Does spinach help with fatigue during perimenopause?

Spinach is a genuinely useful food for perimenopausal fatigue because it addresses several of the physiological drivers of low energy simultaneously. Its combination of iron, folate, magnesium, and dietary nitrates targets oxygen delivery, red blood cell production, cellular energy production, and exercise efficiency in ways that are relevant to the fatigue patterns common in perimenopause.

Iron is the most direct connection. Cooked spinach provides approximately 3.6mg of non-heme iron per 100 grams. Iron is required for the production of hemoglobin, the protein in red blood cells that carries oxygen to every tissue in the body including the brain and muscles. When iron is insufficient, even before full anemia develops, fatigue, difficulty concentrating, and reduced physical stamina are common. Perimenopausal women are at particular risk because irregular and sometimes heavier periods during this transition can increase monthly blood loss without a corresponding increase in iron intake. Non-heme iron from plant sources is less readily absorbed than heme iron from meat, but spinach contains its own vitamin C, which meaningfully enhances non-heme iron absorption. Eating spinach with an additional vitamin C source, such as tomatoes, lemon juice, or bell pepper, further improves uptake.

Folate (approximately 146 micrograms per 100 grams cooked) works alongside iron in red blood cell production. Folate is required for DNA synthesis in rapidly dividing cells, including the precursor cells that produce red blood cells in bone marrow. Folate deficiency can cause megaloblastic anemia, a condition where red blood cells are produced abnormally and carry oxygen less effectively. Even marginal folate insufficiency can contribute to fatigue without producing overt anemia. Folate is also a cofactor in serotonin and dopamine synthesis, and low neurotransmitter levels contribute to the low motivation and mental fatigue that compounds physical tiredness.

Magnesium is essential for ATP production, the fundamental cellular energy currency. Every cell in the body requires magnesium-dependent enzymatic reactions to produce and use ATP efficiently. Cooked spinach provides approximately 78mg per 100 grams. Magnesium depletion, which is common under hormonal stress and in women with poor sleep, directly reduces cellular energy production and can manifest as persistent fatigue and muscle weakness.

Dietary nitrates present in spinach are converted to nitric oxide in the body. A 2010 study by Larsen and colleagues demonstrated that dietary nitrates reduce the oxygen cost of exercise, meaning the body achieves the same physical output with less metabolic effort. For perimenopausal women experiencing fatigue, this translates to less exhaustion from routine physical activity.

Spinach is also extremely low in calories while being high in volume and nutrient density. Unlike calorie-rich foods that might provide a brief energy spike followed by a crash, spinach contributes micronutrients that support sustained energy without disrupting blood glucose stability.

Include cooked spinach in meals four to five times per week. Pair it with a protein source such as eggs, chicken, or legumes to provide amino acids that support muscle function alongside spinach's micronutrient load. If you take an iron supplement, be aware that calcium and some compounds in high-fiber foods can reduce iron absorption when consumed simultaneously, so timing matters.

When to see a doctor: Persistent fatigue that does not improve with rest, dietary changes, and adequate sleep should be evaluated medically. Thyroid dysfunction (hypothyroidism), iron deficiency anemia, B12 deficiency, vitamin D deficiency, depression, sleep apnea, and adrenal insufficiency are all conditions that cause fatigue and require specific diagnosis. Perimenopausal fatigue can also be substantially driven by disrupted sleep, which itself warrants investigation if severe.

This content is for informational purposes only and does not replace medical advice. Always consult your healthcare provider about your specific situation.