Show Notes
More than a third of women under 50 are iron deficient. Most of them have been told their blood results are normal. This episode is about the gap between those two things. Iron deficiency without anaemia is the stage most women are in when they come to see me, and the stage that standard blood testing isn't quite looking for. It's also the stage where women are experiencing very real, measurable symptoms and being told everything is fine. This week's question comes from my lovely friend Sarah on parenting children differently - and yes, Immy does get away with everything as the third child. My recco this week is a podcast that is technically for children but that I am just as obsessed with as they are. In this episode: Why iron deficiency without anaemia is chronically missed and what that means for you What iron actually does in the body - it's a lot more than most people realise The three stages of iron depletion and why most women aren't found until stage three Hepcidin - the master iron regulator most people have never heard of The fascinating relationship between hepcidin and your menstrual cycle and why having a period isn't inherently going to make you deficient Why the body's clever iron regulation system gets overwhelmed and what tips the balance toward deficiency The full symptom picture including the neurological symptoms that get dismissed most often The ferritin reference range problem and what number you're actually aiming for Who is most at risk Exactly what to ask your GP to test and why CRP matters
What to request from your GP: Serum ferritin Serum iron Total iron binding capacity (TIBC) / transferrin Transferrin saturation Full blood count CRP (C-reactive protein)
Links mentioned: In My Clinical Opinion Book a 1:1 consult Dreaming with Mikki podcast
New here? Find me on Instagram (@kate__holm) or at kateholm.com. Thanks for listening!
More from To Make a Mother
Apparently I seem very calm online. Which is lovely, but I am not always a calm mum. I get frustrated. I get short. I have raised my voice. And sometimes I am outwardly holding it together while internally I have 47 tabs open and one is playing loud music at me. Which is partly why I keep talking about the nervous system. Not because nervous system regulation is the latest wellness trend, but because so many mothers (like me!) are living in a state of too much, for too long. And the solution we are usually given involves waking up at 5am and probably becoming a person who makes her own almond milk. I do not need another ten step routine to fail at. And neither does your nervous system. This episode is the practical follow-on from episode one. Small repeatable things that fit into the life you already have. This week's question is what I am actually like when I lose it with my kids and my recco is a book I have really fallen in love with that is also fitting!
Morning sickness sounds like "oh, I felt a little queasy before breakfast". How cute. Actual morning sickness: feel sick when you wake up. Feel sick because you haven't eaten. Feel sick when you eat. Feel sick because someone mentioned chicken. Feel sick because the fridge apparently has a smell now. And somehow you are expected to continue functioning normally while growing a human being and an entirely new organ simultaneously. I had what I would call moderate to severe morning sickness in all three of my pregnancies. Not hyperemesis - I was not hospitalised - but it was incredibly debilitating for the first half of each pregnancy, both physically and mentally. So this episode comes from personal experience as much as clinical knowledge. If you are currently horizontal with an assortment of potato-based foods nearby - you are allowed to be in survival mode. This is not the trimester for nutritional perfection. But there are things that can take the edge off, and that is what this episode is about.
Apparently everything is perimenopause now. Tired? Perimenopause. Irritable? Perimenopause. Can't remember why you walked into the kitchen? Obviously perimenopause. But sometimes it is perimenopause. And sometimes you are sleep deprived, iron deficient, chronically stressed, dealing with subclinical thyroid dysfunction, or enjoying a delightful combination platter of all of the above. And that is why the investigation cannot stop at the first answer that sounds plausible. This is the woman I increasingly see in clinic. Late 30's or early 40's. Exhausted in a way that more sleep does not fix. Reactive. Foggy. Achy. Her cycle has changed. Her body does not feel like hers anymore. She has googled it, Instagram has gotten involved, and within approximately fourteen minutes she has perimenopause. She might be right. But I don't want the investigation to stop there. In this episode: What perimenopause actually is and why it can start earlier than most women realise Why perimenopause is increasingly colliding with active motherhood, and why the timing is tricky to make a diagnosis The full symptom picture, including the ones nobody warned you about What else can look exactly like perimenopause Why I don't want us to replace "of course you're tired, you have kids" with "of course you feel terrible, you're in perimenopause" - you deserve a more thorough answer than that What I actually investigate in clinic before landing on a diagnosis The boring stuff that really helps Why protein becomes particularly important at this stage and what target I work towards The soy conversation, what the evidence actually says, and why she has been wrongly accused of several crimes Why resistance training specifically matters for muscle mass, bone density, and metabolic health Where HRT fits
I used to think I had a really good immune system. Turns out I was just really good at avoiding snotty toddlers. Then I had kids! Can we actually build more resilient immunity in our kids and ourselves? Yes. But probably not by panic buying fourteen immune supplements the second someone sneezes. The boring stuff matters. A lot. And then the supplements sit on top of that. And then there are the things I do that have no clinical trial behind them and I do them anyway. For the price of an onion, I am not concerned. I recorded this one while my entire family was down with suspected influenza A. So this is coming to you very much from the trenches (apologies in advance for my voice!) This week's question comes from a listener asking which of my children is most like me. Bowie said something that stopped me in my tracks. My recco is one of my favourite books of all time - I have bought at least ten copies and I have not got a single one back!
Antibiotics save lives, but they also change your child's gut microbiome. In this episode of To Make a Mother, we're exploring what antibiotics actually do beyond treating infection, why the effects on the gut can last far longer than most parents realise, and the simple, evidence based ways you can support your child's microbiome during and after a course of antibiotics. This isn't an anti-antibiotics conversation. It's about understanding how these medications impact the developing gut and what you can do to help restore balance afterwards.