The link between stress, iron deficiency and the reproductive system.

By Dr. Rebecca Brook

Acupuncturist, and Dr. of Chinese Medicine

Stress plays a large role in how hormones are expressed, how the body responds to these hormones, and how all the internal systems function together (or don’t function together in some cases!). It can also influence the types of food we want to eat, which can mean we opt for not overly nutritious foods.

In Chinese Medicine, food is not just fuel—it is medicine. For women, who naturally give and lose blood through monthly cycles and childbearing, it’s especially important to nourish and replenish the blood regularly. The foods listed below have been used for centuries to support women’s health, restore vitality, and bring harmony to body and spirit.

The link between stress, blood deficiency/iron deficiency and hormonal/reproductive health can be described easily - blood deficiency is a “Chinese medicine pattern”, low iron or anaemia are western medicine descriptions for low levels of either ferritin (stored iron) or iron (readily available in the blood) levels, and they BOTH impact hormone levels in their own right. How?

Stress triggers the hypothalamic-pituitary-adrenal (HPA) axis, leading to the release of cortisol, a primary stress hormone. High cortisol levels can interfere with the normal functioning of the HPA axis and other hormonal systems, potentially impacting E2 production. High cortisol (and especially if elevated long term) has the potential to influence the absorption of iron from the diet. Hepcidin production increases during stressful times, which influences the gut microbiota (Reid & Georgieff, 2023; Chen et. al., 2009).

Additionally, Chinese medicine sees blood deficiency as a broader, more energetic concept and may involve emotional, physical and other clinical complications. Western medicine is able to provide a measured assessment (blood test results) to verify a suspected “blood deficiency”, so often a Chinese Medicine Practitioner will request you go and have a blood test to confirm their suspicions!

Importantly, with both Western and Chinese medicine definitions, there are similarities in the symptoms patients present with.

• Fatigue or low energy levels

• Dizziness, or postural dizziness (when you stand up too quickly)

• Pale complexion

• Palpitations, heart flutters

• Insomnia or trouble sleeping through the night

• Light or completely absent periods

• Poor memory, poor concentration, poor focus and a foggy mind

How is blood deficiency or iron deficiency diagnosed?

Traditional Chinese Medicine (TCM) provides a broad assessment including tongue and pulse diagnosis, observations (skin colour, tongue colour etc), and covering a full medical history. Also assessing your menstrual cycle, the flow, whether pregnancy or childbirth are factors.

The blood test that a GP can request includes full iron studies. This covers all aspects of your blood including ferritin, iron, and cell counts for haemoglobin etc. This is important as it support treatment options in both modalities.

How is blood deficiency or iron deficiency treated?

Your GP may suggest iron supplements, in which case, I am able to suggest a few options in clinic after consultation. In more severe iron deficiency/anemia cases you will find an iron infusion may be offered.

As far as Chinese medicine and dietetics are concerned, I usually suggest a herbal formula, iron supplementation, and also changing some foods in your diet to include BLOOD BUILDING FOODS!

How do I change my diet?

I find it best to try and add in one or two foods a week to your diet. Don’t try and do things all at once. Just take your time and allow your body, and digestive system, to embrace the additions and react accordingly.

Seaweeds, Spirulina & Chlorophyll-Rich Foods

These ocean and earth greens are full of minerals and deeply hydrating to the Blood. They are considered cooling and detoxifying, gently cleansing the Liver (which stores the Blood) while nourishing Yin—the body’s fluids and calm energy. They restore vitality when the body feels dry, weak, or overheated.

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Sprouts & Lightly Steamed Leafy Greens

Sprouts and greens help the Spleen, the organ in charge of turning food into Blood and Qi (energy). When the Spleen is strong, digestion improves, and the body absorbs what it needs more efficiently. These foods are fresh, vibrant, and full of life—perfect for encouraging renewal, balance, and softness within the body.

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Blackberries & Raspberries

These richly colored berries are sweet, slightly sour, and deeply nourishing. The sour flavor helps contain the Blood, making them helpful for heavy periods or emotional overwhelm. They nourish the Liver and Kidneys—organs tied to deep energy, fertility, and emotional steadiness—while helping clear the mind and ease tension.

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Blackstrap Molasses

Molasses is thick, mineral-rich, and warming. It is a classic Blood and Yin tonic, known to help with fatigue, weakness, pale complexion, or irregular menstruation. It helps build warmth and strength in the body, especially useful after loss of Blood or during emotional depletion.

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Royal Jelly, Gelatin, Mussels, Oysters & Animal Liver

These rich, essence-filled foods deeply rebuild the body’s reserves. In Chinese medicine, they are used when a woman feels very tired, cold, pale, dizzy, or emotionally worn down. They are warming, grounding, and filled with Blood-nourishing nutrients that restore both physical and emotional resilience. Liver, especially, is known for helping regulate the menstrual cycle and strengthen fertility.

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Eating to build Blood is not only about feeding the body—it’s about honouring your need for rest, warmth, and care too. These foods help you replenish blood over time, and return to your natural state of inner strength and vitality.

Dr. Rebecca Brook (BHSc Acu, PGCertSexology) is here to support you through the journey of improving your iron uptake, and absorption. Book an appointment for a consult and find ways to get your groove back.

Reid, B. M., & Georgieff, M. K. (2023). The Interaction between Psychological Stress and Iron Status on Early-Life Neurodevelopmental Outcomes. Nutrients, 15(17), 3798. https://doi.org/10.3390/nu15173798

Chen, J., Shen, H., Chen, C. et al. The effect of psychological stress on iron absorption in rats. BMC Gastroenterol 9, 83 (2009). https://doi.org/10.1186/1471-230X-9-83