Most people have occasional bouts of fatigue, but if you’re often tired even after getting a good night's rest, there may be something behind your fatigue. Much of your energy depends on the oxygen you breathe, which is carried by red blood cells. These cells require iron, and if you have low iron levels, you might also be short in red blood cells. If your red cell count is low enough, you could have iron deficiency anemia.

What Is Iron Deficiency Anemia?

Red blood cells and their hemoglobin, which is gas carrying protein inside each red blood cell, transport oxygen and carbon dioxide throughout your body. They bring the oxygen you inhale from your lungs to the tissues in your body, and then take carbon dioxide back to your lungs to be exhaled.

Anemia is when there is a shortage of red blood cells or hemoglobin, which means that your blood can’t transport enough oxygen and carbon dioxide. There are several causes of anemia and iron deficiency is the most common.

Stages and Types of Iron Deficiency Anemia

Iron deficiency anemia is the third phase in a three-step process that involves reduced iron levels in your body.

  • Iron depletion: The level of iron in your bone marrow is reduced because you are not getting enough iron in your diet. Iron depletion usually does not cause symptoms and may not show up in blood tests.
  • Iron deficiency: Your iron levels are low enough that your production of hemoglobin begins to decrease.
  • Iron deficiency anemia: Your iron is so low that your body can’t produce the hemoglobin it needs to transport oxygen properly.

Symptoms and Causes

The symptoms of iron deficiency anemia worsen along with the condition. These symptoms are a result of the insufficient transportation of oxygen and carbon dioxide in your body and include the following:

  • Tiredness
  • Weakness
  • Yellow or pale skin
  • Shortness of breath
  • Chest pain
  • Irregular heartbeats
  • Cold hands and feet
  • Dizziness
  • Light-headedness
  • Headache
  • Decreased immunity
  • Tongue inflammation
  • Slow childhood development
  • Hair loss
  • Whooshing sound in ears

Prevention and Risks

Iron deficiency occurs when your iron intake isn't enough to provide what you need which might be due to not getting enough iron in your diet, problems absorbing iron, or if your need for iron has increased.

Insufficient dietary iron can result from:

  • Young children consuming too much dairy: excess dairy can interfere with the absorption of iron. Dairy is also a poor source of iron, and young children who consume too much of it may not have a diet varied enough to incorporate good sources of iron such as red meat and green leafy vegetables.
  • People on restricted diets who may be missing iron, folate or B12

The following can cause Iron absorption problems:

  • Intestinal disorders such as Crohn’s disease
  • Polyphenols bind to iron cells in the intestines, preventing them from entering the blood stream, and are found in items such as cocoa and coffee. Other food items that prohibit iron absorption include eggs, calcium, oxalates (found in foods like kale, spinach, nuts, and chocolate), and phytate (found in soy protein and fiber)
  • Heart failure

Situations that result in an increased need for iron are:

  • Pregnancy
  • Childhood, during which the rapid rate of growth results in faster use of consumed iron
  • Menstruation
  • Frequent blood donations
  • Slow and chronic blood loss such as from an ulcer
  • Illness, exposure to toxins, and certain medications

Diagnosis and Tests

Your doctor will review your symptoms and order a complete blood count (CBC) to look at your hemoglobin levels and the percentage of red blood cells (hematocrit). These tests reveal your iron level. If the results point to anemia, your doctor may conduct more tests to rule out certain causes, such as chronic internal bleeding from an ulcer or cancer.

Treatment, Procedures, and Medication

The treatment of iron deficiency anemia involves increased iron intake. You may be prescribed a medicinal dose. Your doctor may also ask you to repeat the blood tests to find out if your iron levels are getting back to normal, or if you need supplements.

Since iron deficiency is common in heart conditions, your doctor may send you to a cardiologist for additional care. A registered dietitian can supervise your diet, and gastroenterologists and gynecologists can lend their expertise if contributing factors such as intestinal problems or female reproductive issues are considered suspect.

If you have trouble absorbing iron in the intestinal tract or cannot take medication orally, your doctor may give you iron intravenously (using a syringe or an intravenous tube), or refer you to a hematologist. In severe cases, your doctor may give you a blood transfusion, which is a temporary fix to treat symptoms such as chest pains or shortness of breath until the doctor finds out the cause of your anemia.

Healthy Lifestyle Tips

Eating well is essential for the treatment of iron deficiency anemia. Exercise is beneficial but only under medical supervision to avoid stress. Over-the-counter medicine such as aspirin and ibuprofen can cause hidden problems such as bleeding, so consult with your doctor before you try to self-medicate. Avoid smoking, excess alcohol and recreational drug use.

Eating food rich in iron helps your body produce enough red blood cells to keep anemia at bay. Good sources of iron include:

  • Iron-fortified foods such as cereals
  • Meats such as chicken, pork, beef, and turkey
  • Seafood such as tuna, sardines, and oysters
  • Plant food such as green peas, chickpeas, lentils, and tomatoes

To get the most benefit from the iron-rich foods that you eat, add certain foods to your diet, such as products containing vitamin C, which will help your body absorb iron. Some examples of vitamin C-rich foods include the following:

  • Broccoli
  • Oranges
  • Tomatoes
  • Peppers
  • Grapefruit
  • Kiwi
  • Tangerines


If you have symptoms of iron deficiency anemia, see your doctor sooner rather than later. Treatment is easier if you catch the condition early. If left untreated, it can be severe and lead to complications such as an enlarged heart or heart failure. But if you seek help at the first sign of a problem, your chances of successfully managing anemia are excellent.