Iron deficiency is the most widespread nutritional deficiency in the world, estimated to affect approximately 30 percent of the world’s population (1). When your iron is too low, you can experience a number of uncomfortable and inconvenient symptoms that result from iron deficiency anemia. Although most people with low iron will experience mild symptoms of iron deficiency anemia, some cases can be more severe.
What is iron deficiency anemia?
Iron deficiency anemia, or low iron levels, is a condition that occurs when our bodies don’t have enough iron to carry out normal functions. Iron is an important mineral that is used to produce hemoglobin, which is a protein that the red blood cells need in order to transport oxygen to the different areas of the body. Without enough hemoglobin, the blood cells cannot carry enough oxygen to the muscles, organs, and tissues, which prevents the different parts of the body from working effectively. Anemia can be caused by a number of factors, but the most common cause around the world is iron deficiency (2). Iron deficiency anemia can cause a number of different health problems that can negatively affect a person’s quality of life, so it’s important to address it as quickly as possible.
What happens when your iron is low?
One of the most common symptoms of iron deficiency anemia is feeling unusually tired (3). More than half of people who experience low iron experience feelings of tiredness as a result of their condition (4). People experience low energy and exhaustion when they have anemia because the body must work harder in order to move enough oxygen to each area of the body. Another common symptom is pale skin and pale coloring inside the lower eyelids. This occurs because without hemoglobin, which is what gives blood cells their red coloring, the blood is less red and causes people to appear more pale at the surface of the skin. Unsurprisingly, another symptom of iron deficiency anemia is shortness of breath. With the lack of oxygen being carried in the blood, your overall oxygen levels will be low, causing you to breathe harder to try and take in more oxygen. This can even occur with everyday tasks like walking or climbing stairs. People with low iron may also experience headaches and dizziness as a result of reduced oxygen to the brain, which can cause swelling in the blood vessels that cause pain. Other less common symptoms of iron deficiency anemia include chest pain/fast heartbeat/irregular heartbeat, dry or damaged hair and skin, brittle nails, cold hands and feet, swelling and soreness in the mouth, restless legs syndrome, and brittle fingernails.
How is an iron deficiency diagnosed?
There are several different ways that an iron deficiency can be diagnosed. While your doctor may suspect that you have an iron deficiency based on certain symptoms such as fatigue and pale color, your doctor will perform a blood test to confirm the diagnosis. Blood tests for iron deficiency include, but are not limited to (5):
- Complete blood count: The complete blood count, or CBC, counts the number of red blood cells that you have.
- Hematocrit: The hematocrit test examines what percentage of your blood is comprised of red blood cells. Normal levels range from 35.5 percent to 44.9 percent in adult women, while adult men have a normal range of 38.3 percent to 38.6 percent (6).
- Ferritin: Ferritin is a protein that helps the body with iron stores. When ferritin levels are low, it usually means that the amount of iron stored in the body is also low and you may be iron deficient.
- Hemoglobin: Hemoglobin is the protein in the blood that allows red blood cells to carry oxygen to different parts of the body. Low levels of hemoglobin indicate anemia, but the normal range varies for men and women. Adult men typically have a normal hemoglobin range of 13.2 to 16.6, while adult women have a normal range of 11.6 to 15 (6).
What are the causes of iron deficiency?
Although iron deficiency anemia occurs as a result of low iron in the body, there are several different reasons why someone might have a lack of iron (7). These include:
- Lack of dietary iron: Our main source of iron is the foods we eat, so people who do not consume foods that contain enough iron are likely to experience a deficiency. Iron-rich foods include meat (especially red meat), eggs, green leafy vegetables like spinach and kale, and foods that are fortified with iron.
- Substantial blood loss: Because each of our red blood cells is loaded with iron, losing blood means that your body loses iron. Iron deficiency anemia commonly occurs in women with heavy periods who bleed excessively during menstruation, but people with gastrointestinal bleeding, such as bleeding caused by an ulcer, cancer, polyp, or hiatal hernia, can also experience iron deficiency.
- Pregnancy: Women’s bodies are already working overtime to provide enough oxygen and nutrients to their growing child, which means iron deficiency anemia is common in pregnant women who don’t take an iron supplement. Women not only need to support their own increased blood volume, they also have to have enough iron to provide hemoglobin for the fetus.
- Inability to absorb iron: Some people have medical conditions that affect the absorption of iron. Gastrointestinal disorders such as celiac disease or inflammatory bowel disease are commonly linked to iron absorption issues, as are surgeries such as gastric bypass or those that remove a portion of the small intestine.
Who is at higher risk of developing low iron?
Anyone can develop low iron, but some groups of people are at greater risk for experiencing the deficiency. Risk factors include (5):
- Gender: Women are more likely to experience iron deficiency anemia than men because they lose blood during menstruation (especially with heavy menstrual periods), experience pregnancy, and breastfeed children.
- Age: People over the age of 65, children up to 2 years of age, and teenagers are the groups considered most at risk of iron deficiency.
- Vegetarians and vegans: Because meat is the most significant source of iron in the average diet, people who do not eat meat are at increased risk of iron deficiency. However, this risk can be mitigated by eating other iron-rich foods, such as leafy greens, or by taking a supplement with iron in it.
- Lifestyle: People who spend a significant amount of time exercising, such as athletes, can experience iron deficiency more commonly than other people since the body needs more oxygen.
What complications are associated with iron deficiency anemia?
Most people with iron deficiency anemia experience uncomfortable or frustrating symptoms like fatigue and headaches, but mild cases usually do not cause complications. However, if left untreated, iron deficiency anemia can become worse over time and eventually cause significant health issues. Complications associated with iron deficiency anemia include (7):
- Heart issues, including palpitations (as noted above) or, in more serious cases, an enlarged heart or heart failure
- Premature births and low birth weights among women who experience severe iron deficiency anemia while pregnant and do not treat the condition with supplements
- Delayed growth and development in children and infants who do not receive enough iron, as well as increased likelihood of contracting infections
What can you do to prevent iron deficiency?
One of the easiest things you can do to prevent an iron deficiency is incorporate iron-rich whole foods into your diet. The body is better able to absorb iron from whole food sources than from vitamins, so whether you choose a whole food supplement like GEM that contains the iron you need, or if you prefer to add more iron-rich foods into your meals, it’s best to get your iron from food. Iron-rich foods include:
- Red meat, poultry, and pork
- Beans
- Dried fruits like apricots and raisins
- Peas
- Seafood
- Dark leafy green vegetables like spinach
- Iron-fortified pastas, cereals, and breads
The body is better able to absorb and use iron that it gets from meat than from other sources, so people who choose not to eat meat will have to eat a high volume of plant-based foods in order to absorb the same amount of iron as those who do eat meat. Eating foods rich in vitamin C, such as broccoli, kiwi, leafy greens, oranges, strawberries, tomatoes, and peppers can also help your body absorb iron more efficiently.
In order to prevent low iron in infants, infants should be fed either breast milk or formula that is iron-fortified for their first year of life. Iron intake in babies can also be increased by feeding pureed meats and iron-fortified cereals a minimum of twice per day to children over six months in age. Unfortunately, cow’s milk is not a good source of iron for children, so it is recommended that children do not receive it before the age of one. After they turn one, the quantity of milk should be limited, as children often drink too much milk and aren’t hungry enough to consume iron-rich foods, which can cause a deficiency.
Myth Busters:
Myth: Iron deficiency affects all genders and races equally
Fact: Women are more likely to experience iron deficiency than men, and white women are less likely to experience iron deficiency than Black and Hispanic women (8).
