Low Iron

Iron is a vital component of a healthy diet.¹ Yet, around one billion people across the world have iron deficiency (low iron levels).² … Read More See less

In the UK, it’s estimated that 3% of men and 8% of women have iron deficiency anaemia.²Although anaemia symptoms in women are the same as for men, women tend to have higher rates of iron deficiency due to heavy blood loss during menstruation and not eating enough iron rich foods during pregnancy.² As a result, 12% of premenopausal women and 23% of pregnant women in the UK have iron deficiency anaemia.²

However, not everyone with low iron is aware they have it, as mild anaemia may not cause any signs you are iron deficient.³ Or symptoms may come on so gradually that you don’t notice a difference in how you feel until your iron deficiency has advanced.⁴ Thankfully though, iron deficiency anaemia can be effectively treated.⁴

So, let’s find out more about iron deficiency symptoms, the slightly weirder signs of iron deficiency, iron supplements and what foods are high in iron.

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What is low iron?

Iron helps your bone marrow to make haemoglobin, the protein in red blood cells that carries oxygen around your body and gives your blood its red colour.^5,6,7 Iron also helps to make a protein called myoglobin, which gives your muscles the oxygen they need.¹

Too little iron means too little haemoglobin and myoglobin.¹ And too little haemoglobin and myoglobin means your body doesn’t have enough oxygen.¹ This causes a problem because your body uses oxygen for energy.¹

You may not notice you have low iron levels straight away, as when your iron stores first start running low it doesn’t immediately affect your red blood cells.⁷ However, once your red blood cells don’t have enough haemoglobin, your haemoglobin levels also start to drop, causing the symptoms of iron deficiency anaemia.⁷

How much iron do I need?

You should be able to get all the iron you need from the foods you eat every day. The amount of iron to aim for is:

Men aged 19+: 7mg a day
Women aged 19–49: 8mg a day
Women aged 50+ and still having periods: 8mg a day
Women aged 50+: 7mg a day

Low iron symptoms

The main signs and symptoms of anaemia due to iron deficiency include:^4,7,8

Tiredness and lack of energy
Shortness of breath
Noticeable heartbeats (heart palpitations)
Pale skin

Less common iron shortage symptoms include:^4,7,8

Headaches
A desire to eat non-food items, such as ice, paper or clay (pica)
Hearing sounds that come from inside the body, rather than outside (tinnitus)
An altered sense of taste
Itchiness
Muscle cramps
A sore or abnormally smooth tongue
Hair loss
Difficulty swallowing (dysphagia)
Painful open sores at the corners of your mouth
Spoon-shaped nails (koilonychia)
A fast heart rate (tachycardia)
Irritability

Causes of low iron

Iron deficiency anaemia can be caused by:^4,7–9

Blood loss – caused by heavy periods, or from bleeding in the stomach and intestines due to a stomach ulcer, stomach cancer, bowel cancer, or taking non-steroidal anti-inflammatory drugs (e.g. Ibuprofen and aspirin)
Malabsorption – when iron can no longer be absorbed through your stomach (e.g. Due to coeliac disease or weight loss surgery)
Lack of iron in your diet – when you don’t eat enough iron rich foods. Although, iron deficiency for this reason is rare except in pregnant people
Increased need for iron – pregnant people and people who have heavy periods need higher amounts of iron than the recommended daily dose

How is low iron diagnosed?

If you are experiencing the symptoms of low iron, you should arrange to see your GP who will be able to diagnose you as anaemic using a blood test.¹⁰

If you have iron deficiency anaemia, your blood test will show you have:¹⁰

Lower levels of haemoglobin than normal
Fewer red blood cells than normal
Small and pale red blood cells
Dangerously low ferritin levels (fe; the protein that stores iron)

If you do have low iron and low fe levels, your GP will want to find out what the underlying cause of the deficiency could be.¹⁰They may ask you about your diet, any medicines you take and your periods.¹⁰ They may also perform a physical exam to assess your stomach for signs of gastrointestinal bleeding and look for indicators of heart failure, such as swollen ankles.¹⁰

How to treat low iron

If your blood test indicates iron deficiency, you will be prescribed iron for anaemia and recommended to make some changes to your diet:^7,8,10–13

Iron supplements

Iron supplements can be used to restore your iron levels. Some people can experience side effects when taking iron supplements, such as:

Pain in their abdomen
Constipation
Diarrhoea
Heartburn
Nausea
Black stools

Supplements are usually taken as a tablet once, twice or three times a day, depending on your iron levels and whether you are struggling with any side effects. Vitamin C can help to increase your absorption of iron, so you may also be told to take your supplements with orange juice.

In rare cases, such as if you have chronic kidney disease, you may be recommended to have iron injections instead of tablets.

To keep your eye out for any signs your iron pills are working, pay attention to whether the symptoms of iron deficiency you experience are gradually clearing up.

Foods high in iron

If your GP thinks that a lack of iron in your diet is contributing to your iron deficiency anaemia, they will recommend you up your intake by eating more:

Dark-green leafy vegetables, such as watercress, curly kale and broccoli
Iron-fortified cereals, bread or pasta
Brown rice
Legumes, like green peas
Pulses and beans, like baked beans and black eyed peas
Tofu
Nuts and seeds
Meat, such as beef, pork, lamb, liver and other organs
Poultry, like chicken, duck, turkey and liver
Fish, such as shellfish, including clams, mussels, oysters, sardines and anchovies
Eggs
Dried fruit, such as dried apricots, prunes and raisins