Signs of iron deficiency (Could you benefit from an IV iron drip?)

[This article was first published on] 

Iron deficiency is the most common nutritional deficiency globally, affecting 1 in 3 women worldwide.

Symptoms include fatigue, hair loss, brain fog, poor immune function (i.e. more prone to the common cold/flu), cold intolerance and much more.  

Unfortunately, it is usually only detected when you become anaemic and have been suffering from suboptimal health and lowered mood and brain function for years by that point.

 Get your energy back!

Get your energy back!

I am iron deficient but I feel fine!

This is because iron depletes slowly, day by day, over years.  You may not notice, or put it down to stress or lifestyle.   The human body is excellent at compensating. 

No matter how fine you feel while iron deficient, you are at increased risk of poorer heart health in the long run if iron is not replenished.  

I have thalassemia minor and my doctor said to consume less iron...

Patients with Thalassemia are at risk for iron build up when iron exceeds physiological level. 

However, if iron deficient, these patients will still need to top up their iron to a safe level, for the proper functioning of the heart, lungs, brain and other organs.

How to diagnose iron deficiency

Ask to check your serum ferritin at your next check-up. 

Serum ferritin is a marker of the iron stores in your body. When the blood concentration falls below 30ng/mL you no longer have enough iron in your body and are probably experiencing many of the symptoms of iron deficiency.

Ferritin above 100ng/mL is what I would consider a good number.

My blood tests are normal...

My experience with labs is their ranges are too huge and patients already begin to see changes in their health before an extreme case is reached and the lab test shows you a red mark.

You need someone experienced in the interpretation of micronutrient tests to be able to work out what's going on in your body, and everything is connected. 

Iron, Zinc, Vitamin C status have to be assessed together. 

As an integrative and functional medicine doctor, conventional lab Normal doesn't necessarily mean all is clear. 

Women are at high risk

Women are most at risk of iron deficiency due to regular menses. For every 1mL of blood that is lost we lose 0.5mg iron. Over a year, a woman with heavy menses can have annual losses exceeding 500mg iron. If you consider that most women only have about 3,000mg or iron in their body it is easy to understand why so many are at risk of iron deficiency.

To make things worse, during pregnancy a growing baby will require about 1,000mg of iron from the mother. As 40% of women enter pregnancy in an iron deficient state too many will deliver in a highly iron deficient state. Consequences extist for mother and baby (risk of post-partum depression, low birth weight etc.).

How to increase iron levels in the body?

Humans cannot make iron so we are 100% reliant on our diet. Iron is best absorbed from red meat, fish, seafood and chicken. Whilst many vegetables have high iron content our bodies cannot absorb this phyto-form of iron nearly as well.

1kg of spinach = 200g of fish = 1mg of iron

In a deficiency state one needs 500-1000mg of elemental iron to make a difference to symptoms.

The problem with iron tablets

You will only absorb 10% of the iron in a tablet.  And will need to take them for 6-12 months to replete your stores if you are deficient.

Many forms of oral iron tablets are available, BUT they can cause gastrointestinal issues including diarrhoea, constipation or nausea. It is probably not worth taking iron within a multi-vitamin pack as the iron content is very low and amount absorbed not sufficient to do much.

The game changer:  Iron infusions

Intravenous iron is an extremely safe, fast and clean option for many of my patients, even during pregnancy.

The iron infusions I arrange give 500mg of pure elemental iron safely in a drip, within 15 minutes.  

Clinical data continues to grow and demonstrates that IV iron offers a rapid correction of iron deficiency with just 1 or 2 injections plus symptomatic relief in a matter of days. Improvements in exercise performance as well as overall general well-being are often observed. 

Book a consult to discuss IV iron with me.


Expert Advice: 12 Tips for Choosing a Family Doctor

Whether you’re new to Singapore or have a new bub (and new medical needs), Dr. Cheryl Kam gives top tips on how to find the best family doctor to suit your needs

[This article was first published on Sassymama]

Welcome to Singapore!

You might be an expat, or a local who has spent some time abroad, and now looking to establish a relationship with a good family physician to for your family to grow with. You’re in the right place!

holistic doc.jpeg

The current system

Most private GPs in Singapore run on a walk in basis and have their own dispensary.  This is convenient, and many even open in the evenings.

Private walk-in GP clinics may accept corporate insurance cards, a common employment perk in Singapore.  

For those that hold such a card, little or no payment is needed for simple primary care needs.  

Such a clinic tends to be catered to quick solutions for simple ailments like the cough and cold.  

It often takes a little searching around to find  doctors that are able to offer longer appointment times.

Seeing a specialist

Seeing a specialist is incredible easy; simply pick up the phone and call for an appointment!

There is no referral requirement except for insurance purposes, for which you will have to jump through some simple hoops. 

Read on…

If you have private insurance you may pay first and claim later. Those who hold corporate insurance cards tend to need a referral letter from a General practitioner who is on their panel of approved clinics, to have their specialist fee covered by insurance.

For Singaporeans, to get access to the public health specialists in government institutions, as well as to use their Medisave money to pay for their treatments, you must first see a polyclinic doctor for their referral letter.

Each insurance policy is different and it is worth knowing about yours in detail, especially where specialist referrals and emergency coverage is concerned.




How to pick a good family doctor

  1. A good primary care physician will be able to (and happy to) help you manage simple ailments at home, or even educate about over the counter medicines you can use.
  2. Long waiting times are no longer the only sign of a good doctor. In modern times, respect is paid to the patient’s time, and business processes are sleeker to allow for timely appointments.
  3. Get past the receptionist! Yes, good staff are hard to come by. While a good receptionist might be pivotal in helping you feel welcome, I would not judge a clinic by their receptionist.
  4. Your doctor should never rush you.
  5. Are you compatible?  Some factors to consider: Does the doctor listen to you without interrupting? Do they fully answer your questions? Do they explain your diagnosis and treatment, and specify a date for a follow-up visit?
  6. Your doctor is knowledgeable about preventative care, and does not throw a bag of antibiotics at you, at every small illness.
  7. Your doctor doesn’t roll their eyes when they hear you’ve looked something up on Google. These are millenial times! Even doctors look things up on Google (albeit with trained eyes!). After my consults, I often give patients homework to do, and that includes some online reading. Education is key.
  8. You are made to feel like a partner in your health, not a powerless subordinate.
  9. Group or solo? A group practice means when your usual doctor is not around, their colleague can seamlessly pick up the care, if this is important to you. This is relevant if you have young children or tend to need emergency care. With a group practice there may be the benefit of more brains, when a case is a little more esoteric, requiring discussion.
  10. A doctor’s network. When you get onto a doctor’s patient list, you also get access to their network of practitioners. If you get along with your doctor, you are likely to get along with the specialists they recommend, too.
  11. The doctor does not judge you on your uptake of alternative treatments.
  12. It’s the future today. Google your doctor, get connected. Many doctors also put out helpful material online as part of a community effort in improving health awareness.

Studies show that people who have one family doctor as their primary care provider have better health outcomes than those who skip from specialist to specialist.

Further to that, those with family physicians who had a good understanding of holistic care and complementary therapies live 30% longer and spend less on healthcare overall.


Need more advice?  Book a consult today.