron deficiency through dietary intake alone. ” These eating habits and my lackluster approach to supplements may be why these symptoms lasted so long.
In addition to iron, Floradics may be effective because it also contains vitamin B12, which is not found in plant foods. Perhaps it's a result of both, along with other lifestyle changes. But it's clear that I still haven't fully recovered from the effects it had on me.
Two years of anorexia may have made my menstrual cycle more susceptible to this effect. But perhaps five years of being vegan has solidified iron deficiency as a problem I have to constantly be on the lookout for.
I'm a little embarrassed to admit this because I don't want to criticize vegans. Actually, it's not veganism's fault. She was careless about her health and of course being a woman is my fault. Veganism has only removed an already deteriorating reserve, and now it's my responsibility to make sure it's replenished.
Learning that you can be affected by iron deficiency even if you're not anemic and doesn't show up in your hemoglobin levels was a new discovery. I'm feeling tired right now, but that's normal. You can stand up when needed and focus on what's in front of you. The reason I want to take a nap is simply because I went for an early morning walk with my dog, and now he's dozing on my leg.
But it's easy to backtrack. Fatigue and decreased concentration can make it difficult to notice fatigue and decreased concentration. So from now on, I'm gearing up with iron supplements and steaks, and I hope I can fight the creeping iron deficiency again soon.
