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Iron deficiency anaemia: Everything you need to know

What is iron deficiency anaemia?

Anaemia occurs when you have a level of red blood cells (RBCs) in your blood that is lower than normal. Iron deficiency anaemia is the most common type of anaemia, and it occurs when your body doesn’t have enough of the mineral iron. Your body needs iron to create a protein called haemoglobin. This protein is responsible for transporting oxygen to your body’s tissues, which is essential for them to function effectively. When there isn’t enough iron in your bloodstream, the rest of your body can’t get the amount of oxygen it needs.

What causes iron deficiency anaemia?

Low Iron Intake

Consuming too little iron over an extended amount of time can create a shortage in your body. Foods such as meat, eggs, and some green leafy vegetables are high in iron. Because iron is imperative during times of rapid growth and development, pregnant women and young children may require even more iron-rich foods in their diet.

Pregnancy or Blood Loss Due to Menstruation

In women of childbearing age, the most prevalent causes of iron deficiency anaemia are heavy menstrual bleeding and blood loss during childbirth.

Internal Bleeding

Specific medical conditions can cause internal bleeding that can lead to iron deficiency anaemia. Examples include a stomach ulcer, Intestinal polyps, or colon cancer. Frequent use of pain relievers, such as aspirin, can also cause bleeding in the stomach.

Inability to Absorb Iron

Certain disorders that affect the intestines can also interfere with how your body absorbs iron. Even if you get enough iron in your diet the following conditions may limit iron absorption:

  1. Celiac disease
  2. Non-celiac gluten sensitivity
  3. SIBO
  4. Achlorhydria (Low stomach acid)
  5. Parasites

What Are the Symptoms of Iron Deficiency Anaemia?

The symptoms of iron deficiency anaemia can be very mild at first, and you may not even notice them. According to the American Society of Hematology (ASH), most people don’t apprehend they have mild anaemia until they have a blood test.

The symptoms of moderate to severe iron deficiency anaemia include:

  1. general fatigue
  2. weakness
  3. pale skin
  4. shortness of breath
  5. dizziness
  6. strange cravings to eat items that aren’t food, such as dirt, ice, or clay
  7. a tingling or crawling feeling in the legs
  8. tongue swelling or soreness
  9. cold hands and feet
  10. fast or irregular heartbeat
  11. brittle nails
  12. headaches
  13. lower back pain

How Is Iron-Deficiency Anaemia Diagnosed?

Your doctor can diagnose anaemia with blood tests including:

Complete Blood Cell (CBC) Test

A full blood cell (CBC) test is usually the first test a doctor will use. A CBC test measures the amount of all components of the blood, including:

  1. red blood cells (RBCs)
  2. white blood cells (WBCs)
  3. hemoglobin
  4. hematocrit
  5. platelets

The CBC test provides information about your blood that is helpful in diagnosing iron deficiency anaemia. This information includes:

  1. the hematocrit level, which is the percent of blood volume that is made up of RBCs
  2. the haemoglobin level
  3. the size of your RBCs

In iron deficiency anaemia, the hematocrit and haemoglobin levels are low. Also, RBCs are usually smaller in size than normal.

A CBC test is often performed as part of a routine physical examination. It’s a good indicator of a person’s overall health. It may also be performed routinely before surgery. This test is useful to diagnose this type of anaemia since most individuals who have an iron deficiency don’t realise it.
Other Tests

Anaemia can usually be confirmed with a CBC test. Your doctor might order additional blood tests to determine how severe your anaemia is and assist in identifying treatments including:

  1. Iron level in your blood
  2. Ferritin levels – Ferritin is a protein that helps with iron storage in your body. Low levels of ferritin indicate low iron storage.
  3. Total iron-binding capacity (TIBC)
  4. Transferrin – Transferrin is a protein that transports iron. A TIBC test is used to determine the amount transferrin that’s carrying iron.

What if you have symptoms of low iron, but your doctor says your test results are normal?

If you suspect low or high levels of iron, then check your ferritin test result. The ideal range of ferritin is 50 to 70 ng/ml.

What Are the Potential Health Complications of Iron Deficiency Anemia?

Most cases of iron deficiency anaemia are mild and don’t cause complications. The condition can usually be easily corrected. However, if anaemia or iron deficiency is untreated, it can lead to other health problems, including:

Rapid or Irregular Heartbeat

When you’re anaemic, your heart has to pump more blood to make up for the small amount of oxygen that can lead to irregular heartbeat. In severe cases, it can lead to heart failure or an enlarged heart.

Pregnancy Complications

In severe cases of iron deficiency, a child may be born prematurely or with a low birth weight. Most pregnant women take iron supplements as part of their prenatal care to prevent this from happening.

Delayed Growth in Infants and Children

Infants and children who are severely deficient in iron may experience a delay in their growth and development. They may also be more likely to experience infections.

How Is Iron-Deficiency Anaemia Treated?

Iron Supplements

Iron tablets can help restore iron levels in your body. If possible, you should take iron pills on an empty stomach, which helps the body absorb them better. If they upset your stomach, you can take them with meals. You may need to take the supplements for several months. Iron supplements may cause constipation or stools that are black in colour. A non-constipating form of iron is iron glycinate.


Diets high that include the following foods can help treat or prevent iron deficiency:

  1. red meat
  2. dark green, leafy vegetables
  3. dried fruits
  4. nuts

Additionally, vitamin C helps your body absorb iron. If you’re taking iron tablets, I suggest taking the pills along with a source of vitamin C, like a glass of orange juice or citrus fruit.

Treating the Underlying Cause of Bleeding

If you have tried supplementing, modifying your diet and your doctor has ruled out any serious causes of anaemia such as internal bleeding then you more than likely have an absorption problem. In my clinical experience, the most common causes of poor iron absorption include:

  1. Non-celiac gluten sensitivity
  2. Intestinal Parasites
  3. SIBO

If you have any questions about this article either post them in the comments section below or email using the form on my contact page.


This article in not intended to provide medical advice, diagnosis or treatment.