Iron deficiency anaemia
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Symptoms
Iron deficiency anaemia can cause a variety of symptoms, but many people experience only mild effects, especially if the condition develops slowly over time. Depending on the underlying cause, symptoms may appear suddenly or gradually.
Common symptoms you might notice include:
- Feeling unusually tired or low on energy (lethargy)
- Shortness of breath, even with minimal exertion
- A fast or irregular heartbeat (heart palpitations)
- Looking paler than usual
- Restless legs syndrome
If you notice symptoms of iron deficiency anaemia, it’s important to speak to your GP. A blood test can confirm the diagnosis and can help you get suitable treatment to start feeling better.
Less common symptoms may include:
- Headaches
- Ringing or other sounds in your ears (tinnitus)
- A change in taste
- Itchy and dry skin
- A sore or unusually smooth tongue
- Hair loss
- Cravings for non-food items like ice or paper (known as pica)
- Cracked or sore areas at the corners of your mouth (angular cheilitis)
- Spoon-shaped nails
- Difficulty swallowing (dysphagia) – although this is a rare symptom
What can cause iron deficiency anaemia?
Iron deficiency anaemia happens when your body doesn’t have enough iron to produce red blood cells, which are essential for carrying oxygen around your body. As we can get the iron we need from a healthy, balanced diet, it’s rare for iron deficiency anaemia to be caused just by a lack of iron in your diet, unless you’re pregnant. However, if you do lack dietary iron, it may mean you’re more likely to develop anaemia if you’re affected by any of the below.
For many girls & women, heavy periods (known as menorrhagia) are a common cause of iron deficiency anaemia, as blood loss gradually depletes iron levels over time.
During pregnancy, your body needs extra iron to support the baby’s development and blood supply. If your diet doesn’t meet these increased demands, iron deficiency anaemia can happen. Your GP or midwife may recommend an iron supplement to help.
In men and post-menopausal women, gastrointestinal bleeding is a common cause of iron deficiency anaemia. This bleeding can initially occur without obvious symptoms and may result from:
- Stomach ulcers – open sores in the stomach lining that can lead to slow blood loss. They can develop for several reasons, including side effects of certain medications, like non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen
- In some cases, bleeding may indicate bowel or stomach cancer, especially in people over 60. Symptoms of these conditions can include trace amounts of blood (called ‘occult blood’) in poo or blood in vomit that looks like ground coffee (‘coffee ground vomit’)
- Angiodysplasia– fragile blood vessels in the digestive system can also lead to bleeding
Conditions like coeliac disease or surgeries affecting the intestines can interfere with your body’s ability to absorb iron from food, leading to deficiency, which can then lead to iron deficiency anaemia.
Certain health issues, like chronic kidney disease (CKD), Crohn’s disease or ulcerative colitis, can lead to iron deficiency anaemia due to multiple factors like ongoing blood loss or difficulty absorbing iron. In these cases, a supplement or medical treatments may be recommended.
Less common causes can include frequent nosebleeds, trauma causing blood loss or donating blood frequently.
Diagnosing iron deficiency anaemia
If you're experiencing symptoms of iron deficiency anaemia, like fatigue or shortness of breath on minimal activity, it’s important to see your GP. Diagnosing iron deficiency anaemia usually involves a simple blood test. Here's what to expect:
Blood test & investigations
A blood test is the main method for diagnosing iron deficiency anaemia. This test will measure different types of blood cells and other blood components. If you have anaemia, the results may show:
- Lower levels of haemoglobin, the protein in red blood cells that carries oxygen
- Fewer red blood cells than normal
- Smaller and paler red blood cells
Your GP may also test your ferritin levels, which indicate how much iron your body has stored. Low ferritin levels suggest iron deficiency anaemia.
To help find out why you might have iron deficiency anaemia, your GP may ask about:
- Diet – to check if your meals include enough iron-rich foods
- Medication – to check if you’re taking medicines like ibuprofen or aspirin
- Menstrual patterns, if applicable – you may be asked about heavy periods, a common cause of iron deficiency anaemia
- Family history – to identify any genetic or gastrointestinal conditions that may be a contributing factor
Your GP may conduct a physical examination or investigate for an underlying cause.
- Rectal examination – to help detect abnormalities in the gastrointestinal tract. This is a quick and common examination that should only cause slight discomfort
- Pelvic examination – this may be done to investigate heavy menstrual bleeding. Your GP may examine both externally and internally
If the cause remains unclear or if symptoms suggest a serious underlying issue, your GP may refer you to a specialist.
An at-home test like the MyHealthChecked Iron Deficiency (Ferritin) Rapid Test or the Boots Iron (Ferritin) Rapid Test could provide a helpful insight. These simple, finger-prick tests can give you an indication of your iron levels in just 10 minutes, all from the comfort of your own home. These tests aren't designed to diagnose iron deficiency anaemia. If your results suggest abnormal iron levels, it’s important to speak to your GP for further guidance and support.
If you're experiencing symptoms of iron deficiency anaemia, it’s important to seek medical advice.
Treating iron deficiency anaemia
Treating iron deficiency anaemia focuses on restoring your iron levels and addressing the underlying cause to prevent it from happening again.
Iron supplements
Your GP may prescribe an iron supplement to help replenish your iron levels. In certain cases, such as chronic kidney disease, iron injections might be offered. If you experience any side effects, it is very important to discuss these with your GP, who may recommend a dose adjustment or an alternative supplement. Make sure to keep iron supplements out of children’s reach, as an overdose can be dangerous.
Preventing iron deficiency anaemia
Dietary changes
The iron content of foods is unlikely to be sufficient to replenish low iron stores in the body, but a diet rich in iron-containing foods may play an important role in prevention. Your GP may advise including more iron-rich foods in your meals, such as leafy greens, beans, nuts, wholegrains & fortified cereals. Vegetarians, vegans & pregnant women may need to pay close attention to their iron intake.
Red meats (like beef, lamb & pork) and offal (like liver) are excellent sources of iron, which is easily absorbed by the body. However, if you’re pregnant, it’s important to avoid liver and liver products as they contain high levels of vitamin A, which can be harmful to an unborn baby. Other animal proteins like fish & poultry also contain iron. General dietary advice recommends limiting red & processed meat to around 70g per day to support overall health, so try to include plant-based sources of iron in your diet.
If you follow a vegetarian or vegan diet, there are plenty of plant-based options that can help you meet your iron needs, including:
- Pulses and legumes, like beans, peas and lentils
- Dark green vegetables like spinach, kale and broccoli
- Nuts and seeds
Many foods in the UK are fortified with iron to help boost your intake, including all non-wholemeal bread, many breakfast cereals and baby formulas.
The type of iron from animal sources (which is called haem iron) is more easily absorbed than plant-based (non-haem) iron. To help support your absorption of plant-based iron, pair these foods with:
- Vitamin C-rich foods, like citrus fruits, bell peppers or tomatoes, as vitamin C helps increase non-haem iron absorption
- Animal protein foods
Avoid drinking tea, coffee, or eating bran cereals during or after meals, as they contain compounds that can reduce iron absorption. If dietary changes are challenging, a dietitian can provide tailored advice.
Treating the root cause of your anaemia is key to preventing recurrence. This might include:
- Changing medications like NSAIDs (like ibuprofen) if they are causing stomach bleeding
- Managing heavy periods
Complications of iron deficiency anaemia
Iron deficiency anaemia is possible to manage with supplements, but it can sometimes be severe depending on the underlying cause. Iron deficiency anaemia can have an impact on your daily life. If you’re concerned about any symptoms or how anaemia might be affecting you, it’s important to speak with your GP for advice and support. Many of these complications can be managed with treatment.
Increased risk of infections
Iron deficiency can weaken your immune system, making you more vulnerable to infections. A healthy iron level can help to support your body’s natural defences.
Tiredness
Feeling fatigued or low on energy (lethargic) is a common symptom. This can make it harder to stay productive at work, keep up with regular exercise, or even stay awake during the day.
Pregnancy complications
For pregnant women, untreated severe anaemia can raise the risk of complications during and after birth. These may include:
- Premature delivery (before 37 weeks)
- Low birth weight
- Low iron levels in the baby
- Postnatal depression for the mother
Restless legs syndrome
Iron deficiency anaemia is sometimes linked to restless legs syndrome, which causes an overwhelming urge to move your legs and an unpleasant sensation in the lower limbs. This can often be managed with iron supplements.
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Frequently asked questions
There are more than 4 symptoms of iron deficiency anaemia, and they can vary in severity. Common symptoms include:
- Feeling unusually fatigued or drained
- Struggling to catch your breath during routine activities
- Noticeable or irregular heartbeats
- Skin that appears paler than usual
Other symptoms, like headaches, hair loss or a sore tongue, may also happen. If you’re experiencing these symptoms, it’s important to speak to your GP. A simple blood test can help diagnose the condition and guide you toward treatment.
Iron deficiency anaemia can be treated effectively. However, if left untreated, it can lead to complications like tiredness, an increased risk of infections or restless legs syndrome.
The good news is that with treatment, most people recover well. If you’re experiencing symptoms like fatigue or shortness of breath during daily activities, it’s important to speak to your GP. They can diagnose the condition and help you manage it.
Iron deficiency anaemia happens when your body doesn’t have enough iron to produce healthy red blood cells, which carry oxygen around your body. This can be caused by factors like heavy periods, pregnancy, or conditions that affect iron absorption, such as bowel issues. The good news is that it’s treatable with iron supplements and addressing any underlying causes. If you think you might have symptoms, like tiredness or breathlessness, your GP can help diagnose and guide you to feel better.
While it can take some time, there are steps you can take to help raise your iron levels. It might take some time, but there are steps you can take to help. Eating iron-rich foods like lean meats, dark green vegetables, fortified cereals, and beans is a good start. Pairing these with foods high in vitamin C, like oranges or tomatoes, can help to support iron absorption.
If your GP recommends it, taking an iron supplement can also help, though these should always be taken as directed to avoid side effects. If you're concerned about your iron levels or have symptoms of iron deficiency anaemia like fatigue or breathlessness, speak to your GP for guidance and support.
For most people, eating a varied and balanced diet provides all the iron your body needs, so taking an iron supplement isn’t usually necessary. However, if your iron levels are very low, your doctor may recommend taking an iron supplement to help restore them. It’s important to only take iron supplements if your doctor advises you to, as taking them unnecessarily can cause side effects or lead to high iron levels, which can be dangerous. Some people may experience constipation or nausea when taking iron tablets. If you notice these side effects, it’s important to speak with your doctor for further advice or alternative options to support your iron levels.
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