What to eat when perimenopause is draining your energy
Iron, magnesium, B12, vitamin D, and protein. The nutrients that address perimenopause fatigue directly.
10 min · Nutrition
The fatigue is real
Perimenopause fatigue is not tiredness from a bad night. It is a persistent, bone-deep depletion. Multiple mechanisms: oestrogen regulates mitochondrial function, sleep disruption accumulates, and muscle loss increases the metabolic cost of every activity.
Priority nutrients
Iron (4/5 Strong) — Heavy periods accelerate iron depletion. Get iron tested before supplementing. Ferritin below 50 is associated with fatigue even when haemoglobin is normal.
Magnesium (4/5 Strong) — Involved in ATP synthesis. 200-400mg glycinate daily.
B12 and B6 (3/5 Moderate) — B12 deficiency causes fatigue clinically indistinguishable from perimenopause fatigue. Worth testing.
Vitamin D (3/5 Moderate) — Low vitamin D is associated with fatigue and muscle weakness. 1,000-2,000 IU daily.
Protein (5/5 Very Strong) — 1.2-1.6g per kg body weight. Supports muscle maintenance.
Foods that support this pattern
Include more: Red meat 2-3 times per week, eggs, legumes, dark leafy greens, whole grains, nuts and seeds.
Include less: High-sugar foods, processed carbohydrates, alcohol.
Should you test before you supplement?
For iron and vitamin D: yes. Testing prevents both under-supplementing and over-supplementing.
For magnesium: blood tests are unreliable. Treat based on symptoms and dietary intake.
Evidence summary
| Outcome | Grade | Notes |
|---|---|---|
| Iron for fatigue | Strong | Test before supplementing |
| Magnesium for energy | Strong | EFSA-approved claim |
| B12 for fatigue | Moderate | Test if over 45 or vegetarian |
| Protein for muscle | Very Strong | Highest-impact intervention |
Medical disclaimer
Persistent fatigue should be investigated by a GP to rule out thyroid conditions, anaemia, and sleep disorders. Summ is not a medical service.
References
EFSA (2010-2012). Nutrient health claims.
Barbagallo et al. (2023). Magnesium and women's health. Nutrients.
Traber et al. (2023). Iron deficiency and fatigue. Current Opinion.
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