Iron & Melanin
The deficiency that goes undiagnosed in too many women of colour.
Iron deficiency is the most common nutritional deficiency in the world — and in women of colour it hides in plain sight. Symptoms are dismissed as busy lives, and blood work is read against reference ranges that were never calibrated for darker skin tones and different baseline norms.
Why it hides
Fatigue, brain fog, hair shedding, breathlessness on stairs, cold hands, restless legs — iron deficiency wears the costume of ordinary life. In Black, South Asian, and other women of colour, research consistently shows higher rates of deficiency and anaemia, alongside lower rates of diagnosis and treatment.
Part of the gap is clinical: pallor — the classic textbook sign — is harder to see in melanin-rich skin, so clinicians rely more on labs. Part of it is structural: symptoms in women, and especially in women of colour, are more often explained away rather than investigated.
Know your numbers
Do not accept 'your bloodwork is normal' without seeing the values. Ask specifically for: hemoglobin, ferritin (your iron storage — optimal for energy is often well above the lab's anaemia cutoff), and transferrin saturation.
Ferritin is the number most often missed. You can be firmly inside the 'normal' range yet iron-deficient by every functional measure — and still feel exhausted.
Building iron back
- Pair iron-rich foods (lentils, beans, red meat, dark leafy greens) with vitamin C — it can multiply absorption.
- Keep tea and coffee an hour away from iron-rich meals; their tannins block uptake.
- Cook in a cast-iron pan — a small, real, free contribution.
- Supplement only with guidance: dose and form matter, and retesting confirms what is working.
You are not 'just tired'. Your fatigue has a name, a number, and a treatment — and you have every right to ask for all three.