Iron Deficiency Anemia: Causes, Symptoms, Diagnosis and Prevention

Posted by My Pura Vida Wellness Private Limited on

Do you often feel tired and exhausted after doing basic life activities? Along with the fatigue, the cause of your brittle nails, hair loss, and headache could be due to some deficiency in the body. Maybe it points to some health issue like anemia which needs your prior attention! Also, if you want to increase your performance in sports, build muscle mass, and increase the concentration power, micronutrients like iron are extremely important.

All body cells and tissues need a constant supply of oxygen for healthy growth, development, reproduction and energy generation for proper functioning. This oxygen is supplied via red blood cells (RBCs) in the blood. The hemoglobin in the RBCs binds the oxygen with itself, which is then transported throughout the body. Decreased levels of hemoglobin in the red blood cells indicate anemia. There are multiple types of anemia, but iron deficiency anemia is the most common, especially in women.

What is Iron Deficiency Anemia?

Iron is the vital nutrient in hemoglobin production, and the body is unable to make hemoglobin without iron resulting in anemia. Deficiency of iron causes lower levels of hemoglobin resulting in iron deficiency anemia. Blood becomes depleted of healthy red blood cells due to iron deficiency, which leads to decreased oxygen supply to the tissues. Hence the body needs sufficient iron supplementation, for production of healthy RBCs for better body functioning.

Anemia can be mild to severe. Many times the anemia goes undiagnosed for years, as the symptoms could be very mild till the deficiency becomes severe. Mild forms of iron deficiencies may come to notice early during some routine blood tests that could help reverse the anemia sooner. But most of the time it is diagnosed when the person starts having severe symptoms like weakness, breathlessness, and low energy levels. Iron deficiency anemia can be reversed with proper supplements, good diet and exercises. Let's understand iron deficiency anemia in detail along with its symptoms, causes and the treatment.

What are Signs and Symptoms of Iron Deficiency Anemia?

The signs and symptoms of iron deficiency anemia may vary from mild to severe depending upon the level of iron deficiency in the body:

  • Tiredness
  • Weakness
  • Dizziness
  • Malaise
  • Lethargy
  • Pale skin (Pallor)
  • Shortness of breathing
  • Tingling in hands and feet
  • Sore tongue
  • Cold hands and feet
  • Restless leg syndrome
  • Irregular heartbeats
  • Chest pain
  • Brittle nail
  • Hair loss
  • Difficulty concentrating
  • Irritability
  • Headache
  • Poor appetite
  • Food craving for unhealthy substances like ice, chalk, dirt, clay, paper or starch.

Iron deficiency anemia can not be self-diagnosed only on the basis of such symptoms, as there are many other diseases which may have similar signs and symptoms. But if someone experiences these symptoms, a medical specialist should be consulted to diagnose iron deficiency anemia.

What are the Causes of Iron Deficiency Anemia?

When there is depletion of iron levels in the body which reduces hemoglobin production, it causes iron deficiency anemia. The reasons for reduced iron levels in the body can be:

Low Iron Consumption

Lack of dietary intake of iron rich foods, and insufficient supplementation result in deficiency of iron in the body. Consuming a little amount of iron-rich foods for a longer time also depletes the body of iron. Hence low consumption of iron-rich foods causes iron deficiency anemia.

Blood Loss

Iron is stored in the red blood cells attached to hemoglobin. Hence when there is heavy blood loss due to any reason, it causes iron deficiency. Acute blood loss may cause temporary iron deficiency, and chronic blood loss can lead to iron deficiency anemia. Long term blood loss can be caused due to peptic ulcers, hiatal hernia, colon polyp, colorectal cancer, bleeding fissures, gastrointestinal bleeding due to some medications, and internal bleeding due to certain medical conditions. All these forms of chronic bleeding can cause iron deficiency anemia.

Menstrual Periods

Iron deficiency anemia is more common in women than men, as every month women of childbearing age go through menstrual bleeding. Heavy menstrual bleeding causes heavy blood loss resulting in iron depletion. Women with excessive menstrual bleeding usually bleed for more than 7 days and lose twice the amount of blood than normal menstruation causing iron deficiency anemia. Also during menopause there is irregular bleeding, frequent spotting and heavy bleeding leading to iron deficiency anemia. Conditions like uterine fibroids, and pcos also cause irregular and heavy menstrual bleeding. Endometriosis is also a cause of excessive menstrual bleeding and heavy blood loss resulting in anemia, and many women are unaware of this disorder occurring inside the body.


During pregnancy the body needs increased blood supply than normal to serve the growing fetus, maintain the endometrium, and meet the other needs of the mother's body. A good hemoglobin level is important for the healthy growth and development of the fetus. Hence, usually women need iron supplementations during pregnancy. When the supplements do not meet the body's need, and the body consumes large amounts of iron to provide oxygen to the growing baby; may result in iron deficiency anemia.

Malabsorption of Iron

Certain intestinal diseases can affect the body's ability to absorb the iron from the food. Iron-rich foods need to be digested properly in the stomach and the nutrients absorbed by the intestine. Most of the dietary iron gets absorbed in the duodenum of the small intestine. And any condition which disrupts the small intestine affects iron absorption adversely causing iron deficiency anemia in the body. Celiac disease, Crohn's disease, ulcerative colitis, gastric bypass surgery, gastrectomy, H.pylori, and autoimmune gastritis are some gastrointestinal conditions that may cause malabsorption of iron leading to iron deficiency anemia. Even on consuming sufficient amounts of dietary iron, these conditions result in deficiency.


Genetics plays an important role in deciding most of our health conditions. Celiac disease can be passed down through families in which natural iron absorption capability is hampered. TMRP 6 gene mutation causes too much production of hepcidin, a hormone that blocks the intestines from absorbing iron. Von Willebrand disease and hemophilia are examples of genetic disorders that cause abnormal bleeding resulting in anemia.

Knowing the cause helps with better diagnosis and treatment planning of the iron deficiency anemia. It also helps in avoiding further depletion of body reservoirs of nutrients by taking preventive measures. 

What are the Risk Factors of Iron-Deficiency Anemia?

It is important to understand the risk factors of iron deficiency anemia so as to take proper preventive measures, and avoid any consequences. Some people can be at a greater risk than others:

Women of Child Bearing Age

Heavy menstrual periods are the main reason that makes women more susceptible for iron deficiency anemia. Women from the start of their menstrual periods till they attain menopause in life, are considered to be in the child bearing age needing more iron supplementation.

Pregnant Women

Increased body needs during the pregnancy can cause scarcity of essential micronutrients like iron. The growing fetus needs greater blood supply, more oxygen and therefore more iron. Hence doctors may prescribe iron supplements during pregnancy.

Malnourished Children

Nutritional deficiencies, lack of iron-rich foods, feeding problems, special healthcare needs, poor absorption of iron, poor growth of children increase the risk of iron deficiency anemia. If the child does not eat enough, or eats unhealthy food the risks of developing iron deficiency is increased.

Prematurely Born Infants

Usually normal born infants experience a decrease in hemoglobin concentration after birth due to the transition from "in utero" to "outside the womb" environment. In preterm infants a physiologic and asymptomatic anemia has been seen, upto about 12 weeks after birth. Premature babies may not get enough iron from breast milk as the chances of their mother being deficient in iron are greater. Also formula fed infants can also develop iron deficiency. The risks of iron deficiency anemia is greater in prematurely born due to lower iron stores at birth, accelerated growth in initial years of life, depletion physiological storage due to excessive utilization for development, and phlebotomies while in hospital.


The risk of having iron deficiency anemia in vegetarians increases because of the bioavailability of iron from plant sources. Meat, poultry and fish are the richest sources of iron, with bioavailability of iron easier to absorb by the body. Iron is found to be in two forms: heme and non-heme. Heme iron is easy to be used up by the body, and is found in non-vegetarian sources. Whereas non-heme iron comes from plant sources, and has a low bioavailability and low dietary absorption; which means the body can use this iron but not easily. Also vegetarians encounter an increase in iron inhibitors. 


Teenage is the period of growth spurts, hence the body's iron needs are high during this phase of life. As teenage is the most active phase of life, it demands greater oxygen supply to the tissues and organs. During adolescence there is expansion of blood volume, increase in muscle mass and intensive growth, making it extremely important to meet the iron requirements. Hence due to increased need of iron, teenagers are at increased risk of developing iron deficiency anemia.

Elderly Over 65 Years of Age

Advancing age may cause problems like poor dietary absorption of iron, and nutritional deficiencies leading to iron deficiency anemia. Also old age may have certain health conditions causing blood loss. Some medications may also interfere with iron availability, absorption and excretion. Chronic inflammations are common with elderly over 65 years of age, which may elevate levels of circulating hepcidin responsible for iron metabolism. Poor diet, digestive issues, inappropriate tissue iron deposition, and low metabolism contribute towards increasing the risk of developing iron deficiency anemia. Anemia in old age may cause depression, confusion, and susceptibility to falling.


Muscles need sufficient oxygen to work, and iron is crucial in muscle build up. Iron plays a major role in metabolism, oxygen transport and maintaining the acid-base balance in the body. Athletes have high work demands during training and competitions, hence they need more iron than general people. Iron is lost through sweat, excretion, menstruation, skin and gastrointestinal tract. High intensity and endurance workouts increase iron loss by 70% more than a sedentary lifestyle. Meeting these needs of iron is important, as insufficient iron supplement increases the risk of iron deficiency anemia in athletes affecting their performance.

Special attention is to be given to these groups to prevent them from developing iron deficiency and the consequences of the anemia. High risk people should consult a doctor to determine any deficiency, dietary changes and supplementations needed.

What are the Health Complications of Iron-Deficiency Anemia?

Mild forms of iron deficiency anemia do not cause serious complications, but affect the routine performances due to fatigue. If left untreated, the mild forms of anemia could progress to severe forms, and cause some serious complications like:

Heart Problems

The heart needs to pump more blood to compensate for the lack of oxygen, when there is anemia. To meet the oxygen needs of tissues and organs, the workload of the heart increases. This can lead to enlarged heart, rapid or irregular heartbeat, and heart failure. Iron supplements help to maintain good heart health.

Problems During Pregnancy

Severe iron deficiency anemia of the pregnant women can cause premature births, low birth weight babies and miscarriage. These complications are preventable with the intake of prenatal iron supplements. Doctors usually prescribe iron supplementations to expecting mothers.

Growth Problems

Delayed growth and development, growth retardation, increased susceptibility to infections, difficulty to concentrate, weakness, pale skin, loss of appetite, low performance in curriculum and developing pica are some serious growth problems that occur in children with iron deficiency anemia. 

In time treatment of iron deficiency anemia helps to avoid such serious complications.

How to Prevent Iron-Deficiency Anemia?

Taking a diet rich with natural iron sources helps the body to get the required amount naturally. Iron rich foods combined with foods rich in vitamin C benefit the most to prevent iron deficiencies. Vitamin C boosts iron absorption in the body, hence foods like citrus fruits, broccoli, kiwi, melons, pepper and tomatoes should be eaten along with iron-rich foods. Meat like lamb, chicken, beef and pork have high iron contents. Poultry, seafood, beans, dark green leafy vegetables like spinach, peas, pumpkins, squash-seeds, raisins, apricots, orange, papaya, guava, kiwi, pineapple, strawberries, and brewer's yeast are iron rich foods to be added to the daily diet. Iron-fortified cereals, breads and pastas are better choices to prevent iron deficiency.

Body absorbs more iron from meat than from any other sources. Vegans and vegetarians should increase the intake of iron-rich plant based foods. A balanced diet with wholegrains, legumes, nuts, seeds, dried fruits, green leafy vegetables and iron fortified cereals provide adequate iron intake.

Infants fed by formula milk should be fed with iron-fortified formulas. Breastfeeding mothers should take iron supplements to pass iron through breast milk.

How is Iron-Deficiency Anemia Diagnosed?

When one suffers through some signs and symptoms of iron deficiency anemia like extreme tiredness, brittle nails, loss of appetite, they may suspect iron deficiency anemia, which should be ruled out by consulting a medical specialist. The doctor may ask to do some blood tests to diagnose the deficiency and anemia. There can be other diseases with similar symptoms, hence a proper diagnosis for better treatment is important. Self-diagnosis and treatment can lead to other health complications. Some diagnostic tests suggested by the doctor include:

Complete Blood Count (CBC) Test

It measures all the components in the blood like RBC count, WBC count, hemoglobin levels, hematocrit and platelets.

The healthy range of hemoglobin is: 13.2 to 16.6 gm/deciliter in males, and 11.6 to 15 gm/deciliter in females.

Pelvic Ultrasound

This is done to find the sources of excessive bleeding for example a fibroid. Uterine fibroids can cause heavy menstrual blood loss.

Blood Sampling Tests and Blood Examination through Microscope

These can be done to check the RBC size, shape and colour. Also to check ferritin levels, and total iron-binding capacity(TIBC). Ferritin is a protein which helps with iron storage in the body and its low levels indicate low iron storage. TIBC test is used to detect the amount of transferrin carrying iron. Transferrin is a protein that transports iron.

Tests for Internal Bleeding

Tests like fecal occult, endoscopy, colonoscopy, help identify the sources of internal bleeding.

Other Tests

Doctors may suggest some other tests to diagnose problems like poor absorption in the body.

Some home test kits are also available in the market, but consulting a specialist is important for avoiding any complications or false diagnosis.

How is Iron-Deficiency Anemia Treated?

The treatment depends on the severity of the deficiency, the cause and the complications associated:

Dietary Changes

Mild forms of iron deficiency anemia are treated with good dietary intake of iron rich foods, iron fortified foods, and iron supplementations. Limiting or avoiding the foods like black tea, coffee, and tannin rich foods, that cause lower iron levels or decrease iron absorption is important. Lactose intolerance also causes decreased iron absorption, hence such people should avoid dairy products.

Treating the Cause of Blood Loss

Iron supplements won’t help much if excess bleeding is the cause of the deficiency. Treating heavy menstrual bleeding may include birth control pills prescribed by the doctor. Internal bleeding due to injury may need surgery. Some severe cases may need RBC transfusion or intravenous iron drip.

Iron Supplements

Iron tablets and gummies can help restore the iron levels and prevent developing iron deficiency.

IronPlus Gummies can be taken regularly to refill the body's reservoirs of essential vitamins and minerals for generating healthy red blood cells. The IronPlus gummies are packed with vitamins like A, C, B2, B6, B12, copper and iron needed for formation of hemoglobin and RBCs. These gummies provide high bioavailability of iron, hence are fast acting with great taste. These make the best choice for vegans, vegetarians, athletes, children and elderly for getting the daily dose of much needed iron for healthy growth and development. IronPlus gummies:

  • Support red blood cell formation
  • Maintains healthy Hemoglobin levels
  • Eliminates fatigue
  • Boosts immunity
  • Supports brain function

Recommended dose is 1-2 gummies per day or as directed by the healthcare professional. Do not exceed the recommended daily dosage.

Taking the gummies on an empty stomach 1 hour before meals, benefits the most.

People having gastric upset should take the IronPlus gummies with the food. 

Treating Other Deficiencies

Other nutritional deficiencies may interfere with the iron absorption of the body. Treating the vitamin C deficiency is equally important to enhance iron absorption. Micronutrients other than iron which are important for the formation of hemoglobin and RBCs are: folic acid, B6  B12  Copper and vitamin A. It is important to treat these deficiencies with increased dietary intake and needed supplementation.

A good diet, exercise and better preventive measures help avoid health conditions like nutritional deficiencies and iron deficiency anemia. Do not neglect any symptoms that are different from normal, as it could be an indicative of certain underlying health conditions. Timely diagnosis and treatments benefit from preventing any serious complication.

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