Vitamin D and Iron Deficiency in Jordan: Why So Common, and What to Do

Two deficiencies appear again and again in Amman clinics, and both explain a large share of the fatigue people assume is just stress or poor sleep.

Neither is difficult to diagnose. Both are frequently missed because the symptoms are vague enough to be attributed to everything else.

Vitamin D: the deficiency that shouldn't happen here

Jordan gets around 300 sunny days a year. Vitamin D deficiency is nonetheless widespread — and disproportionately so among women.

Why:

• Sun avoidance during peak hours. Amman summers make midday sun genuinely unpleasant. Most people are indoors precisely when vitamin D synthesis is most efficient.
• Clothing coverage. Modest dress substantially reduces the skin surface available for synthesis. This is a straightforward physiological fact, not a criticism.
• Sunscreen, appropriately used, blocks the relevant wavelengths.
• Indoor lifestyles. Office work, school, car travel, and air-conditioned buildings.
• Very little dietary vitamin D. Few foods contain it in meaningful amounts, and Jordan doesn't broadly fortify dairy or cereals.
• Skin tone. Higher melanin requires longer exposure for the same synthesis.

Symptoms that often go unattributed: persistent fatigue, muscle aches and weakness, bone and lower back pain, low mood, frequent infections, hair thinning.

The test: serum 25-hydroxyvitamin D. Ask for it by name.

Correction: dietary sources — oily fish (salmon, sardines, mackerel), egg yolks, fortified products where available — help but rarely correct a genuine deficiency alone. Supplementation is usually necessary, and the dose depends on how low your level is. This is why guessing from an online article doesn't work: correcting a level of 12 ng/mL requires a different approach from maintaining a level of 28.

Get tested, correct under supervision, and retest after around three months.

Sensible sun exposure — 15–20 minutes on arms and legs, outside peak hours, several times a week — helps where it's practical for you.

Iron deficiency: extremely common, especially in women

Iron deficiency is one of the most common nutritional deficiencies globally, and it's particularly prevalent among women of reproductive age in the region.

Why it develops:

• Menstrual blood loss, especially with heavy periods
• Pregnancy and closely spaced pregnancies
• Diets low in red meat, or vegetarian patterns without careful planning
• Poor absorption — tea and coffee with meals are a major and widely overlooked factor
• Coeliac disease, H. pylori infection, or gastrointestinal blood loss

Symptoms: fatigue that sleep doesn't fix, breathlessness on stairs, pallor, dizziness, cold hands and feet, hair loss, brittle nails, poor concentration, restless legs, and — distinctively — cravings for ice or non-food substances.

Critically: you can be iron deficient with a normal haemoglobin. Ferritin falls first, and depleted iron stores cause symptoms well before anaemia appears. Many people are told "your blood count is fine" while their ferritin is at the floor.

Ask for ferritin specifically, alongside a full blood count. Ferritin can be falsely elevated during inflammation or infection, so context matters.

Improving iron intake and absorption

Haem iron (well absorbed): red meat, liver, chicken, fish.

Non-haem iron (less well absorbed): lentils, chickpeas, beans, spinach, molasses (dibs), tahini, dried fruit, fortified products.

What increases absorption:

• Vitamin C alongside the meal — lemon on lentils, tomato in salad, orange after. This is a large effect, and Jordanian cooking already does it: the lemon squeezed over ful and shorbet adas is genuinely functional.
• Cooking in cast iron
• Pairing plant iron with a small amount of meat

What blocks absorption:

• Tea and coffee with meals — the tannins substantially reduce iron absorption. This is probably the single most impactful and easiest change for many Jordanian households, where tea accompanies almost every meal. Move tea to 60–90 minutes after eating.
• Calcium supplements or large dairy amounts taken at the same meal as iron
• Some antacids

On supplements: iron supplementation should follow a blood test, not a guess. Excess iron is harmful, and constipation and stomach upset cause many people to abandon supplements before they work. Correction typically takes three to six months, and you need to continue past the point at which you feel better, in order to rebuild stores. Alternate-day dosing is often better tolerated and, in some evidence, better absorbed — worth discussing with your doctor.

When "just tired" deserves a blood test

Fatigue gets normalised. If you've been persistently exhausted for more than a few weeks, it's worth asking your doctor for:

• Full blood count
• Ferritin (not just haemoglobin)
• 25-hydroxyvitamin D
• Vitamin B12
• Thyroid function (TSH)
• HbA1c

That panel identifies the majority of nutritional and metabolic causes of ongoing fatigue. Bringing the results to a dietitian allows the dietary side to be addressed properly rather than guessed at.

Bring your blood work to a consultation in Amman →

Frequently asked questions

Why is vitamin D deficiency common in Jordan despite the sun? Sun avoidance during peak hours, clothing coverage, sunscreen, indoor lifestyles, minimal dietary sources, and limited food fortification.

What vitamin D test should I ask for? Serum 25-hydroxyvitamin D — usually written as 25(OH)D.

How much vitamin D should I take? It depends on your measured level. Get tested and have the dose set by a professional, then retest in around three months.

Can I be iron deficient with normal haemoglobin? Yes. Ferritin — your iron store — falls first and can cause significant symptoms before anaemia develops. Ask for ferritin specifically.

Does drinking tea affect iron? Yes, significantly. Tannins in tea and coffee reduce iron absorption when consumed with meals. Move tea to at least an hour after eating.

How long does it take to correct iron deficiency? Typically three to six months of consistent supplementation, and you should continue past symptom improvement to rebuild stores. Retesting confirms it.

Rula Abu Ghazaleh is a clinical dietitian practising in Amman. Book a consultation →

This article is general nutrition information and is not a substitute for individual medical advice. Do not start supplementation without testing and professional guidance.