Kirsten King joined PhD nutritional biochemist, author, speaker, Dr Libby on her podcast series, The Iron Conversation, for an insightful and revealing discussion about why so many women who are deeply invested in their health still feel exhausted, anxious or in pain.
The conversation begins with iron deficiencies and anxieties in teenage years, the inspiration behind the creation of Teen Moves, Fluidform’s dedicated at-home Pilates program, through to perimenopause, and the interrelation of overlooked iron deficiencies, anxiety, poor health and pain, linked to functional movement and the body as a vehicle of communication.
On iron deficiencies in teenagers.
Libby: In those teenage years, it’s often a time where some girls are very motivated by performance and improving athletic ability and for others, it’s about body image. And so there can be a real self-restriction of food, which I think sometimes it can be tricky for parents and trainers to spot, because it looks like they’re taking care of themselves and they’re taking more responsibility to eat nutritiously. But then before you know it, they’re skipping meals or they’re obsessed with eating “clean”.
Sometimes they’re (influencers) sharing the information that’s made a difference for them, but they don’t have any education behind what they’re saying. And I worry with things like that, that people aren’t necessarily aware of how their words might impact others and lead them to change their diet or change their movement practices.
Kirsten: I had mums coming into me saying, I’ve walked into my daughter’s bedroom and she’s following something on TikTok about how to get abs in five minutes. And then I see it the next day and she’s looking in the mirror saying, why haven’t I got abs yet? Sometimes the universe brings you something and it was emails about “please, I need my daughter to understand healthy functional movement. I need her to move but in a supportive, non-competitive way.”
The link between iron deficiency, movement and anxiety.
Libby: How important is it for you to help people to just move each day in a consistent way? Obviously that’s where results come from. And when we want it faster and harder and yesterday, it often means we don’t get that, doesn’t it?
Kirsten: We now can use AI to get everything faster. You don’t even have to go to the grocery store if you don’t want to anymore, and you can pay for faster delivery and so everything is faster. These clients that are high achievers, they’re wanting everything else faster. So they want their classes to be shorter. They want to get results. They want to use heavier weights. They are trying to dictate the way that they move and train because they’re looking for that speed.
In the studio I’ll start with three or four deep breaths. And at the end of that, you feel them give in and melt and just be. There’s so much tension in their muscles that they’re not actually working. They’re moving, but they’re not getting any results. The oxygen is not entering their body. They can’t even breathe properly. And so if all I can get them to do in that time is breathe and be and relax, then for me sometimes that’s the best workout they can have.
Dr Libby: One of the symptoms of iron deficiency is anxiety. Anxiety can be caused by lots of different things, but it is a symptom of iron deficiency and it’s being missed. There was a study published in 2023 called the Psychiatric Manifestations of Iron Deficiency Anaemia. And it was looking at people who’d been diagnosed with clinical depression and anxiety and another condition called anhedonia, which is the inability to feel pleasure, so to feel happy. And they went looking for iron deficiency.
Having awareness that if there is a flat mood, if there is anxiety, if you have had a history of iron deficiency, and also if your recovery from your exercise is not what you imagine it needs to be. Of course it’s normal to feel tired at the end of the day. We work hard, we think hard, we might have trained hard, but when the fatigue is persistent and it’s never relieved. And then you couple that with some of these emotional symptoms. I guess I’m hopeful that that’s a bit of a red flag for women that they go and have their iron assessed.
Kirsten: We’re wanting things too quickly. And if we’re not getting it in the time period that we’ve heard on social media or we believe we should be, we’re then dropping it and moving to the next thing. Because there are so many options. And so then we’re chopping and changing and nothing becomes a habit. And if there’s no habit, there’s no result really. So it’s sort of a bit of a crazy wheel of confusion, over-information and just too much pace. And we should be moving in consultation with all of our health professionals. That integrated approach is really important for me.
Dr Libby: Iron deficiency is the most common nutritional deficiency in the world. So many people would say they’re tired and it’s just because life’s busy. Right now it’s all about protein and creatine and I think collagen’s probably still in the mix and magnesium and vitamin D. And what worries me, that when the light has shone on those things, we forget about some of the basics. We need iron to be able to produce collagen. And I worry about the pushing of these singular messages. We can simplify nutrition. We need to eat more food and less junk on a very surface level. That’s ultimately the message. In regards to movement, people feel like they have to do 8 million thousand strength sessions a week to keep up these days. Have you seen a swing towards that, due to social media?
Kirsten: I think whether we want to admit it or not, I think it’s almost like human nature to compare, unfortunately. Social media just made it way too easy to do the comparison. There’s all these different conversations you can have around strength. And that’s why it’s so important to have that 360 approach to movement. Because everyone, even though they say they won’t, will have a bias. The outcome should be that we want a well-rounded functional body. And that’s what we’re trying to achieve.
The link between iron deficiency and movement for perimenopause.
Dr Libby: We’re so used to just having coffee for lunch (and coffee is not a meal) or skipping meals. And then someone might end up in your studio saying, I’m having a really tricky time through perimenopause and my body isn’t responding the way it used to and there can be all of this stuff in the background being missed. Once our sex hormones start to change, we sometimes get an experience of what’s been there in the background and the sex hormones have been buffering our experience of (for example) the insulin resistance or the thyroid that’s not working as well as it once was. So I’m encouraging women to really pay attention to their body and use it as feedback.
Kirsten: I think for women when they hit perimenopause too, they quite often still have teenage children. So they are busy, you know, they’re “mum taxi”. They’re still cooking dinner. They’re still working. And we are almost trained to think that it’s normal to feel fatigue. So I think it’s a great topic to raise and discuss and bring attention to because I would say nine out of ten of my clients are talking like that.
Dr Libby: It’s just all been blamed on hormones right now. And there can be 4,000 other things in the puzzle. And I don’t want that statement to overwhelm people, but rather encourage people to think, my body is this most magnificent vehicle of communication, endlessly offering me feedback about my choices. And instead of seeing it as something that betrays you, if we can see it as our absolute best friend – that is just trying to help us tune in.
We’re trying to get people to just appreciate themselves, care just that little bit more about their amazing selves because we treat things we care about very differently from things we’re frustrated with.
Kirsten: And I say to my clients, if this was your daughter or son coming to you and saying I feel this way, how would you speak to them? Because we say to ourselves, oh, you’re just tired. You had a big day yesterday. Get up out of bed and keep going. How would you talk to your child? And then what advice would you give? If we step out of our own shoes and into our children’s shoes, our mum shoes, our best friend shoes, and we treat ourselves in that way, I think we’d be a giant step forward. Our body is our most precious thing we own. And I feel so privileged to look after people’s bodies. They allow me to teach them, fix them. So that’s a real privilege for me. The best pharmacist you will ever have is inside of you. We have to get better at being kinder and looking in and listening and then taking action.
Small lifestyle changes that make a difference.
Dr Libby: There are all these unintentional lifestyle hacks or trends that people can adopt that lead them to become iron deficient. There’s a real matcha craze right now, so if you’re having iron rich foods or an old-school iron supplement at the same time that you’re having your coffee or your matcha, it can be a big disruptor. And also I worry particularly for women who are really committed to their training, there is a protein that the liver makes called hepcidin that when it goes up, it blocks iron absorption. It’s naturally lower in the morning, so our iron absorption is better in the morning, but it will elevate after exercise.
Sometimes just little tweaks to these lifestyle things, even if it goes against something that you’ve heard on Instagram, it can make a difference. So iron rich foods in the morning, you’ll absorb them better than at night. Having iron-rich foods or an iron supplement away from tea and coffee or matcha. They can just be little tiny tweaks like that that can just make such a difference. We might have lots of knowledge. We’re not necessarily applying it. We can obtain information, but we don’t necessarily act on it. And it’s kind of wasted if it just sits with us.
…helping everyone from teenagers right through to men and women of all ages to understand what healthy fatigue is versus a biochemical or nutritional depletion, some kind of situation where the fatigue is so deep and so persistent. There’s very strong literature showing that when ferritin is less than 50, there will usually be fatigue. There often won’t be enough iron to supply all the processes inside of us that it’s needed for. You might start to notice more anxious feelings, lower mood, irritability, and less patience. I would much rather address what’s happening in the person’s lifestyle and address that. Our period’s really heavy, why is that? Let’s see if we can lighten them. Are you not eating enough iron-rich foods? Let’s see if we can address your dietary intake or move your coffee to mid-morning away from your breakfast.
Kirsten: Whether you are iron deficient, whether you have every symptom of perimenopause, whether you do get an injury, or you’re just not feeling great, you’re feeling tired. All of those things are not a failure. They’re just another step, another piece in the puzzle. Continue to look inward and talk to yourself like you would those that you love. And don’t wait for tomorrow to take action.
Listen to the full conversation on Dr Libby’s podcast channel, Apple Podcasts and Spotify.
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