symptoms of iron deficiency

What is anemia? 14 symptoms

Anemia comes from the ancient Greek άναιμία, anaemia, which means lack of blood. It is defined by a decrease in the number of red blood cells in the body/total amount of haemoglobin or a lowered ability of the blood to carry oxygen.1

What is iron deficiency anemia?

Iron deficiency anemia is the most common form of anemia, which affects around two billion people worldwide.2 It occurs when someone doesn’t have sufficient iron levels to form normal red blood cells.3

Humans don’t produce iron naturally, so we have to rely on diet alone to maintain healthy levels. This condition is often tied to:

  • Diets lacking in iron
  • Losing a lot of blood through excessive menstruation (very heavy and prolonged periods)
  • Gastrointestinal bleeding4
  • Being pregnant and/or lactating – especially for mothers who have poor iron levels prior to getting pregnant5

Is having low iron levels the same as having iron deficiency anemia?

No, you can have low iron without having full-blown iron deficiency anemia and may be on track to developing it, but not the other way around.

Iron deficiency anemia manifests when the iron levels in your body fall below an acceptable level and your body can no longer maintain healthy levels of haemoglobin or transport oxygen efficiently, which can cause all sorts of problems.

14 Symptoms of iron deficiency anemia

Iron deficiency anaemia symptoms and symptoms of low iron are pretty similar. They may come on overnight or they may appear gradually. Here are some of the most common and least common signs of low iron levels and iron deficiency you should look out for:6,7

1. Tiredness, fatigue and impaired mental function

Even if you don’t have full-blown iron deficiency anemia, low iron levels can still have you feeling tired and fatigued.8

Even if you get all the rest in the world, having the energy to go around day-to-day can still feel like a very big and extremely tiring task when you’re low on iron. This is because iron deficient people don’t have enough haemoglobin to transport enough oxygen to their muscles and tissues, which then become energy deprived.

Researchers part of an Australian study found that 29,000 women with low iron levels felt tired all the time and also had lower levels of wellbeing and general health than women who had no history of iron deficiency.9

A tired brain is also not a very efficient brain so you may find that you lack concentration or focus.

2. Fast or irregular heartbeat

Your heart has to work harder to pump the blood around your body when you are iron deficient, which can cause tiredness.10 Although usually only a symptom for people who have suffered from iron deficiency for a long time, this can lead to the feeling of your heart beating much faster than usual or irregular heartbeats.11,12

3. Shortness of breath and chest pain

When you have iron deficiency, your body can struggle to transport enough oxygen around the body – including to your muscles.

If you feel short of breath doing normal daily activities that you used to do with ease, like walking, climbing up the stairs or doing a light workout, this may be a sign that your body is struggling to distribute enough oxygen to your muscles.13

4. A pale complexion

Been feeling a little pastier lately? Pale skin and pale inner lower eyelids are common symptoms of iron deficiency.

A lack of haemoglobin means that our blood could become less red, which is why some people can lose their healthy rosy glow when they are deficient in iron.14

5. Weakness

Just like iron deficiency can cause you to feel out of breath more often due to lack of oxygen reaching the muscles, this can also cause feelings of weakness.15

6. Headaches and dizziness

Iron deficiency may contribute to headaches accompanied by feelings of dizziness or light-headedness.16

It is thought that this is because low haemoglobin can reduce the amount of oxygen reaching the brain, which can cause the brain to swell and cause headaches and pressure.

7. Cold hands or feet

The lack of oxygen transportation around the body due to iron deficiency may mean that your hands and feet are put at the bottom of the priority list for oxygen, and lack of blood flow can make them feel cold.

8. Mouth ulcers or cracks at the corners of the mouth

Iron deficiency anemia is one of the most common causes of recurrent ulcers.17 This may be because a lack of iron could mean the skin in your mouth isn’t getting enough nutrients, which is one of the main causes of chronic ulcers.18

9. Poor or slow wound healing

Our body needs iron to heal wounds well, and if you are deficient in iron it could lead to slow and poor wound healing.19

10. Tinnitus

There seems to be link between iron deficiency and hearing problems like tinnitus – a condition that causes you to hear noises from within the body like buzzing or ringing. It is thought that people with iron deficiency anemia commonly experience tinnitus symptoms as the blood cells are failing to carry enough oxygen through the body.20

11. Inflammation, extreme smoothness or soreness of your tongue

Anemia tongue, aka glossitis, can be caused by low iron levels. This condition causes the tongue to become inflamed, change colour, swell in size and lose its natural texture / become smooth.21

12. Brittle/spoon-shaped nails

Symptoms of more severe iron deficiency anemia are brittle/spoon-shaped nails.22 This spans from brittle nails that are prone to cracks and chips, all the way to spoon-shaped nails that dip in the middle and raise at the edges – making them look a bit like a spoon!

13. Lack of appetite

Iron deficiency and decreased appetite have been linked. One study showed that iron supplementation helped iron-deficient patients to eat more due to its influence on the hormone leptin that helps us feel satisfied and full.23

14. A desire to eat non-food items

Rather weirdly, a lack of iron can cause you to crave non-food items like paper, ice, dirt, chalk or clay! This behaviour is linked to a condition called pica, where patients develop cravings for non-nutritious substances. Iron supplementation has been found to help get rid of this behaviour.24

If you have some of these symptoms, please contact your GP who can do a simple blood test to find out if you’re lacking in iron.

What are iron deficiency anemia causes?

What causes low iron levels? Here are some of the most common reasons your body is lacking in iron and is struggling to make enough red blood cells:25

Causes of iron deficiency in women

  • Iron deficiency anemia during pregnancy is usually caused by a lack of iron in your diet
  • Heavy periods and pregnancy are very common causes of iron deficiency anemia

Iron deficiency in men, and women whose periods have stopped

Iron deficiency anemia can be a sign of bleeding in the intestines and stomach caused by:

  • Stomach ulcers
  • Taking non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin and ibuprofen
  • Piles
  • Swelling of the food pipe (oesophagus) large intestine (colitis)
  • Simply not getting enough iron in the diet

Other actions or conditions that cause blood loss could also lead to iron deficiency anemia.

What are the 3 stages of iron deficiency anemia?

  1. The body starts to use storage iron, there’s a decrease in total body iron but haemoglobin synthesis and red blood cell health remain unaffected.
  2. Iron supply to bone marrow becomes strained and problematic.
  3. Insufficient iron supply to the body for maintaining a normal haemoglobin concentration, which develops in iron deficiency anemia.

How do I know if I’m anemic?

Your GP can arrange a blood test to see the exact levels of iron in your blood and determine if you have healthy levels, low iron or are iron deficient anemic.

How do you fix low iron?

Think you have low iron? Please visit your GP to get tested and receive treatment. If your blood test shows that your red blood cell count is deficient (low) you will be given iron tablets to replenish your bodily supplies. These prescribed tablets are much stronger than supplements sold in supermarkets and pharmacies.

You can also start to eat more iron-rich foods, like:

  • Red meat
  • Eggs
  • Chickpeas
  • Seeds
  • Nuts
  • Baked beans
  • Spinach
  • Lentils
  • Broccoli
  • Dried fruit
  • Tofu
  • Soya milk
  • Tempeh
  • Green leafy vegetables
  • Fortified breakfast cereals

Make sure you get enough vitamin C too so that your body can absorb iron more efficiently. Try having a glass of orange juice with your meals and regularly snacking on fresh fruit and vegetables.

Last updated: 10 November 2020

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