by Joannie Almonte, NP-BC
You feel perpetually exhausted despite what you do. Not the kind of exhaustion that adequate sleep fixes, but a deep fatigue that persists through every meeting, every workout, every power nap, every moment with your kids. You blame the pace of modern life, but is it?
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The Quiet Epidemic
Anemia is a condition in which a low level of hemoglobin is available to carry the oxygen necessary to fuel the body. Depending on the severity, the low levels may go unnoticed for months or even years. Multiple causes of anemia exist, but low iron often constitutes the leading, yet most preventable contributor. As a vital mineral, iron assists in making hemoglobin, the protein in red blood cells responsible for bringing oxygen to your cells. Therefore, low levels of iron can have profound effects on the body. Anemia affects nearly one in three women of reproductive age (15-49 years) worldwide. The reasons, often painfully straightforward, may include iron deficiency caused by monthly menstrual blood loss, the enormous iron demands of pregnancy, and modern diets that routinely fall short of the 18 milligrams of iron women need each day.
If you are Black, Latina, or Afro-Latina, your risk for developing anemia is even higher compared to other groups. These disparities, driven by factors including diverse dietary patterns and direct access to healthcare, also include a higher prevalence of conditions like uterine fibroids. Fibroids, defined as noncancerous tumors, may cause heavy, painful menstrual bleeding and have a higher prevalence in Black women.
Bariatric surgery embodies another important and overlooked risk factor of anemia. Even when taking oral supplements, patients may still become deficient. Following weight loss surgery, the body may no longer effectively absorb essential nutrients like before. Additionally, low folate, low vitamin B12, chronic inflammatory conditions, and inherited blood disorders like sickle cell disease or thalassemia can also drive hemoglobin down. Sickle cell affects approximately 1 in 10 African Americans, and thalassemia trait is common among people of African, Caribbean, Mediterranean, and Latin American descent. These conditions can cause mild anemia on their own and further lower hemoglobin levels when iron deficiency is also present. The point is this: anemia is not one disease. It is a signal, a red flag that something deeper deserves attention.
Recognize the Signs
Often mistaken as part of the hustle and bustle of everyday life, the symptoms of anemia may include persistent fatigue, breathlessness climbing a flight of stairs, and a racing or pounding heart especially with exertion. Brain fog, headaches, and dizziness that come and go without explanation, as well as pale skin, brittle nails, thinning hair and unusual cravings for chewing ice, clay or even starch may also manifest.
Sound familiar? A simple blood test, a complete blood count and a ferritin level, can reveal whether anemia is the silent thief.
What You Can Do at Home
While anemia treatment differs based on the cause, women with iron deficiency anemia can implement changes in their own kitchens and daily routines to protect and rebuild iron stores. And it may be simpler than you might think:
- Build an iron rich plate. Many staples in Afro-Latino and Caribbean cooking are naturally rich in iron by often including red meat, dark meat poultry, organ meats like liver, sardines, shellfish, black beans, lentils, chickpeas, and pigeon peas as sources of protein. Dark leafy greens like collard greens, callaloo, and cooked spinach are also excellent sources of iron to include in your plate.
- Time your supplement wisely. Take iron once daily on an empty stomach in the morning, with vitamin C, to optimize absorption. Many tropical fruits common in Afro-Latino diets, including guava, papaya, and mango, are excellent sources of vitamin C. Add a small meal if necessary or follow an every-other-day dosing schedule to help improve iron tolerance.
- Watch out for iron blockers. Coffee and tea contain tannins that can be potent iron inhibitors, while calcium rich foods (milk, cheese, yogurt) and whole grains may reduce iron absorption when consumed at the same time. Avoid drinking or eating these within two hours of taking iron.
- Cook in cast iron. Cook acidic foods like tomato sauce, sofrito, or bean stews in cast iron cookware to leach small but meaningful amounts of iron into your food.
When Kitchen Fixes Are Not Enough
If the iron deficiency is found to be severe, even the most iron conscious plate may not fully increase the low levels. Oral iron
supplements are the standard first line treatment, with typical dosing prescribed as ferrous sulfate 325 milligrams once daily. For women who cannot tolerate oral iron or have conditions that impair absorption, newer intravenous iron formulations can safely replenish stores in a single short visit.
The Bottom Line
Anemia is not just a minor inconvenience — it steals energy, clouds thinking, and quietly undermines quality of life. Black and Latina women face a disproportionately higher risk, and women who have undergone bariatric surgery carry an additional vulnerability that requires lifelong monitoring. The good news is that anemia is one of the most treatable conditions in medicine. But treatment starts with awareness: knowing the symptoms, understanding the causes, and taking simple steps in your daily life to keep your iron stores strong.
If you recognize yourself in these paragraphs, do not wait. Talk to your doctor. A blood test today could be the first step toward feeling like your best self again.
