Iron is a mineral that's important for the health of your red blood cells. It's found in two red blood cell proteins: hemoglobin and myoglobin. Iron helps transport oxygen from your lungs to the rest of your body, supports connective tissue health, and promotes muscle metabolism.
Iron deficiency can occur if you have a condition that decreases your body's ability to absorb iron, such as inflammatory bowel or celiac disease. People who don't eat enough iron-rich foods or who have higher iron needs due to pregnancy or breastfeeding can also become deficient.
Since iron is found in blood, losing blood can also cause a deficiency. This can happen from heavy menstrual periods, gastrointestinal bleeding, traumatic injuries, and urinary tract bleeding.
Noticing signs of iron deficiency early on is crucial to prevent it from progressing and leading to more severe complications like heart problems, pregnancy complications, and developmental delays in children.
Fatigue is one of the most common symptoms of iron deficiency. You may feel weak and tired for no apparent reason, even if you're getting enough sleep. This happens because when you lack iron, there isn't enough hemoglobin to transport oxygen to all of your tissues, causing fatigue.
Iron deficiency is also linked with sleep disorders like insomnia and restless leg syndrome, which can disrupt sleep and exacerbate feelings of fatigue.
While there are other reasons for fatigue, many people with iron deficiency experience this symptom. Feeling fatigued, along with other iron-deficient symptoms, might indicate you're dealing with a deficiency.
2. Your Hands and Feet Are Always Cold
A lack of iron can sometimes result in cold fingers and toes, even when the surrounding environment is not cold. Similar to fatigue, this symptom is related to the role of hemoglobin in the body.
Without enough hemoglobin, your blood circulation decreases, and adequate oxygen doesn't reach your extremities. You may generally feel colder than people around you, not just in your hands and feet.
You may be low on iron if your skin is paler than usual. Unusual paleness is another sign of decreased blood circulation, which can happen when your body isn't producing enough red blood cells due to iron deficiency.
This symptom can present differently depending on skin tone. Paleness may be more evident in lighter skin tones, visible across the face. In darker skin tones, abnormal paleness may be easier to detect in the inner mouth and lining of the eyes.
4. You Often Feel Dizzy or Lightheaded
Another common symptom of iron deficiency is dizziness or lightheadedness. This happens because when your body is low in iron, it lacks enough red blood cells to carry oxygen to the brain and other organs.
Lightheadedness is another symptom that isn't specific to iron deficiency. It could indicate a wide range of issues and various levels of severity. Consider whether you're experiencing this symptom in combination with other symptoms or signs of iron deficiency.
When your brain isn't getting enough oxygen, a headache can follow. Iron deficiency can also cause your blood vessels to swell, which could create pressure that leads to a headache.
A recent study found a strong link between iron deficiency anemia and chronic daily headaches. Migraines were also common among study participants with iron deficiency.
6. Your Hair and Nails Are Weak or Brittle
Having brittle nails can be another indicator of iron deficiency. If the iron deficiency progresses, you may also develop koilonychia, a condition where your nails curve inward and have raised ridges, similar to spoons.
Koilonychia affects about 5% of people with iron deficiency. It may happen due to abnormalities in blood flow to the nails and mechanical pressure that causes the outer portions of the nails to grow upward.
Iron deficiency can also lead to hair thinning and loss due to a lack of nutrition and blood flow, which your hair needs to grow. Research shows iron deficiency is a frequent cause of hair loss.
Iron deficiency can cause pica, eating or craving non-nutritive substances like ice, dirt, uncooked rice, or paper. In the United States, an estimated 25% of people with iron deficiency experience pagophagia—craving ice.
This symptom occurs most often in pregnant people or preadolescents. There's no known cause of pica or explanation for why it's often linked with iron deficiency.
How To Test for Iron Deficiency
If you notice any of the above signs or symptoms of iron deficiency, consider contacting a healthcare provider. You should also talk to a healthcare provider if you notice blood or a black tar-like appearance in your stool.
Your healthcare provider can check for iron deficiency using blood tests, including a complete blood count (CBC) and a reticulocyte count. These tests check your red blood cells, platelets, hemoglobin, and more, which can help diagnose anemia.
Your healthcare provider may also check your serum iron level, total iron binding capacity, and serum ferritin to diagnose iron deficiency.
To prevent or manage iron deficiency, start by eating iron-rich foods. Good sources include beans, dried fruit, eggs, lean red meat, salmon, iron-fortified grains, peas, tofu, and dark leafy greens. Pairing these foods with sources of vitamin C (e.g., oranges, tomatoes, strawberries) helps your body absorb more iron, especially from plant-based sources.
If you have iron deficiency or are at risk of developing it, taking an iron supplement under the guidance of a healthcare provider may help keep your iron levels within normal range.
Your healthcare provider can help determine an appropriate dose of supplemental iron based on your current iron levels and any health conditions you have. Restoring iron levels to the normal range can take 3-6 months of supplementation.
Iron supplements often cause side effects like nausea, diarrhea, or constipation. If you experience these, your healthcare provider may suggest pairing a supplement with food or lowering the dose.
In severe cases of iron deficiency, you may need intravenous iron or a blood transfusion. If the iron deficiency is caused by internal bleeding or kidney disease, interventions like surgery or medication may be necessary to stop the underlying cause of the deficiency.
Who's at Risk?
Groups at higher risk of deficiency include people with heavy menstrual bleeding, cancer, gastrointestinal disorders, or heart failure and people who are pregnant. Infants and young children are more likely to experience iron deficiency.
A Quick Review
Iron deficiency can cause symptoms like fatigue, cold hands and feet, dizziness, headaches, and ice cravings. If you're experiencing these symptoms, consider speaking with a healthcare provider. They can perform a blood test to make a diagnosis and recommend a treatment plan.
To prevent or manage iron deficiency, eat plenty of iron-rich foods, such as lean meat, dark leafy greens, beans, and fortified grains.
