Iron Deficiency Anemia: Symptoms, Causes, and Treatment

Iron deficiency anemia occurs when the body doesn't have enough iron to produce adequate hemoglobin — the protein in red blood cells that carries oxygen. It is the most common nutritional deficiency worldwide, affecting approximately 1.2 billion people.

Symptoms

• Fatigue and weakness (most common)
• Pale or yellowish skin
• Shortness of breath
• Dizziness or lightheadedness
• Cold hands and feet
• Brittle nails
• Unusual cravings for non-food items (pica) — ice, dirt, starch
• Restless legs syndrome
• Headache

Who Is Most at Risk?

• Women of reproductive age (menstrual blood loss)
• Pregnant women (increased iron demand)
• Infants and young children (rapid growth)
• Vegetarians and vegans (non-heme iron from plants is less absorbable)
• People with GI conditions (celiac disease, Crohn's, gastric bypass)
• Frequent blood donors
• Athletes (especially endurance runners)

Diagnosis

A complete blood count (CBC) is the initial test. Low hemoglobin and hematocrit suggest anemia. Additional tests (serum ferritin, serum iron, TIBC) confirm iron deficiency specifically.

Important: Always identify the underlying cause. In adults, especially men and postmenopausal women, iron deficiency may indicate GI bleeding that requires investigation.

Treatment

Dietary changes:

• Red meat, poultry, and fish (heme iron — most absorbable)
• Legumes, tofu, fortified cereals, spinach (non-heme iron)
• Pair non-heme iron with vitamin C to enhance absorption
• Avoid coffee, tea, and calcium supplements with iron-rich meals

Iron supplements:

• Ferrous sulfate is the most common form
• Take on an empty stomach if tolerated; with food if GI upset occurs
• Side effects: constipation, dark stools, nausea

IV iron infusion: For severe deficiency or when oral iron isn't tolerated

Treat the underlying cause — supplements alone won't fix ongoing blood loss.