Initially, iron deficiency anemia can be so mild that it goes unnoticed. But as the body becomes more deficient in iron and anemia worsens, the signs and symptoms intensify.
Iron deficiency anemia symptoms may include:
- Extreme fatigue
- Pale skin
- Shortness of breath
- Chest pain
- Frequent infections
- Dizziness or lightheadedness
- Cold hands and feet
- Inflammation or soreness of your tongue
- Brittle nails
- Fast heartbeat
- Unusual cravings for non-nutritive substances, such as ice, dirt or starch
- Poor appetite, especially in infants and children with iron deficiency anemia
- An uncomfortable tingling or crawling feeling in your legs (restless legs syndrome)
When to see a doctor
If you or your child develops signs and symptoms that suggest iron deficiency anemia, see your doctor. Iron deficiency anemia isn't something to self-diagnose or treat. So see your doctor for a diagnosis rather than taking iron supplements on your own. Overloading the body with iron can be dangerous because excess iron accumulation can damage your liver and cause other complications.
Iron deficiency anemia occurs when your body doesn't have enough iron to produce hemoglobin. Hemoglobin is the part of red blood cells that gives blood its red color and enables the red blood cells to carry oxygenated blood throughout your body. If you aren't consuming enough iron, or if you're losing too much iron, your body can't produce enough hemoglobin, and iron deficiency anemia will eventually develop.
Causes of iron deficiency anemia include:
- Blood loss. Blood contains iron within red blood cells. So if you lose blood, you lose some iron. Women with heavy periods are at risk of iron deficiency anemia because they lose blood during menstruation. Slow, chronic blood loss within the body — such as from a peptic ulcer, a hiatal hernia, a colon polyp or colorectal cancer — can cause iron deficiency anemia. Gastrointestinal bleeding can result from regular use of some over-the-counter pain relievers, especially aspirin.
- A lack of iron in your diet. Your body regularly gets iron from the foods you eat. If you consume too little iron, over time your body can become iron deficient. Examples of iron-rich foods include meat, eggs, leafy green vegetables and iron-fortified foods. For proper growth and development, infants and children need iron from their diet, too.
- An inability to absorb iron. Iron from food is absorbed into your bloodstream in your small intestine. An intestinal disorder, such as celiac disease, which affects your intestine's ability to absorb nutrients from digested food, can lead to iron deficiency anemia. If part of your small intestine has been bypassed or removed surgically, that may affect your ability to absorb iron and other nutrients.
- Pregnancy. Without iron supplementation, iron deficiency anemia occurs in many pregnant women because their iron stores need to serve their own increased blood volume as well as be a source of hemoglobin for the growing fetus.
These groups of people may have an increased risk of iron deficiency anemia:
- Women. Because women lose blood during menstruation, women in general are at greater risk of iron deficiency anemia.
- Infants and children. Infants, especially those who were low birth weight or born prematurely, who don't get enough iron from breast milk or formula may be at risk of iron deficiency. Children need extra iron during growth spurts. If your child isn't eating a healthy, varied diet, he or she may be at risk of anemia.
- Vegetarians. People who don't eat meat may have a greater risk of iron deficiency anemia if they don't eat other iron-rich foods.
- Frequent blood donors. People who routinely donate blood may have an increased risk of iron deficiency anemia since blood donation can deplete iron stores. Low hemoglobin related to blood donation may be a temporary problem remedied by eating more iron-rich foods. If you're told that you can't donate blood because of low hemoglobin, ask your doctor whether you should be concerned.
Mild iron deficiency anemia usually doesn't cause complications. However, left untreated, iron deficiency anemia can become severe and lead to health problems, including the following:
- Heart problems. Iron deficiency anemia may lead to a rapid or irregular heartbeat. Your heart must pump more blood to compensate for the lack of oxygen carried in your blood when you're anemic. This can lead to an enlarged heart or heart failure.
- Problems during pregnancy. In pregnant women, severe iron deficiency anemia has been linked to premature births and low birth weight babies. But the condition is preventable in pregnant women who receive iron supplements as part of their prenatal care.
- Growth problems. In infants and children, severe iron deficiency can lead to anemia as well as delayed growth and development. Additionally, iron deficiency anemia is associated with an increased susceptibility to infections.
You can reduce your risk of iron deficiency anemia by choosing iron-rich foods.
Choose iron-rich foods
Foods rich in iron include:
- Red meat
- Dark green leafy vegetables, such as spinach
- Dried fruit, such as raisins and apricots
- Iron-fortified cereals, breads and pastas
Your body absorbs more iron from meat than it does from other sources. If you choose to not eat meat, you may need to increase your intake of iron-rich, plant-based foods to absorb the same amount of iron as someone who eats meat.
Choose foods containing vitamin C to enhance iron absorption
You can enhance your body's absorption of iron by drinking citrus juice or eating other foods rich in vitamin C at the same time that you eat high-iron foods. Vitamin C in citrus juices, like orange juice, helps your body to better absorb dietary iron.
Vitamin C is also found in:
- Leafy greens
Preventing iron deficiency anemia in infants
To prevent iron deficiency anemia in infants, feed your baby breast milk or iron-fortified formula for the first year. Cow's milk isn't a good source of iron for babies and isn't recommended for infants under 1 year. Between the ages of 4 and 6 months, start feeding your baby iron-fortified cereals or pureed meats at least twice a day to boost iron intake. After one year, be sure children don't drink more than 24 ounces of milk a day. Too much milk often takes the place of other foods, including ones that are rich in iron.