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Meet the symptoms of iron deficiency and iron deficiency anaemia

Recognising the symptoms of iron deficiency and iron deficiency anaemia is often the biggest hurdle to getting a diagnosis6. The symptoms can manifest in different ways, they are hard to pinpoint and can be associated with a number of other health conditions6,7.

This Iron Deficiency Day, we want people to get iron-informed! To understand why iron is so important to our bodies and what can happen if we are not getting enough, by recognising the symptoms and taking action. By informing people about the importance of healthy iron levels, we will encourage more people to speak to their healthcare providers about iron deficiency and iron deficiency anaemia.

Our Symptom Checker lists the main symptoms associated with iron deficiency and iron deficiency anaemia and brings them to life with an animated character, to further explain each symptom.

If you recognise one or more of these symptoms in yourself, you should visit a healthcare professional to have them check your iron levels and investigate further. There are simple tests to find out what's wrong and help you to manage your iron levels. To help you discuss your symptoms, use this patient discussion guide.

Meet the symptoms of iron deficiency using our Symptom Checker

Symptoms that slow you down
Fatigue / physical exhaustion
Extreme tiredness can affect more than just the body – you can suffer from mental fatigue too. Iron is essential for the healthy functioning of the brain, so if you are finding it hard to focus or manage your mood, it could mean that you are iron deficient.

Fatigue / physical exhaustion

Symptoms that slow you down
Feeling worn out
Feeling permanently exhausted or extremely tired is often referred to as fatigue – one of the most common symptoms of iron deficiency. If you feel drained or have little energy or enthusiasm to complete daily tasks you could be iron deficient. Fatigue can have a significant detrimental effect on the social, physiological and psychological elements of your life, so it is important to get it checked out.

Feeling worn out

Symptoms that slow you down
Hearing Loss
There are many reasons why you might suddenly struggle to hear properly and it is important you get a proper diagnosis. One reason for sudden hearing loss can be iron deficiency anaemia.

Hearing Loss

Symptoms you can see
Hair Loss
To keep a healthy head of hair your body needs iron. If you are losing clumps of hair or more hair than normal, it could be an indication of iron deficiency.

Hair Loss

Symptoms you can see
Brittle nails
If you have nails with abnormalities in colour, shape or texture, it could be because of a lack of iron. In particular, nails that are dipped in the middle and raised at the edges to give a rounded appearance like a spoon are associated with iron deficiency anaemia.7

Brittle nails

Symptoms you can see
Paleness
If you have severe iron deficiency, there may be less haemoglobin in your blood which can make you look pale. This is more noticeable on your face, nails, inner mouth and lining of your eyes. If you pull your lower eyelid down and it is a very pale peach colour or yellow, this may indicate that you have iron deficiency anaemia.

Paleness

Symptoms you can see
Bruising easily
Bruising easily has long been associated with iron deficiency. A bruise appears when you have damaged the blood vessels beneath the skin, enough for a small amount of blood to leak out. If your body doesn’t have enough iron, you are more likely to bruise easily.

Bruising easily

Symptoms you can see
Mouth Ulcer
Mouth ulcers (sore white patches on the inside of your mouth) can occur for many reasons including biting the inside of your mouth, stress and being run-down. In some cases, mouth ulcers can also develop due to iron deficiency.

Mouth Ulcer

Symptoms that slow you down
Irritability
Exhaustion, mood swings and an inability to concentrate can cause frustration. If you feel that you are easily irritated, it may be a sign of iron deficiency.

Irritability

Symptoms that slow you down
Memory Loss
Are you forgetting little things more frequently? Talk to your doctor about what could be causing your short-term memory loss; it may be because of iron deficiency.

Memory Loss

Symptoms that slow you down
Eating non foodstuffs / pica
Unusual cravings and eating things with no nutritional value can be an indication of iron deficiency. If you regularly feel like eating non-food items like clay, dirt, ash and starch, it is important not to give in to your cravings and seek medical advice.

Eating non foodstuffs / pica

Symptoms that slow you down
Chewing on Ice
One of the most common symptoms of iron deficiency is the desire to eat or chew ice. Regularly chewing ice can damage the teeth and the gums, so it is important to seek treatment.

Chewing on Ice

Symptoms that slow you down
Cold intolerance
If you find yourself struggling to keep warm or your hands and feet get cold easily, you may have iron deficiency. Iron is important for a range of functions that are involved in keeping our bodies at the right temperature. It is important that we maintain a certain body temperature, and having iron deficiency can make it harder to do that.

Cold intolerance

Symptoms that slow you down
Restless legs syndrome
If you feel the need to move your legs to get rid of uncomfortable or strange sensations while resting, you may have restless legs syndrome. The feelings are sometimes described as itching, burning or crawling and can often affect your sleep. This can be a symptom of iron deficiency.

Restless legs syndrome

Symptoms that slow you down
Loss of Breath
Iron deficiency can reduce your ability to exercise. If you find you can’t exercise as much as you would like, or you get out of breath doing simple things like walking up the stairs, you may be iron deficient.

Loss of Breath

Symptoms that slow you down
Susceptibility to infections
The immune system is your body’s defence against infections and disease, but for it to work properly it requires iron. If there isn’t enough iron available then you may become prone to recurrent infections like common colds.

Susceptibility to infections

Symptoms that slow you down
Headache
Headaches and migraines can be caused by many things such as dehydration or having a cold, but iron deficiency can affect this too. If you are getting more headaches or they are becoming more severe you should speak to your doctor.

Headache

Symptoms that slow you down
Loss of Libido
A lack of iron can lead to a low sexual libido and erectile dysfunction. You should talk to a healthcare professional, if you are experiencing either.

Loss of Libido

Symptoms that slow you down
Fatigue / physical exhaustion
Extreme tiredness can affect more than just the body – you can suffer from mental fatigue too. Iron is essential for the healthy functioning of the brain, so if you are finding it hard to focus or manage your mood, it could mean that you are iron deficient.

Fatigue / physical exhaustion

Symptoms that slow you down
Feeling worn out
Feeling permanently exhausted or extremely tired is often referred to as fatigue – one of the most common symptoms of iron deficiency. If you feel drained or have little energy or enthusiasm to complete daily tasks you could be iron deficient. Fatigue can have a significant detrimental effect on the social, physiological and psychological elements of your life, so it is important to get it checked out.

Feeling worn out

Symptoms that slow you down
Hearing Loss
There are many reasons why you might suddenly struggle to hear properly and it is important you get a proper diagnosis. One reason for sudden hearing loss can be iron deficiency anaemia.

Hearing Loss

Symptoms you can see
Hair Loss
To keep a healthy head of hair your body needs iron. If you are losing clumps of hair or more hair than normal, it could be an indication of iron deficiency.

Hair Loss

Symptoms you can see
Brittle nails
If you have nails with abnormalities in colour, shape or texture, it could be because of a lack of iron. In particular, nails that are dipped in the middle and raised at the edges to give a rounded appearance like a spoon are associated with iron deficiency anaemia.7

Brittle nails

Symptoms you can see
Paleness
If you have severe iron deficiency, there may be less haemoglobin in your blood which can make you look pale. This is more noticeable on your face, nails, inner mouth and lining of your eyes. If you pull your lower eyelid down and it is a very pale peach colour or yellow, this may indicate that you have iron deficiency anaemia.

Paleness

Symptoms you can see
Bruising easily
Bruising easily has long been associated with iron deficiency. A bruise appears when you have damaged the blood vessels beneath the skin, enough for a small amount of blood to leak out. If your body doesn’t have enough iron, you are more likely to bruise easily.

Bruising easily

Symptoms you can see
Mouth Ulcer
Mouth ulcers (sore white patches on the inside of your mouth) can occur for many reasons including biting the inside of your mouth, stress and being run-down. In some cases, mouth ulcers can also develop due to iron deficiency.

Mouth Ulcer

Symptoms that slow you down
Irritability
Exhaustion, mood swings and an inability to concentrate can cause frustration. If you feel that you are easily irritated, it may be a sign of iron deficiency.

Irritability

Symptoms that slow you down
Memory Loss
Are you forgetting little things more frequently? Talk to your doctor about what could be causing your short-term memory loss; it may be because of iron deficiency.

Memory Loss

Symptoms that slow you down
Eating non foodstuffs / pica
Unusual cravings and eating things with no nutritional value can be an indication of iron deficiency. If you regularly feel like eating non-food items like clay, dirt, ash and starch, it is important not to give in to your cravings and seek medical advice.

Eating non foodstuffs / pica

Symptoms that slow you down
Chewing on Ice
One of the most common symptoms of iron deficiency is the desire to eat or chew ice. Regularly chewing ice can damage the teeth and the gums, so it is important to seek treatment.

Chewing on Ice

Symptoms that slow you down
Cold intolerance
If you find yourself struggling to keep warm or your hands and feet get cold easily, you may have iron deficiency. Iron is important for a range of functions that are involved in keeping our bodies at the right temperature. It is important that we maintain a certain body temperature, and having iron deficiency can make it harder to do that.

Cold intolerance

Symptoms that slow you down
Restless legs syndrome
If you feel the need to move your legs to get rid of uncomfortable or strange sensations while resting, you may have restless legs syndrome. The feelings are sometimes described as itching, burning or crawling and can often affect your sleep. This can be a symptom of iron deficiency.

Restless legs syndrome

Symptoms that slow you down
Loss of Breath
Iron deficiency can reduce your ability to exercise. If you find you can’t exercise as much as you would like, or you get out of breath doing simple things like walking up the stairs, you may be iron deficient.

Loss of Breath

Symptoms that slow you down
Susceptibility to infections
The immune system is your body’s defence against infections and disease, but for it to work properly it requires iron. If there isn’t enough iron available then you may become prone to recurrent infections like common colds.

Susceptibility to infections

Symptoms that slow you down
Headache
Headaches and migraines can be caused by many things such as dehydration or having a cold, but iron deficiency can affect this too. If you are getting more headaches or they are becoming more severe you should speak to your doctor.

Headache

Symptoms that slow you down
Loss of Libido
A lack of iron can lead to a low sexual libido and erectile dysfunction. You should talk to a healthcare professional, if you are experiencing either.

Loss of Libido

Symptoms that slow you down

Feeling worn out

Feeling permanently exhausted or extremely tired is often referred to as fatigue-one of the most common symptoms of iron deficiency. If you feel drained or have little energy or enthusiasm to complete daily tasks you could be iron deficient. Fatigue can have a significant detrimental effect on the social and physiological elements of your life, so it is important to get it checked out.

If you recognise one or more of these symptoms in yourself, you should visit a healthcare professional to have them check your iron levels and investigate further. There are simple tests to find out what's wrong and help you to manage your iron levels. To help you discuss your symptoms, use this patient discussion guide.

Downloads

Symptom Browser (App)

Download the App to check your symptoms and what they could mean. Or, simply learn more about how iron deficiency affects the body with the Symptom Browser.

 

Google Play Store

App Store

References

Hassan, Tamer Hasan et al. “Impact of Iron Deficiency Anemia on the Function of the Immune System in Children.” Medicine 95.47 (2016): e5395. PMC.

Peyrin-Biroulet L, et al. Guidelines on the diagnosis and treatment of iron deficiency across indications: a systematic review. Am J Clin Nutr.2015;102(6):1585-94.

3 Camaschella C. 2015. Iron‐deficiency anemia. N. Engl. J. Med. 372:1832–1843

4 Beard JL. Iron biology in immune function, muscle metabolism and neuronal functioning. J Nutr. 2001:568-580.

5 Pinero DJ, Connor JR. Iron in the Brain: An Important Contributor in Normal and Diseased States. Neurosci. 2000;6(6):435-453.

6 Cappellini MD et al. Iron deficiency across chronic inflammatory conditions: International expert opinion on definition, diagnosis, and management. Am J Hematol. 2017 Oct;92(10):1068-1078.

Auerbach M, Adamson JW. How we diagnose and treat iron deficiency anemia. Am J Hematol. 2016;91(1):31-38.

8 World Health Organisation. Iron deficiency anaemia. Assessment, prevention and control: A guide for programme managers. 2001. Available at URL: http://www.who.int/nutrition/publications/en/ida_assessment_prevention_control.pdf Last accessed: June 2018.

World Health Organisation. Nutritional anaemias: tools for effective prevention and control. 2017. Available at URL: http://www.who.int/nutrition/publications/micronutrients/anaemias-tools-prevention-control/en/. Last accessed: June 2018.

10 Fernando B, et al. A guide to diagnosis of iron deficiency and iron deficiency anemia in digestive diseases. World J Gastroenterol. 2009 Oct 7; 15(37): 4638-4643.

11 PubMed Health. Erythrocytes (red blood cells). Available at URL: https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0022014/. Last accessed: June 2018.

12 World Health Organization. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Vitamin and Mineral Nutrition Information System. Available at URL: http://www.who.int/vmnis/indicators/haemoglobin.pdf. Last accessed: June 2018.

13 National Heart Lung and Blood Institute. How is Iron Deficiency Anemia Diagnosed. Available at URL: https://www.nhlbi.nih.gov/health/health-topics/topics/ida/diagnosis. Last accessed: June 2018.

14 Elsayed M, et al. Transferrin Saturation: A Body Iron Biomarker. Adv Clin Chem. 2016;75:71-97.

15 Hercberg S, et al. Iron deficiency in Europe. Public Health Nutr. 2007;4(2b).

16 World Health Organisation. Worldwide prevalence of anaemia 1993-2005. 2008. Available at URL: http://apps.who.int/iris/bitstream/handle/10665/43894/9789241596657_eng.pdf;jsessionid=9C613E2F4D481EDEB9DE07986AFCE0C7?sequence=1. Last accessed: June 2018.

17 Thachil J. Iron deficiency: still under-diagnosed? Br J Hosp Med. 2015;76(9):528-532.

18 Miller JL. Anemia: a common and curable disease. Cold Spring Harb Perspect Med. 2013 Jul; 3(7).

19 Caramelo L, Mezzacasa A and Kassebaum NJ. Iron Deficiency. Understanding perceptions of sufferers and the general public. EHA 21st Annual Congress, 9-12 June 2016, Copenhagen, Denmark

20 Patterson A, et al. Iron deficiency, general health and fatigue: Results from the Australian Longitudinal Study on Women’s Health. Qual Life Res.2000;9:491-497.

21 World Health Organisation. Nutritional anaemias: tools for effective prevention and control. 2017. Available at URL: http://www.who.int/nutrition/publications/micronutrients/anaemias-tools-prevention-control/en/. Last accessed: June 2018.

22 Zimmermann M, Hurrell R. Nutritional iron deficiency. Lancet. 2007;370:511-520.

23 Abbaspour N, et al. Review on iron and its importance for human health. J Res Med Sci. 2014;19(2):164-174.

24 Hurrell R, Egli I. Iron bioavailability and dietary reference values. Am J Clin Nutr. 2010;91:1461-1467.

25 Hunt JR. Bioavailability of iron, zinc, and other trace minerals from vegetarian diets. Am J Clin Nutr. 2003;78(3).

26 Waldmann A, et al. Dietary iron intake and iron status of German female vegans: results of the German vegan study. Ann Nutr Metab. 2004;48(2):103-8.

27 McDonagh T, Macdougall IC. Iron therapy for the treatment of iron deficiency in chronic heart failure: intravenous or oral? Eur J Heart Fail. 2015;17(3):248-62.

28 Favrat, B, et al. (2014). Evaluation of a single dose of ferric carboxymaltose in fatigued, iron-deficient women--PREFER a randomized, placebo-controlled study. PLoS One 9(4): e94217. eCollection 2014.

29 Nijrolder I, et al. Diagnoses during follow-up of patients presenting with fatigue in primary care. CMAJ. 2009;181(10):683-7.

30 Schieffer KM, et al. Association of Iron Deficiency Anemia With Hearing Loss in US Adults. JAMA Otolaryngol Neck Surg. 2017;(800).

31 Trost LB, et al. The diagnosis and treatment of iron deficiency and its potential relationship to hair loss. J Am Acad Dermatol. 2006;54(5):824-44.

32 Cashman MW, Sloan SB. Nutrition and nail disease. Clin Dermatol. 2010;28(4):420-5.

33 Whitfield A, et al. Iron Deficiency Anemia Diagnosed in Female Teenagers. J Family Med Community Health. 2015. 2(7): 1058.

34 Scully C. ABC of oral health: Mouth ulcers and other causes of orofacial soreness and pain. Bmj. 2000;321(7254):162-165

35 Barton JC, et al. Pica associated with iron deficiency or depletion: clinical and laboratory correlates in 262 non-pregnant adult outpatients. BMC Blood Disord. 2010;10:9. doi:10.1186/1471-2326-10-9.

36 Silber MH, et al. Willis-Ekbom Disease Foundation Revised Consensus Statement on the Management of Restless Legs Syndrome. Mayo Clin Proc.2013;88(9):977-986.

37 Brigham D, Beard J. Iron and thermoregulation: a review. Crit RevFood Sci Nutr. 1996;36(1040-8398):747-763.

38 Jankowska E, et al. Iron deficiency: an ominous sign in patients with systolic chronic heart failure. Eur Heart J. 2010;31(15):1872-80.

39 Fallah R, et al. Evaluation Efficacy of Ferrous Sulfate Therapy on Headaches of 5-15 Years Old Iron Deficient Children with Migraine. Iran J Pediatr Hematol Oncol. 2016;6(1):32-7.