Iron Deficiency: Symptoms & Treatments

[Article updated on 19/09/2023]

Iron is an essential element in the production of blood. It is mainly stored in red blood cells and helps in oxygen transport. Therefore, a deficiency is an obstacle to the proper functioning of the human body and must be quickly treated. In this article, I will show you the causes, symptoms, diagnosis of this lack, but also its prevention.

What is an iron deficiency?

Iron deficiency is often accompanied by iron deficiency anemia which means the body does not have enough red blood cells. This nutrient is essential in the production of hemoglobin, a protein essential for transporting oxygen from the lungs to all cells and organs of the human body.

Hemoglobin is also responsible for the red color of blood. In all cases, a lack leads to a reduction in the level of oxygen circulating throughout the body.

What are the causes of iron deficiency?

Iron deficiency anemia can happen for many reasons.

• Diet low in Iron: the main source of nutrients for the body is food. Favoring products containing very little or no iron for a prolonged period of time can lead to a deficiency. The amount required per day depends on age and gender. For example, adult men need 8 mg of iron per day, while it is 18 mg per day for women not yet in menopause;

• Inability of the body to absorb: iron from food is absorbed by the small intestine. But certain diseases complicate its task, such as celiac disease, ulcerative colitis or even Crohn’s disease. The same goes for surgical operations, gastric bypass for example, which involves the removal of a small part of the intestine;

• Massive blood loss: Blood contains iron which means that if you bleed a lot, you lose it too. Women with heavy periods and people with illnesses that can cause internal bleeding (peptic ulcer, hernia, colorectal polyp, etc.) may be victims of iron deficiency anemia;

• Pregnancy: For a pregnant woman, the iron reserve is both for her and the fetus growing inside her. The fetus greatly needs it to be able to develop properly;
• Medications: Certain medications like aspirin and anti-inflammatories can cause stomach bleeding. And PPI medications prevent the body from absorbing more iron.

Note that the probability of suffering from iron deficiency anemia is higher in certain categories of individuals. Here are the people most at risk:

• Women: since adolescence, due to menstruation, women bleed every month. Then upon arrival at pregnancy, the need for iron increases exponentially;
• Vegans: through their diet;
• Children (0 – 4 years old), adolescents and people over 65 years old;
• Frequent blood donors.

What are the symptoms of iron deficiency?

Symptoms vary depending on the progress of the deficiency, state of health and age. People who are in the early stages may not even show any signs.

Here are the most common symptoms:

• Unusual fatigue and shortness of breath: the body does not have enough energy due to lack of oxygen;
• Palpitation: the heart needs to work harder to circulate oxygen throughout the body;
• Paleness on certain parts of the body such as the face, nails, inside of the eyelids due to the lack of hemoglobin giving the red color of the blood;
• Migraine;
• Very dry skin and hair, hair loss;
• Swelling and pain in the tongue and lips;
• Restless legs syndrome: a desire to move the legs especially at night.

There are also other less common signs:

• Pica syndrome: a desire to eat inedible things like ice cubes, bricks, chalk, paper, etc.;
• Koilonychia: the nails are half-moon shaped;
• Infections: iron also helps in strengthening the immune system. A lack increases the risk of infection;
• Depression and anxiety;
• Cold hands and feet.

What to do in case of iron deficiency?

Please note that the symptoms mentioned above are similar to the symptoms of other diseases. If you suspect a deficiency, the first thing to do is to consult a doctor to get the exact diagnosis. In the meantime, you can start consuming iron-rich foods. However, please do not consume supplements without your doctor’s recommendation. Too much can damage other organs like the heart, kidney and pancreas.

How to diagnose iron deficiency?

To confirm the presence or not of an iron deficiency, the doctor will do at least one of the tests listed below:

• Hemogram: this test consists of analyzing all the components in the blood;
• Hematocrit measurement: the volume occupied by red blood cells in the blood is estimated. The normal rate is between approximately 35 and 44.5% in women and 39 to 50% in men;
• Blood smear: This test analyzes the size, shape and number of red blood cells. They are smaller than normal in the case of iron deficiency anemia;
• Hemoglobin measurement: the normal amount is between 12 to 15.5 g/dL for women and 13.5 to 17.5 g/dL for men. A level below normal indicates iron deficiency anemia;

• Ferritin dosage: this test makes it possible to determine the quantity of iron stored in the body by measuring the ferritin level;

• Total transferrin binding capacity: this test consists of measuring the number of free transferrin that can transport iron throughout the body;

• Reticulocyte count: This test evaluates the number of reticulocytes (young red blood cells) in the blood. In the case of iron deficiency anemia, this is low because the body does not produce enough red blood cells.

If the test confirms iron deficiency anemia, you may need to do other tests to find the cause:

• Fiberoscopy: to see if there is bleeding along the gastrointestinal tract;
• Pelvic ultrasound or biopsy of the cervix: for those with heavy periods, these tests help determine the cause;
• Fecal occult blood immunochemical test: This can detect if there is a small amount of blood in your stool that may indicate colon cancer or simply to determine the cause of intestinal bleeding.

Treatment for iron deficiency

Iron deficiency anemia can be corrected with a dietary supplement. For the dosage, it is the doctor who determines it according to the iron level in the blood. Taking vitamin C may also be recommended to help the body better absorb this nutrient. If the intestine really has difficulty absorbing it, an intravenous infusion is necessary.

Symptoms should disappear after a week of treatment. But for the iron level to return to normal, you will have to follow the treatment for a few months. However, supplements may have some side effects such as nausea, constipation, vomiting, diarrhea, heartburn, dark-colored stools. Do not hesitate to notify your doctor if the effects are unbearable.

Foods to choose to limit the risk of iron deficiency

To incorporate more iron into the body and prevent iron deficiency anemia, here is the list of foods rich in iron:

• Red meats: beef, pork, lamb, veal, goat;
• Seafood: shrimp, clams, oysters;
• Leafy vegetables: broccoli, kale, collard greens, spinach, turnip tops;
• Beans: lima beans, cornille beans, pinto beans;
• Eggs ;
• Cereals rich in iron;
• Pumpkin seeds;
• Dried fruits: grapes.