HOW TO SPOT AN IRON DEFICIENCY, ACCORDING TO DOCTORS

What do ice cravings, hair loss, and mood have in common? They're all potentially weird signs of iron deficiency, which is actually relatively prevalent in women.

An estimated 14% of US adults are lacking this mineral responsible for making red blood cells, according to a September 2024 JAMA Open Network report. However, when you hone in, the study says 34% of women between the ages of 18 and 50 are iron-deficient.

There’s one slight problem: while iron deficiency was found to be 'very common' in the 'apparently healthy' general population and associated with all-cause mortality in a 2020 article published in Clinical Research in Cardiology, it’s also not routinely screened for.

In the UK, according to recent NHS figures, hospital admissions for lack of iron increased almost 10 times between 1998-99 and2023-24 – 20,396 to 191,927. An earlier National Diet and Nutrition Survey also found that over a quarter of 19-64-year-old women were eating below the recommended intake of iron.

'There are a lot of people who are iron-deficient for so long and don't even know,' says Imo J. Akpan, MD, a haematologist at NewYork-Presbyterian/Columbia University Irving Medical Center. 'Picking it up early can lead to it being treated early and potentially prevent anaemia and other symptoms,' including restless leg syndrome, impaired neurocognitive function, and decreased physical capacity – as per the 2024 study.

Women in particular are at risk mainly because of their reproductive systems; if you’re getting a period each month, you’re losing iron through menstrual blood. Plus, pregnant people have an increased need for iron to support their foetus.

Here’s what you need to know about recognising the signs of an iron deficiency – and the fixes you can make to help get your levels back on track.

Meet the experts: Imo J. Akpan, MD, is a hematologist at NewYork-Presbyterian/Columbia University Irving Medical Center. Keri Peterson, MD, is an internal medicine specialist and WH Advisory Board member.

What is iron and how does it function in the body?

Iron is a naturally occurring mineral that plays a big role in transporting oxygen around your body. Its number one job is making haemoglobin, which carries oxygen to your red blood cells, and myoglobin, which carries oxygen to your muscles.

'Iron is a metal that is very abundant on the earth and unfortunately it's also one of the most common deficiencies that we have,' says Dr Akpan. In order to test for an iron deficiency, providers tend to look at your ferritin, a protein found in your blood that contains iron. You can think of this number as a savings account, she says. The reserves are used when needed and replenished through your diet.

It’s common to hear about iron in the context of anaemia, which is a condition that can be caused when iron stores are too low. Anemia is when you don’t have enough red blood cells, which iron plays a role in making, but the test for it wouldn’t catch an iron deficiency.

Signs of iron deficiency

Though iron deficiencies aren’t routinely checked for, they can have a big impact on your quality of life. If you’re iron-deficient, you might experience any of the following, according to the experts. Although, experiencing one or more of these symptoms alone does not mean you have an iron deficiency.

• Fatigue
• Feeling dizzy, lightheaded, or fainting
• Pica, or cravings for non-food, like ice
• Chest pains, including discomfort or pinching
• Impaired brain function
• Exercise intolerance
• Shortness of breath
• Irritability or mood changes
• Restless leg syndrome
• Hair loss

How is an iron deficiency diagnosed?

Firstly, if you’re ever experiencing severe and/or worrying symptoms of any kind, you should always call your doctor or 999. After more serious conditions are ruled out (like in the case of chest pains, a heart problem, for instance), healthcare professionals may do a blood test to look at ferritin levels, which is a protein in your blood that contains iron and will tell you just how much you have stored up in your savings account. Normal levels of ferritin are between 30 and 150 nanograms per milliliter for women, and anything below 30 would be deficient, says Dr Akpan.

When iron is low, it’s because you’re either not getting enough of it or you’re losing too much, says Keri Peterson, MD, an internal medicine provider and WH Advisory Board member. You get iron through your diet, so getting enough could be a challenge for vegetarians or vegans because we absorb iron best from meat sources, she says. If you have a gastrointestinal condition like irritable bowel syndrome, Crohn’s Disease, or Celiac Disease, or have had bariatric surgery, you also might have a tougher time absorbing iron and therefore not be getting enough, adds Dr Akpan. Some medicines might also affect iron absorption.

When it comes to losing iron, this could be from getting your period or more serious conditions like ulcers, fibroids, or colorectal cancer. For menopausal people, it’s especially important to get to the bottom of an iron deficiency because it can’t be explained by a period, says Dr Peterson. Otherwise, periods are the most common reason why a woman might be iron-deficient, says Dr Akpan. While you shouldn’t need to do anything special with your diet specifically during that time of month to make up for the iron lost, if your period is so heavy that it’s causing a deficiency, you should see your doctor.

Iron levels are also particularly important for pregnant people, who need more of it to support their growing foetus. In the first trimester, you’ll only need an additional 0.5 milligrams of iron per day, but by the third trimester, you’ll need an extra six milligrams, says Dr Akpan. However, always talk to your doctor for personalised recommendations before starting any new supplement. Because so many people are unknowingly deficient, this could pose a problem going into pregnancy, she says. Pregnant people who don’t know they are iron-deficient are at risk for developing anaemia. Additionally, severe iron deficiency could lead to abnormal placentas, premature delivery, or low birthweight, according to a 2020 study published in Nutrients. If you’re newly pregnant and have a question about your iron levels, ask your doctor for a test.

How to boost your iron levels

Boosting iron levels can be pretty simple – and you should be back on track in as quickly as 48 hours or a few months depending on your starting point and the treatment you select with your doctor, says Dr Akpan.

Make sure you’re getting enough iron through your diet

You absorb iron best through meat sources, says Dr Peterson. Iron-rich foods include beef, chicken, eggs, lamb, ham, and turkey and plant-based options include dried beans, lentils, chickpeas, peas, almonds, sunflower seeds, spinach, broccoli, and prune juice. You can also find cereals that are fortified with iron, Dr Peterson adds. And, Btw, some foods inhibit iron absorption, so you might want to space them out when you’re trying to get more iron-rich foods into your day. Coffee, tea, and calcium can all make it harder to absorb iron. Meanwhile, vitamin C can increase iron absorption.

A well-balanced diet should be giving you a sufficient amount of iron, Dr Akpan says, but if you’re looking to track your intake, the NIH recommends 18 milligrams a day for women between the ages of 19 and 50.

Consider iron supplements

Iron supplements can also help you get your levels back up, but you should talk to your doctor before taking them. 'You want to make sure you’re being monitored closely,' says Dr Akpan. Your doc will best be able to recommend which supplement to take, how much, and how often. They’ll also check back in with you to make sure they’re going well. Dr Peterson says she usually checks in with a patient after one or two months to see if their iron levels have improved.

Some downsides to iron supplements could be a metallic taste in your mouth, constipation, or diarrhoea.

Ask your doc about an iron infusion

Iron infusions are for people who don’t tolerate supplements well, have a tough time absorbing iron, or for people who need to boost their levels quickly.

'Intravenous iron is very efficient,' says Dr Peterson. 'You can replenish your stores with one intravenous treatment.'

2025-06-03T09:32:39Z