A 40-year-old stunt performer from Wales says she spent months assuming she was going through early menopause, only to discover she was severely deficient in iron and vitamin D, with low vitamin B12 as well.
Rachelle Smith began feeling so exhausted after work that she could do little more than collapse onto the sofa. She had previously spent hours playing sports or at the gym, but even social events became too much, and she regularly cancelled plans.
"I'd arrange to go for coffee or horse riding with friends and pull out at the last minute," Smith said. "I lacked the motivation. I didn't want to do anything, it was like my entire personality had changed." She said she started taking daytime naps, which was unlike her, and found herself simply trying to get through each day before going to sleep.
She also developed aching joints, irregular periods, trouble focusing and memory lapses, and began turning down work because she was too exhausted. "My mum went into an early menopause, so I assumed this is what was happening to me too," she said.
Menopause symptoms typically begin during perimenopause, often in a woman's forties, as hormone levels fluctuate before periods stop completely. But when a friend recommended Smith try an at-home finger-prick blood test, called the YorkTest Essential Health Check, it pointed to something else.
The test showed Smith was severely deficient in iron and vitamin D, with borderline low vitamin B12. According to the source material, around one in three women experience iron deficiency at some point in their lives, with heavy menstrual bleeding one of the most common causes. If severe iron deficiency progresses to anaemia, it can reduce the blood's oxygen-carrying capacity, placing extra strain on the heart and, in rare cases, contributing to complications such as irregular heart rhythms.
Iron and vitamin D deficiencies often occur together and can share overlapping symptoms, including severe fatigue, muscle weakness and low mood.
"I really underestimated how much nutrition can impact your life," Smith said. "That's why I assumed it was a hormonal problem; I didn't think a vitamin deficiency could cause such extreme symptoms."
Expert caution on at-home testing
Professor Toby Richards, a surgeon and iron deficiency specialist at the University of East London, said at-home tests are useful for screening but cannot replace formal clinical blood draws and professional diagnosis. Nutrient and vitamin deficiencies typically improve within four to 12 weeks of starting targeted treatment.
"I started Googling how to fix this and realised that because I'm vegan, the plant-based iron I'm getting in my diet is harder for the body to absorb," Smith said. "Now, I actively try to eat more vitamin C found in fruit and veg such as red peppers and oranges, to increase my iron absorption."
Iron is described as the hardest deficiency to correct through diet alone because the body tightly controls how much is absorbed. Even when stores are low and absorption increases, diet alone often isn't enough to replenish them, particularly when heavy periods or gut issues are driving the loss.
On a friend's advice, Smith started using iron and vitamin D supplements in oral spray form, since she struggles to swallow pills. The sprays are applied to the inside of the cheek or under the tongue, where they are absorbed through the mouth's mucous membranes into the bloodstream, potentially bypassing much of the digestive tract.
Clinical studies on vitamin D supplements show that oral sprays raise blood levels just as effectively as standard capsules or tablets. However, experts have raised concerns about oral iron sprays, saying they deliver much lower doses of iron than standard tablets and lack robust clinical trials proving they can treat iron deficiency anaemia.
Professor Richards instead recommends 200 to 300 milligrams of oral iron, in liquid or tablet form, taken for three to six months before repeating blood tests and reassessing. He also advises that women who don't eat meat take a low-dose iron supplement either daily or on the days of their period to maintain normal iron levels.
"The best thing is that these lifestyle tweaks have been really easy to incorporate into my routine," Smith said. "It's such an easy fix and doesn't have to be a difficult, massive change."
Smith said her energy levels have been restored. "Within two weeks, I felt like a different person," she said. "The fog lifted. I started running and I even took up horse riding again after work, something I had not done in years."
Her advice to others is not to underestimate the importance of diet. "The easiest thing to fix is diet, especially as you're getting a little bit older and your body might require a bit more energy from these things," she said. "Even if you think you're getting everything you need from your food, it doesn't hurt to get your levels checked out if you're exhausted all the time, things like iron and vitamin D are such an easy fix."
While her friends are glad she is spending more time with them, Smith said her husband has seen the biggest change. "It had got to the point where he was always worried about me and trying to care for me," she said. "Now we've both got our lives back and I feel much more independent, like the woman he married. I'm just so pleased that it wasn't just my age kicking in and there was something that could make my horrible symptoms go away."
