Tired Is Not a Personality: Iron Deficiency, Perimenopause, and Being Believed

Tired Is Not a Personality

They said I was fine. They always do, don’t they?

I’ve had heavy periods since the beginning—biblical, ruin-your-jeans, iron-smelling, crime scene heavy. I bled like that for decades. If this were The Red Tent, I’d have been the main attraction. People would’ve come from villages away just to marvel at my uterine output.

Instead, I got told to hydrate and take more iron.

And every time I said I felt exhausted, dizzy, foggy, like my limbs were made of sandbags, they ran labs. They checked my ferritin.

Ferritin is the storage form of iron—your body’s backup supply for making healthy red blood cells. It was low. Always low. Very low.

And still—“Just take more oral iron.”

By the time I was in naturopathic medical school, I was already taking oral iron religiously. I tried every formulation, every timing trick. I paired it with vitamin C. I spaced it out from calcium. I skipped coffee. I followed every absorption rule like it was scripture.

I ate steak. Lots of steak. Grassfed fucking steak. I was basically on the Ribeye Protocol, chewing my way through cows trying to stay conscious.

I wasn’t uninformed. I had clinical training. I knew what low ferritin meant. What I also knew—but couldn’t get anyone else to act on—was that ferritin isn’t just a lab number. Below about 30, you can look “fine” on paper while your cells are gasping for oxygen.

And I still couldn’t get what I needed. Because education doesn’t guarantee access. Being a “good patient” doesn’t guarantee care. Not in a system that minimizes female fatigue like it’s background noise.

I got the colonoscopy. I got the endoscopy. I followed the algorithm. I proved it wasn’t a gastrointestinal bleed.

And still: no iron infusions. No help. Just more pills. More waiting. More slow-motion unraveling.

When Low Ferritin Runs Your Life

Chronic blood loss compounds. When early perimenopause arrived, the bleeding went from bad to absurd—longer bleeds, more frequent cycles, barely catching my breath between one period and the next. Each one took a little more from me: color from my face, sharpness from my mind, stamina from my muscles.

My body felt like a zinnia with no sun—still upright, but every petal too heavy to lift. Visiting a friend in New York, I couldn’t manage more than a slow walk to the corner café. My chest tightened on the stairs. Talking left me winded. By 2 p.m., no matter what the clock said, my body had already shut itself down.

This is what low ferritin does: it doesn’t just sap your strength; it robs your capacity to live in real time. You’re a garden without rain.

That “petal-heavy” feeling? It’s your cells literally under-oxygenated because low ferritin means too little iron to make hemoglobin. Without oxygen delivery, even small tasks feel daunting.

Iron Deficiency in Women: Common, Missed, Dismissed

Iron deficiency is one of the most common nutrient deficiencies in women, especially those with:

Heavy or prolonged periods
Short menstrual cycles
Perimenopause-related bleeding changes
Pregnancy or postpartum depletion
GI absorption issues

Symptoms often include:

Persistent fatigue
Brain fog or poor concentration
Dizziness or lightheadedness
Shortness of breath with mild exertion
Paleness
Hair shedding
Anxiety or low mood

And yet, it’s routinely under-treated.

Why? Because hemoglobin may still fall within “normal” ranges. Because ferritin cutoffs are outdated. Because fatigue is treated like a personality flaw instead of a diagnostic clue.

Why Pills Sometimes Fail—and When Infusions Help

It took twenty years—twenty years of brain fog, dizziness, pallor, anxiety, and bone-deep fatigue—before someone finally said: “You need infusions.”

An iron infusion is just rain—liquid iron delivered straight into your vein, bypassing the stubborn gates of your gut. It’s for when pills can’t keep up, when you’re losing more than you can grow back, or when you need your ferritin and hemoglobin replenished fast.

Unlike oral iron, it doesn’t just green up the leaves—it revives the roots. Your strength returns. Your mind sharpens. And because it sidesteps your digestion, you skip the constipation, nausea, and endless “try another pill” loop.

When I got them, it felt like someone rebooted my nervous system. My brain sharpened. My limbs felt lighter. I could move. Think. Breathe. I could live.

The Knowledge Gap. The Trust Gap.

All those years, the message wasn’t just “you’re fine” or “it’s all in your head.”

It was worse: “We know. But there’s nothing else we’re going to do.”

Apathy wrapped in protocol. Shrugs in place of solutions. Deal with it. Take another supplement. Eat more steak. Try harder. Suffer better.

What I needed wasn’t more effort. I needed access. Options. Care. Curiosity.

This is what Doing Harm author Maya Dusenbery calls the knowledge gap and the trust gap—and I lived both. The knowledge existed. The labs showed it. The solution was available. But as a woman describing “nonspecific” symptoms—fatigue, forgetfulness, dizziness—I wasn’t trusted to need more than the default response.

I didn’t need more spinach. I didn’t need yoga. I didn’t need mindfulness. I needed iron—in a form my body could actually use. I needed someone to believe me when I said: I don’t feel right.

How I Practice Differently

I see her every month.

She walks in holding a spreadsheet of supplements, labs no one explained, and a bone-deep exhaustion that’s been labeled everything but real.

She’s tried iron pills, vitamin B shots, antidepressants, acupuncture, Whole30, green juice, journaling, CBT. She’s had the scopes. The scans. The blood draws. The dismissals.

Her ferritin is 7. She’s been told to just “keep up the oral iron.”

She cries—not because she’s dramatic, but because she’s tired of being responsible for her own rescue.

I ask: “Do you want to try infusions?”

She looks at me like I just handed her an oxygen mask.

I remember what it felt like to be her—to be the only sane person in a room full of people telling you to wait it out while your body falls apart.

I don’t need her to prove she’s sick enough.
I don’t need her to suffer longer.
I don’t need to normalize dysfunction.

I believe her.

I order the infusions.

I tell her what no one told me for twenty years: “You’re not crazy. You’re not weak. You’re not imagining it. You’re iron-deficient. And you deserve to feel better.”

That’s the work now—not just to treat, but to believe and to trust. To refuse to normalize dysfunction in female bodies. To stop treating symptoms as moral failings or mental health liabilities.

Fatigue, pain, brain fog—they’re not personality flaws. They’re diagnostic clues. Ignore them and we’re complicit.

This isn’t just a story about fatigue. It’s a bloodletting. And I’m not offering mine up quietly anymore.

🌀 Quick Ritual: Say the Symptom

Take sixty seconds. Name the thing you’ve been downplaying. The pain you’ve been pushing through. The exhaustion you’ve blamed on yourself.
Say it out loud: “This is real.”
Say it again: “This matters.”
Then write it down. Bring it to your next appointment like it’s scripture—or tape it to your mirror until someone listens, including you.
This is your sacred symptom—and it will not be dismissed.

Tired isn’t your personality. It’s a lab value—and a fixable problem.

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