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Iron Deficiency

Understanding Iron and Your Health 

Iron is an essential mineral that your body needs to work properly. Think of it as the delivery service for oxygen in your body. It is a key part of haemoglobin, a protein in your red blood cells that carries oxygen from your lungs to every part of you. [1]

Iron also plays a vital role in [1]:

  1. Helping your body create energy.
  2. Supporting your immune system to fight infection. 
  3. Supporting healthy brain function.  

How Common is Iron Deficiency? 

Iron deficiency is surprisingly common. In fact, the World Health Organisation (WHO) considers it the most widespread nutritional issue in the world, affecting an estimated 30% of the global population [2]. It is especially common in women. Studies show that in developed countries, nearly 4 in 10 women of childbearing age have low iron levels [3,4]. 

Signs and Symptoms of Iron Deficiency 

You might not notice any symptoms at first, but as your iron levels drop, you may start to experience a range of issues [4,5]. When left untreated, this can lead to iron-deficiency anaemia, where your body cannot produce enough healthy red blood cells. 

Common signs and symptoms include: 

  • Constant Tiredness: Feeling unusually weak or fatigued is the most common symptom. 
  • Dizziness or Light-headedness: You might feel faint, especially when standing up. 
  • Shortness of Breath: Getting breathless after simple activities like walking up stairs. 
  • Heart Palpitations: A feeling of your heart racing or fluttering. 
  • Brain Fog: Difficulty concentrating or thinking clearly. 
  • Pale Skin: Your skin, especially on the inside of your lower eyelids, may look paler than usual. 
  • Other Signs: You may also notice hair loss, brittle nails, cold hands and feet, or more frequent infections. Some people develop a strange craving to eat non-food items like ice or dirt, a condition known as pica [4,5]. 

Who Is Most at Risk? 

Some people are more likely to become iron deficient than others. This includes: 

  • Women and girls of reproductive age, especially those with heavy periods, who are pregnant, or breastfeeding. 
  • Vegetarians and vegans, as iron from plants is harder for the body to absorb. 
  • People with digestive conditions like coeliac disease or inflammatory bowel disease (IBD). 
  • People who have had bariatric (weight loss) surgery. 
  • Individuals with chronic conditions like kidney disease or heart failure. 
  • Older adults, often due to diet or other medical conditions [4,6]. 

How is Iron Deficiency Diagnosed and Treated? 

Diagnosis Your doctor can diagnose iron deficiency with a simple blood test. This test will check your body’s iron ‘storage tank’ (a protein called ferritin) and how much iron is circulating in your blood [4,6]. 

Treatment The goal is to restore your iron levels to a healthy range. While eating iron-rich foods like red meat, poultry, beans, and leafy greens is important for maintaining healthy iron levels, diet alone is often not enough to correct a significant deficiency [7].

  • Oral Iron Supplements: For most people, taking iron tablets or liquids is the first step. It can take a few months to fully rebuild your body’s iron stores, so it is important to take them as directed by your doctor. 
  • Intravenous (IV) Iron: If you cannot take tablets, have a condition that prevents you from absorbing iron well, or need to increase your iron levels quickly, your doctor may recommend an IV iron infusion [3,4,8]. 

For more information, please don’t hesitate to get in touch. Our gastroenterologists are experienced in diagnosing and managing iron deficiency, and can provide guidance on dietary strategies, oral supplementation, and intravenous iron infusions as needed.

References

  1. Weyand AC, Sholzberg M, Cowan K, et al. Screening for iron deficiency and iron deficiency anemia in non-pregnant females of reproductive age, a clinical practice guideline. Am J Hematol. 2024;99(3):586–95. 
  2. Al-Naseem A, Bews-Hair M, Al-Jafar A, Soutar R. An update on iron deficiency anaemia. J R Coll Physicians Edinb. 2022;52(1):47–53. 
  3. Pai RD, Chong YS, Clemente-Chua LR, et al. Prevention and Management of Iron Deficiency/Iron-Deficiency Anemia in Women: An Asian Expert Consensus. Nutrients. 2023;15(14):3125. 
  4. Camaschella C,ELI-I, Girelli D, Pasricha S-R, Westerman M. Iron Deficiency and Iron-Deficiency Anemia. JAMA. 2023;329(24):2164. 
  5. MacLean B, Sholzberg M, James P, Allen L, D’Souza R, Ito E, et al. Identification of women and girls with iron deficiency in the reproductive years. Int J Gynaecol Obstet. 2023;162(Suppl 2):58–67. 
  6. Sholzberg M, MacLean B, James PD. Iron deficiency in females of reproductive age: a public health crisis. CMAJ. 2024;197(24):E680–1. 
  7. Sholzberg M, MacLean B, James PD. A health equity lens on iron deficiency and iron deficiency anemia. Best Pract Res Clin Obstet Gynaecol. 2023;90:102377. 
  8. Kumar A, Pratt J, Ali A. American Gastroenterological Association Institute Guideline on Intravenous Iron for Iron-Deficiency Anemia. Clin Gastroenterol Hepatol. 2024;22(6):1154–62.