Iron Deficiency 101 (8 Symptoms to Watch For)

Iron is an essential mineral that is found in every cell in the body. It is used in countless bodily processes such as the transport of oxygen and the production of energy. Iron deficiency occurs when you have a lower number of red blood cells in your blood than what is considered normal.

Iron deficiency anemia is common, and is a result of your body not having enough iron. Iron is necessary in the production of hemogoblin, which is responsible for the transport of oxygen to tissues. When there is a lack of iron in the blood stream, other parts of the body do not receive an adequate amount of oxygen.

Though iron deficiency anemia affects millions of people around the world, many do not even know that they have it. It’s possible to experience the symptoms of this condition without knowing the cause.

Most of those who suffer from iron deficiency are plagued by extreme exhaustion. Every year, over five thousand people die as a result of complications of severe anemia. (1) This article will discuss the causes of iron deficiency, treatment options, dietary recommendations, as well as signs to look for if you suspect that you are suffering from iron deficiency.

8 Symptoms of Iron Deficiency

If you are suffering from an iron deficiency, there are a couple of common symptoms and some less common symptoms to watch out for.

  1. Excessive Fatigue

The most common symptom of an iron deficiency is excessive fatigue. One of the main functions of iron in the body is the production of hemoglobin, which creates red blood cells that bring oxygen throughout the body. This lack of oxygen causes this fatigue.

If your body is having trouble transporting oxygen to cells, it could affect your energy levels. Being sluggish, tired and week, even after some rest, is a sign of iron deficiency. You could try to avoid this by having more iron-rich foods, or by incorporating a green smoothie to fight mid-day fatigue and increase iron levels in the body.

2. Susceptible to infections

Evidence over the past few decades have shown that iron is a fundamental element in the development of a healthy immune system. Deficiency in this mineral affects your capacity to have an adequate immune response. Iron in immunity is necessary for the maturation and proliferation of immune cells. Lymphocytes in particular, are associated with the generation of a specific response to infections. (2)

Red blood cells transport oxygen to the different organs to help fight infections, among other bodily functions. Without adequate oxygen, cells cannot function optimally. If you find yourself falling ill too often, it could be a sign of iron deficiency. (3)

3. Discolored Hands and Feet

People who do not have enough red blood cells may feel weak from the diminished oxygen, and the poor circulation may result in discolored hands and feet. (4) This is usually in severe cases however. Milder symptoms may include discolored nails, cold fingertips, numb fingertips, and tingling in the fingertips and toes.

4. Brittle Nails

Less common or easily recognized symptoms of include brittle hair and nails, caused by lack of hemoglobin.

In iron depleted subjects, researchers found a correspondence between iron content in the nails and epithelial nail changes. The most common symptom was found to be brittleness. As part of the study, researchers pursued treatment with iron supplementation. Results showed that iron therapy saw an increase in nail iron content, and decreased epithelial changes in nails.  (5)

5. Pica Cravings

Iron deficient individuals have been known to crave for substances that have no nutritional value. These usually include chalk, dirty, ice, crayons, toilet paper, cornstarch, moth balls, toothpaste, soap, plaster, and other non-food items. The word “pica” is Latin for magpie, a bird that eats almost anything. (6)

6. Restless Legs Syndrome (RLS)

The most common causes of restless legs syndrome (RLS) are peripheral neuropathy (nerve damage to the legs and arms) and iron deficiency anemia.

Brain iron insufficiency is now a well-established cause of RLS. All conditions that compromise iron availability in the body will increase risk of RLS, and will lead to higher prevalence of RLS in patients that have marginal central nervous system status. (7)

Restless legs syndrome is characterized by a circadian variation involving the urge to move the arms and legs, with symptoms worsening at night. This reflects a circadian fluctuation of dopamine in the brain which can be treated with iron administration. Folic acid may also help alleviate symptoms of RLS.

7. Heart Arrhythmia

Severe iron deficiency can cause left ventricular dysfunction and heart failure. Extreme cases can lead to cardiomyopathy. Similar to other types of heart failure, high-output heart failure is driven by increased sympathetic nervous activity. As many as two thirds of patients diagnosed with severe anemia show cardiomegaly on chest radiography. The cardiac silhouette returns to normal with weeks of resolving iron deficiency. (8)

Anemia was associated in patients with coronary heart disease. Researchers reported that abnormalities in heart rate variability may be representative of cardiac disease in patients. (9)

There is growing evidence that anemia could contribute to cardiac disease. In patients diagnosed with heart fialure, anemia was linked to increased morbidity. When the anemia is corrected, symptoms and risk factors decrease.

8. Hair Loss

Several studies have examined the link between hair loss and iron deficiency, but almost all studies involve female participants. Some results suggest that iron deficiency may be related to telogen effluvium, androgenetic alopecia, alopecia areata, and diffuse hair loss. However, there are also some studies that are inconclusive since any nutrient deficiency may eventually lead to hair loss.

In one particular study, participants with iron deficiency anemia with serrum ferritin levels below 30ng/ml were strongly associated with telogen hair loss. (10) Also, when hair does not get enough oxygen, they do not receive much-needed nutrients, leading to breakage and weakening of the hair follicles.

What Causes Iron Deficiency?

The Center For Disease Control and Prevention (CDC) identifies two main causes of iron deficiency: increased need and decreased absorption.

Certain populations need more iron in a day than others, primarily those in times of greater need. Infants, children, and adolescents are going through times of quick growth, meaning the body needs more iron to function properly.

Likewise, pregnant women need increased iron to support the growing fetus for nine months. Women who have reached menstruating age need increased iron to make up for the blood lost monthly, and this need continues until they go through menopause. Men generally need less iron than women, and subsequently experience iron deficiency at lower rates.

Those who suffer from bleeding disorders are also in need of increased iron intake. People who abstain from meat and/or dairy products also tend to have lower levels of iron from their diet and need to be more particular about monitoring their iron intake. (11)

Additionally, decreased absorption can result in iron deficiency. People who suffer from celiac’s disease, an autoimmune disease that is triggered when the sufferer consumes gluten, as it impacts the intestine’s ability to absorb nutrients, including iron. Calcium, eggs, and certain medications can also inhibit the absorption of iron. (12)

How To Treat Iron Deficiency

Treatment options for iron deficiency are very similar regardless of the cause of your iron deficiency.

Most iron deficiencies can be treated with iron supplements and increasing the amount of iron in your diet. Plant-based foods that are high in iron include vegetables such as spinach, beans, and peas, dried fruit like prunes and dried apricots, meats and seafood. Vitamin C can help the body absorb iron, so make sure to eat a well balanced diet to ensure you are getting enough of the essential vitamins and minerals. (13)

Your doctor may also prescribe iron supplements, which should not be taken in conjunction with other over the counter iron supplements. Iron supplements may have some side effects, particularly on the stomach, including nausea, vomiting, constipation, diarrhea, cramping, and bloating.

If possible, take iron supplements with food if you are experiencing severe side effects. However, avoid taking your supplements with foods that are rich in calcium or with coffee, as both of these things will hinder the absorption. (14)

What Happens If An Iron Deficiency Isn’t Treated Promptly?

For some people, iron deficiency anemia can cause exhaustion and cold hands, but beyond that, it may not impact daily life. However, for some, iron deficiency that isn’t treated promptly and completely can cause organ damage from lack of oxygen and put undue stress on the heart and cardiovascular system, potentially leading to arrhythmia and heart failure.

Is It Possible To Get Too Much Iron?

While more people suffer from not enough iron in the body, it is possible to have too much iron in your diet, a condition known as hemochromatosis.

Hemochromatosis occurs when there is a buildup of iron in the body, leading to tiredness and weakness, which are the same symptoms of an iron deficiency, as well as a variety of other health conditions. Other symptoms include weight loss, joint pain, and increased urination. (15)

Additionally, accidental iron overdose is a leading cause of death in children under the age of five, which usually occurs when children take too many prenatal vitamins or iron supplements intended for adults.

Symptoms include vomiting, diarrhea, and stomach pains, but immediate symptoms may not manifest. Children who have overdosed on iron need to be seen by a doctor immediately, and may require hospitalization to help prevent permanent organ damage or even death. (16)


Iron is an incredibly important nutrient throughout the body for a variety of different reasons. However, iron is only one part of a healthy diet.

It is important to consume a diet that is balanced in all essential nutrients by eating plenty of fruits and vegetables, lean proteins, and whole grains, while limiting food that is high in ‘bad’ fats, artificial sweeteners, and foods that are very processed.

Eating iron-rich foods, in combination with plenty of water and regular exercise, will help ensure you stay happy and healthy.

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