Iron deficiency anemia is a condition where there are too few red blood cells in the body due to a shortage of iron.

The body uses iron to produce red blood cells, which transport oxygen around the body.

Without enough iron, there may be too few healthy red blood cells to carry sufficient oxygen to satisfy the body’s needs.

The result of this situation is called iron deficiency anemia, which can leave a person feeling extremely tired and out of breath.

This article further defines iron deficiency anemia. It also explains the causes, risk factors, symptoms, and treatment for the condition.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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Anemia is a blood condition characterized by a lower number of red blood cells or a lower concentration of hemoglobin within those cells.

Hemoglobin is the part of the red blood cells that binds to oxygen. When the body does not have enough hemoglobin circulating, not enough oxygen gets to all parts of the body. As a result, organs and tissues may not function properly, and a person may feel fatigued.

According to the World Health Organization (WHO), anemia is a serious global health concern. It generally affects children, females who are menstruating, and females who have recently had a baby or recently completed menopause. The WHO estimates that anemia affects around:

  • 30% of females ages 15-49
  • 37% of pregnant people
  • 40% of children ages 6-59 months

Iron deficiency anemia occurs when the body does not have enough iron. It is the most common type of anemia worldwide.

Iron deficiency anemia relates directly to a lack of iron in the body. However, the cause of iron deficiency varies based on age, gender, and socioeconomic status.

Some common causes include:

  • blood loss
  • diet
  • decreased ability to absorb iron
  • pregnancy

Blood loss

One of the most common causes of iron deficiency in adults is blood loss.

There are various causes of blood loss that can lead to iron deficiency. These include:

Up to 5% of females develop iron deficiency anemia due to heavy bleeding during their periods.

Some less common causes of blood loss that can lead to iron deficiency include chronic nose bleeds and frequent blood donations.

Diet

Iron deficiency may occur due to a lack of iron in a person’s diet. This may be especially true during times that require more iron, such as:

  • infants
  • young children
  • adolescent females
  • pregnant people

However, in the United States, iron deficiency from consuming too little iron is rare. This is mainly due to supplemental iron being added to various foods.

Foods rich in iron, such as eggs and meat, supply the body with much of the iron it needs to produce hemoglobin. If a person does not eat enough to maintain their iron supply, an iron deficiency can develop.

Decreased ability to absorb iron

There are certain medications, factors, and conditions that can make it more difficult to absorb iron. This can lead to iron deficiency anemia.

Some of these conditions and factors include:

  • Endurance sports: Athletes who participate in endurance sports may be more likely to lose iron through the GI tract and the breakdown of red blood cells.
  • Surgery: Surgery on the stomach or intestines, including weight loss surgery, can make it more difficult for an individual to absorb iron.
  • Digestive and intestinal conditions: Certain conditions may make it more difficult to absorb iron. These include:

Pregnancy

Low iron levels are a common issue during pregnancy. This is because the body needs more iron than normal in order to support the developing fetus.

Pregnancy can also cause low iron levels because plasma and blood volumes are increased in the pregnant person during this time.

Some groups of people may have a higher risk of developing iron deficiency anemia.

Vegetarians and vegans

People, such as vegetarians or vegans, who eat a plant-based diet, may have low iron levels. This may be at least partially due to the body absorbing iron from vegetables differently from iron from meat and poultry.

It is important for vegetarians and vegans to make sure they are including enough iron in their diet. The Vegetarian Society suggests the following foods:

  • chickpeas, lentils, and other pulses
  • tofu
  • breakfast cereals
  • kale
  • cabbage
  • broccoli
  • nuts
  • dried fruits

Individuals can also discuss iron supplements with their healthcare professional.

Females

Pregnancy, menopause, and heavy bleeding during menstruation can all increase the risk of iron deficiency anemia in females.

Blood donors

Regular blood donation can lead to iron deficiency or iron deficiency anemia. According to research from 2022, this is a potential risk of blood donation that individuals should be made aware of.

The research also notes that it may be able to be prevented by limiting the amount of blood that is drawn, screening for iron deficiencies, and extending the amount of time between donations.

Infants and children

Infants and children may be at risk for iron deficiency. By 6-9 months, full-term infants may become iron deficient unless they get enough iron through their diet or through iron-rich formula.

Similarly, children going through growth spurts may have an increased risk of iron deficiency. It is important for children to eat a varied and nutrient-rich diet to help prevent iron deficiencies.

Iron deficiency anemia often develops slowly. This is partially due to it taking several months for the body to use up its iron reserves.

In some cases, an iron deficiency may improve with no intervention, as a person’s situation changes, such as after giving birth.

However, if a person has any symptoms of iron deficiency anemia, they should speak with a healthcare professional.

A person with an iron deficiency can have some of the following symptoms:

  • general weakness
  • dizziness or lightheadedness
  • extreme fatigue
  • fast heartbeat
  • easily broken and brittle nails
  • paleness
  • chest pain
  • shortness of breath
  • headaches
  • cold hands and feet
  • soreness or inflammation of the tongue
  • cravings for non-nutritive things, such as dirt, starch, or ice
  • poor appetite, especially in children

Complications

In milder cases of iron deficiency anemia, a person is unlikely to experience complications. However, additional complications can occur if the iron deficiency anemia is left untreated.

Possible complications include:

  • slow growth and developmental delays in children and infants
  • heart problems, including heart failure or an enlarged heart due to it compensating for lack of oxygen
  • pregnancy complications, including low birth weights and an increased risk of premature birth
  • depression
  • restless leg syndrome

Only a healthcare professional can diagnose iron deficiency anemia. It is important for a person to seek advice from a medical professional if they have noticeable symptoms.

It is likely that a healthcare professional will usually begin the exam by asking questions about a person’s general health. They may examine the skin tone, the fingernails, and under the eyelids to look for physical signs of iron deficiency anemia.

A healthcare professional will also generally order blood tests to check complete blood count (CBC), hemoglobin levels, blood iron levels, and ferritin levels.

They may ask further questions or run additional tests to help determine if the iron deficiency anemia is the result of an undiagnosed underlying condition.

These tests may vary, depending on other symptoms a person describes. For example, someone experiencing pain during digestion may require an endoscopy to see if a gastrointestinal disease is the cause of the iron deficiency.

Iron deficiency anemia is usually treated in two ways, which involve increasing iron intake and treating any underlying conditions.

Healthcare professionals may recommend using iron supplements to help correct iron intake levels. Supplements are often available over the counter. It is important to take the supplements as prescribed, because too much iron can be toxic and damage the liver.

Furthermore, large amounts of iron can cause constipation. As a result, a healthcare professional may prescribe stool softeners or laxatives to ease bowel movements.

If an underlying condition is found, further treatment may be needed. Treatments for underlying conditions will depend on the problem but may mean additional medications or surgery.

Self-management can involve adding more iron and vitamin C to the diet.

Foods rich in iron include:

  • beans
  • red meat
  • oysters
  • liver
  • dried fruits
  • iron-fortified cereals
  • peas

Foods rich in vitamin C include:

  • citrus fruits
  • leafy greens
  • broccoli

It is important to remember that correcting iron deficiency takes time. Treating iron deficiency anemia with supplements typically takes 3-6 weeks and requires continuation for 6 months after blood levels return to normal.

Iron deficiency anemia is the most common type of anemia. It occurs when there are too few red blood cells in the body due to a lack of iron.

It often occurs during pregnancy, due to blood loss, or due to a decreased ability to absorb iron. Symptoms can include fatigue, pale skin, and shortness of breath.

Treatment for iron deficiency anemia typically involves iron supplements and treating any underlying conditions.