Iron & Menopause Brain Fog: What’s the Link?

Menopause · Brain fog · Iron status

New research suggests that even without anemia, low or suboptimal iron levels could play a role in the “menopause brain fog” many women describe. Below, we walk through what the science says so far, where the uncertainties remain, and how to use this information in real-world conversations with your care team.

What Is Brain Fog During Menopause?

During the menopausal transition, estrogen and progesterone levels fluctuate and eventually decline. These shifts can influence neurotransmitters, blood flow, and metabolism in the brain. Many women in midlife report mild to moderate changes in memory, attention, or processing speed—often described as feeling “foggy,” scattered, or not quite as sharp as usual.

For most people, these cognitive changes are temporary and mild. For others, they can interfere with work, home life, or confidence. Researchers have long known that estrogen supports brain regions involved in memory and cognition, but hormones aren’t the whole story. Sleep, mood, thyroid function, and nutrient status all play important roles in how your brain performs. That’s where iron enters the conversation.

Why Iron Matters for Brain Function

Iron is essential for:

• Transporting oxygen throughout the body (via hemoglobin in red blood cells)
• Supporting energy production in cells
• Helping synthesize neurotransmitters such as dopamine, which are critical for focus and motivation

The brain is highly energy-intensive and depends on a steady supply of oxygen and glucose. When iron levels are too low, the result can be fatigue, reduced concentration, and a generalized sense of mental “fogginess.”

In women, menstrual blood loss is a leading cause of iron depletion. During perimenopause, periods can become irregular and, for some, heavier than usual, which may further drain iron stores. Even when blood tests don’t show full-blown anemia, low or borderline ferritin (the body’s stored form of iron) can still affect how the brain works.

Considering iron as part of your brain fog workup?

If labs confirm low iron or iron-deficiency anemia, IV iron can be one option to help replenish your levels more efficiently than pills alone. At purelyIV, iron infusions are NP-prescribed and delivered by licensed RNs in your home, office, or hotel.

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The OUHSC Study Linking Iron and Brain Fog

A recent study from the University of Oklahoma Health Sciences Center, published in the journal Nutrients, looked specifically at women in the menopausal transition who were not anemic. Researchers examined iron status and cognitive performance across several domains, including attention, memory, and reaction time.

Women with higher systemic iron levels performed better on these cognitive tests, even though they did not have elevated brain iron (which can be a concern at very high iron levels). In other words, women whose iron levels were in a healthier range tended to think more clearly and process information more quickly.

The authors suggested that addressing low iron before it progresses to anemia could be one strategy for reducing menopause-related brain fog. At the same time, they emphasized that their study was relatively small and cross-sectional, meaning it shows an association rather than proof of cause and effect.

Other Supporting Studies

The OUHSC study builds on earlier research linking iron status and cognition in women:

• A 2015 review in Nutrition Reviews reported that women of reproductive age with low iron levels— even without anemia—showed reduced cognitive performance and greater mental fatigue.
• A controlled trial in the Journal of Nutrition found that women who received iron supplementation improved on attention and memory tasks compared with those receiving placebo.
• Additional studies in midlife and older adults suggest a “Goldilocks” pattern, where both too little and too much iron can negatively impact brain function.

Together, these findings point toward an important nuance: it’s not about pushing iron as high as possible, but rather aiming for an optimal range that supports healthy brain function.

What This Means (and What It Doesn’t)

The emerging link between iron status and menopause-related brain fog is promising, but still early. For women who are noticing more forgetfulness, slower thinking, or difficulty concentrating—especially alongside heavy bleeding, dizziness, or low energy—checking iron status may be a useful part of the conversation.

Typical lab work might include:

• Hemoglobin and hematocrit (to assess for anemia)
• Serum ferritin (your body’s iron stores)
• Transferrin saturation or a full iron panel

At the same time, iron deficiency is unlikely to be the only driver of brain fog. Hormonal changes, sleep loss, mood changes, thyroid disorders, and chronic stress are all important contributors. It’s also crucial to remember that too much iron can be harmful, potentially contributing to oxidative stress and organ damage. Supplementation should always be guided by lab results and medical advice—not guesswork.

Practical Insights for Women

If you suspect that low iron could be part of your menopause symptoms, consider discussing the following with your clinician:

• Your full symptom picture (energy, sleep, mood, bleeding patterns, cognition)
• Recent or upcoming lab work, including ferritin and a complete blood count
• Dietary patterns (especially red meat intake, vegan/vegetarian diets, or low-calorie plans)
• Use of medications or supplements that may affect iron absorption

Day to day, you can also:

• Include iron-rich foods such as lean red meat, chicken, fish, lentils, beans, spinach, and fortified cereals.
• Pair plant-based iron sources with vitamin C (like citrus, berries, or bell peppers) to improve absorption.
• Avoid excessive coffee or tea with meals, which can reduce iron uptake.

For women found to have low iron or iron-deficiency anemia, treatment options can include oral supplements or, in some cases, iron infusions. Self-supplementation without lab confirmation is discouraged, because overtreatment can create new problems.

Want help connecting the dots?

purelyIV’s clinicians review your symptoms and recent labs to determine whether low iron, hormonal changes, or both might be contributing to brain fog. When appropriate, we can coordinate NP-led menopause care alongside iron infusions or other IV therapy.

Book menopause consult Explore menopause coaching & treatment

Research Gaps and Future Directions

While the OUHSC study opens the door to understanding how iron may influence cognitive function during menopause, many questions remain:

• Longitudinal studies are needed to see whether improving iron levels actually leads to measurable gains in attention, memory, or processing speed.
• Researchers are still unraveling how fluctuating hormones, inflammation, and metabolic changes interact with iron in the brain.
• “Brain fog” is not a standardized diagnosis. Clearer definitions and measurement tools would make it easier to study and treat.

As these gaps are addressed, we’ll get a clearer picture of whether iron plays a primary, secondary, or amplifying role in menopause-related cognitive changes.

Conclusion

Menopause-related brain fog is real, common, and multifactorial. Hormonal shifts are central, but emerging evidence suggests that low or suboptimal iron levels may add another layer to the story. For many women, simply being aware of this connection is empowering—it offers another avenue to explore when symptoms feel vague or hard to explain.

Working with a clinician who understands both menopause and iron metabolism can help you decide which labs to order, how to interpret results, and whether dietary changes, supplements, or iron infusions make sense for you. Personalized guidance remains the best path forward.

Ready to talk about brain fog and menopause?

Our menopause coaching & treatment service pairs NP-led care with lab guidance, symptom tracking, and tailored treatment options. When appropriate, we can also coordinate at-home iron infusions and other IV therapies through purelyIV.

Book menopause consult Learn more about menopause care

Disclaimer: The information in this blog post is for informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified health professional with any questions you may have regarding a medical condition.

References

1. Wenger, M. et al. (2025). Cognitive Performance in Relation to Systemic and Brain Iron at the Menopausal Transition. Nutrients, 17(5), 745. https://www.mdpi.com/2072-6643/17/5/745
2. Gunn, J. et al. (2025). Cognitive Function in Peri- and Postmenopausal Women: Implications for Considering Iron Supplementation. Nutrients, 17(11), 1762.
3. McCann, J. C. & Ames, B. N. (2015). Iron deficiency, cognition, mental health and fatigue in women of childbearing age: a review. Nutrition Reviews, 73(2).
4. Bruner, A. et al. (2005). Iron treatment normalizes cognitive functioning in young women. Journal of Nutrition, 135(4).
5. Beard, J. L. & Connor, J. R. (2010). The effects of oral iron supplementation on cognition in older adolescents and women. Nutrition Journal, 9(4).
6. Ding, J. et al. (2022). Midlife Iron Status Is Inversely Associated with Subsequent Cognitive Performance That Is Sex- and Menopause-Dependent. Journal of Neuroscientific Research.
7. Li, W. & Huang, C. (2009). Association between Body Iron Status and Cognitive Task Performance in Older U.S. Adults. Journal of Nutrition, 139(5).
8. Alhazmi, S. et al. (2024). The association between iron deficiency anemia and cognitive abilities among female university students. Electronic Journal of General Medicine, 21(2): em576.
9. Hong, C. H. et al. (2013). Anemia and risk of dementia in older adults. Journal of Alzheimer's Disease, 33(3), 753–760.
10. University of Oklahoma Health Sciences Center. (2025). Low Iron Could Cause Brain Fog During Menopause Transition, OU Study Suggests. inside.ouhsc.edu.

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