The body uses iron to make hemoglobin, the substance in red blood cells that carries oxygen,” says Blaire Morriss, a nurse practitioner at the Vanderbilt Center for Integrative Health.
Here are 10 signs and symptoms of iron deficiency, starting with the most common.
- Unusual Tiredness
Feeling very tired is one of the most common symptoms of iron deficiency, affecting more than half of those who are deficient.
This happens because your body needs iron to make a protein called hemoglobin, which is found in red blood cells. Hemoglobin helps carry oxygen around the body.
When your body doesn’t have enough hemoglobin, less oxygen reaches your tissues and muscles, depriving them of energy. In addition, your heart has to work harder to move more oxygen-rich blood around your body, which can make you tired.
Since tiredness is often considered a normal part of a busy, modern life, it’s difficult to diagnose iron deficiency with this symptom alone.
However, many people with iron deficiency experience low energy alongside weakness, feeling cranky, difficulty concentrating or poor productivity at work.
Pale skin and pale coloring of the inside of the lower eyelids are other common signs of iron deficiency.
The hemoglobin in red blood cells gives blood its red color, so low levels during iron deficiency make the blood less red. That’s why skin can lose its healthy, rosy color in people with iron deficiency.
This paleness in people with iron deficiency can appear all over the body, or it can be limited to one area, such as the face, gums, inside of the lips or lower eyelids and even the nails.
This is often one of the first things doctors will look for as a sign of iron deficiency. However, it should be confirmed with a blood test.
Paleness is more commonly seen in moderate or severe cases of anemia.
If you pull your lower eyelid down, the inside layer should be a vibrant red color. If it is a very pale pink or yellow color, this may indicate that you have iron deficiency.
- Shortness of Breath
Hemoglobin enables your red blood cells to carry oxygen around the body.
When hemoglobin is low in your body during iron deficiency, oxygen levels will also be low. This means your muscles won’t get enough oxygen to do normal activities, such as walking.
As a result, your breathing rate will increase as your body tries to get more oxygen.
This is why shortness of breath is a common symptom.
If you find yourself out of breath doing normal, daily tasks that you used to find easy, such as walking, climbing stairs or working out, iron deficiency could be to blame.
- Headaches and Dizziness
Iron deficiency may cause headaches.
This symptom seems to be less common than others and is often coupled with lightheadedness or dizziness.
In iron deficiency, low levels of hemoglobin in red blood cells mean that not enough oxygen can reach the brain. As a result, blood vessels in the brain can swell, causing pressure and headaches.
Although there are many causes of headaches, frequent, recurrent headaches and dizziness could be a sign of iron deficiency.
- Heart Palpitations
Noticeable heartbeats, also known as heart palpitations, can be another symptom of iron-deficiency anemia.
Hemoglobin is the protein in red blood cells that helps transport oxygen around the body.
In iron deficiency, low levels of hemoglobin mean the heart has to work extra hard to carry oxygen.
This can lead to irregular heartbeats, or the feeling that your heart is beating abnormally fast.
In extreme cases, it can lead to an enlarged heart, heart murmur or heart failure.
However, these symptoms tend to be a lot less common. You would have to suffer from iron deficiency for a long time to experience them.
- Dry and Damaged Hair and Skin
Dry and damaged skin and hair can be signs of iron deficiency.
This is because when your body is iron deficient, it directs its limited oxygen to more important functions, such as organs and other bodily tissues.
When skin and hair are deprived of oxygen, it can become dry and weak.
More severe cases of iron deficiency have been linked to hair loss.
It is completely normal for some hair to fall out during everyday washing and brushing, but if you are losing clumps or much more than normal, it may be due to iron deficiency.
- Swelling and Soreness of the Tongue and Mouth
Sometimes just looking inside or around your mouth can give you an indication of whether you are suffering from iron-deficiency anemia.
Signs include when your tongue becomes swollen, inflamed, pale or strangely smooth.
Low hemoglobin in iron deficiency can cause the tongue to become pale, while lower levels of myoglobin can cause it to become sore, smooth and swollen.
Myoglobin is a protein in red blood cells that supports your muscles, such as the muscle that makes up the tongue.
Iron deficiency can also cause dry mouth, sore red cracks at the corners of the mouth or mouth ulcers.
- Restless Legs
Iron deficiency has been linked to restless leg syndrome .
Restless leg syndrome is a strong urge to move your legs at rest. It can also cause unpleasant and strange crawling or itchy sensations in the feet and legs.
It is usually worse at night, meaning that sufferers may struggle to get much sleep.
The causes of restless leg syndrome are not fully understood.
However, up to 25% of people with restless leg syndrome are thought to have iron-deficiency anemia, and the lower the iron levels, the worse the symptoms.
- Brittle or Spoon-Shaped Fingernails
A much less common symptom of iron deficiency is brittle or spoon-shaped fingernails, a condition called koilonychia.
This often starts with brittle nails that chip and crack easily.
In later stages of iron deficiency, spoon-shaped nails can occur where the middle of the nail dips and the edges are raised to give a rounded appearance like a spoon.
However, this is a rare side effect and usually only seen in severe cases of iron-deficiency anemia.
- Other Potential Signs
There are several other signs that your iron could be low. These tend to be less common and can be linked to many conditions other than iron deficiency.
Other signs of iron-deficiency anemia include:
- Strange cravings: A hankering for strange foods or non-food items is called “pica.” It usually involves cravings to eat ice, clay, dirt, chalk or paper and could be a sign of iron deficiency. It can also occur during pregnancy.
- Feeling anxious: The lack of oxygen available to body tissues in iron deficiency may cause feelings of anxiety. However, this tends to improve or resolve as iron levels are corrected.
- Cold hands and feet: Iron deficiency means less oxygen is being delivered to the hands and feet. Some people may feel the cold more easily in general or have cold hands and feet.
- More frequent infections: Because iron is needed for a healthy immune system, lack of it may cause you to catch more illnesses than usual.
What to Do If You Think You’re Iron Deficient
If you think you have iron-deficiency anemia, consider the following advice.
Talk to Your Doctor
If you think you’re showing signs or symptoms of iron deficiency, you should make an appointment to see your doctor. A simple blood test will confirm whether you have iron-deficiency anemia.
If your doctor confirms you have iron deficiency, you will likely be able to treat it fairly easily by increasing your intake of iron from your diet or with iron supplements.
The main aim of treatment is to restore hemoglobin levels to normal and replenish iron stores.
Try to ensure you are getting enough iron through real food in your diet. Only take supplements if your doctor recommends them.
Eat Iron-Rich Foods
If your doctor thinks your iron deficiency may be caused by a lack of iron in your diet, think about consuming more iron-rich foods, such as:
- Red meat, pork and poultry
- Dark green, leafy vegetables, such as spinach and kale
- Dried fruit, such as raisins and apricots
- Peas, beans and other pulses
- Iron-fortified foods
- Seeds and nuts
Help Boost Your Iron Absorption
Importantly, eating vitamin C will help your body absorb iron better. Make sure you eat enough vitamin C-rich foods, such as fruits and vegetables.
It may also be beneficial to avoid certain foods that can inhibit iron absorption when eaten in large amounts. These include tea and coffee and foods high in calcium such as dairy products and whole-grain cereals.
Take Iron Supplements If Your Doctor Recommends Them
Generally, you should only take an iron supplement as a last resort and if your doctor recommends it. This will likely be the case if you are unable to restore your iron levels through diet alone.
If you do take an iron supplement, try drinking orange juice with it to boost iron absorption.
Keep in mind that there are some unpleasant side effects of taking iron supplements. These include stomach pain, constipation or diarrhea, heartburn, nausea and black stools.
However, these side effects usually decrease over time and depend on the dose of iron you take.