Iron Deficiency: Symptoms, Tests and When to See a Doctor
Reviewed by Dr. Sheena Cherry, Specialist in Internal Medicine
3 min read
Feeling tired all the time is one of the most common reasons people see a doctor, and low iron is one of the most common causes. This guide explains what iron deficiency is, how it is diagnosed and treated, and when to get checked.
Key points
- Iron deficiency means your body does not have enough iron to make healthy red blood cells.
- Tiredness, breathlessness and pale skin are common signs, but some people have no symptoms.
- A simple blood test, including ferritin, confirms it.
- Finding the cause is as important as treating the low iron.
What is iron deficiency?
Iron helps your body make haemoglobin, the protein in red blood cells that carries oxygen around the body. When iron stores run low, the body eventually cannot make enough haemoglobin. This is called iron-deficiency anaemia. It is possible to have low iron stores before anaemia develops.
Common symptoms
- Tiredness and lack of energy
- Shortness of breath on exertion
- Pale skin
- Headaches or dizziness
- Noticeable heartbeats (palpitations)
- Brittle nails or thinning hair
- Restless legs
- Craving non-food items such as ice
Who is at higher risk?
- Women with heavy periods
- Pregnant women
- People on vegetarian or vegan diets without good iron sources
- People with conditions that reduce absorption, such as coeliac disease or inflammatory bowel disease
- People losing blood from the stomach or bowel, for example from ulcers or some medicines
- Frequent blood donors
How is it diagnosed?
Iron deficiency is diagnosed with blood tests. A full blood count shows whether you have anaemia, and ferritin shows how much iron your body has stored. Depending on your history, your doctor may also check vitamin B12 and folate, and arrange tests that look for a cause, such as coeliac screening or stool tests.
How is it treated?
Treatment usually involves iron tablets or liquid, taken for several months to rebuild your stores. Some people cannot tolerate tablets or need a faster response, and iron can then be given through a drip in hospital. Your doctor will also look for and treat the underlying cause.
Iron tablets can cause stomach upset or constipation. Avoid taking them at the same time as tea, coffee or calcium supplements, which can reduce absorption, and ask your doctor about the best way to take them.
Can diet help?
Iron-rich foods include red meat, poultry, fish, beans, lentils, tofu, dark green leafy vegetables and fortified cereals. A balanced diet helps maintain healthy levels, but once you are deficient, supplements are often needed as well.
When to see a doctor
- Tiredness that lasts more than a few weeks
- Any of the symptoms above
- Heavy periods
- Known low iron that is not improving with treatment
Dr. Sheena also discussed this topic on the Emirates Hospitals podcast, Ep. 18: Iron-Deficient? Here’s Why.
Sources
This guide is for general information and does not replace a medical consultation.
Specialist in Internal Medicine at Emirates Hospital Jumeirah, Dubai. MD in Internal Medicine, Fellowship in Critical Care Medicine and Postgraduate Certification in Cardiology from Johns Hopkins University. About Dr. Sheena
