Iron Deficiency: Symptoms, Causes, Risk Factors and Treatment Options

What is Iron Deficiency?

Iron deficiency, or iron deficiency anemia, is a health condition characterized by low iron stores. It’s fairly common in Canada, with about 10.5% of the population having an iron deficiency at any point.

Without enough iron, your body can’t build hemoglobin—a protein on red blood cells that carries oxygen throughout the body. This can significantly reduce the amount of oxygen your vital organs and tissues receive, making you feel lethargic and tired.

Fortunately, you can correct an iron deficiency by making dietary changes and starting a supplement. If your deficiency is advanced, you may require an iron infusion, which can be administered in under an hour.

Keep reading to learn more about iron deficiency symptoms and treatment options.

Iron Deficiency Symptoms

Iron deficiency symptoms develop slowly over time, and many people don’t recognize the subtle signs of a deficiency until their symptoms are advanced.

Iron deficiency symptoms include:

• Tiredness and fatigue
• Shortness of breath
• Chest pain (in advanced cases)
• Dizziness or light-headedness
• Cold hands, feet, and toes
• Pale skin

Iron supports brain function and neurological health, and a deficiency can impact your mental well-being. If you’re experiencing low mood, anxiety, or sleeping problems, ask your doctor to be assessed.

Remember that your mental health is as important as your physical well-being. Consistently feeling drained, tired, and anemic can impact your quality of life, and correcting the deficiency could help you feel more energized and like yourself.

When to See a Doctor

It’s important to see a doctor as soon as you have concerns about your health. An undiagnosed iron deficiency may have symptoms that mimic other health conditions like hypothyroidism (underactive thyroid). Your doctor can assess you and rule out other possible conditions that could be contributing to your symptoms.

If your energy levels are lower than normal, you look peaked (or pale), or you’re experiencing lightheadedness—it’s time to book an appointment. If you’re experiencing heart palpitations or fainting, you need to go to the emergency room as soon as possible. 

Iron Deficiency Risk Factors

There are a few risk factors that could contribute to an iron deficiency. Common groups of people who are most susceptible include:

• Anyone following a vegetarian or vegan diet. They don’t eat iron-rich animal proteins and need to rely on plant-based sources (which are harder to absorb).
• Pregnant people or anyone who is breastfeeding. Their iron needs are much higher, and keeping up with daily intake can be challenging.
• Women who are excessively menstruating. Heavy monthly blood loss caused by periods can make it challenging to maintain adequate iron stores.
• Children and youth. Their iron needs are very high, and sometimes, they can’t eat enough iron-rich foods at meals.
• Anyone who had bariatric surgery. Their stomach and gastrointestinal tract are reduced, and they can’t absorb iron as much iron. They must take supplements indefinitely after surgery to help maintain healthy levels.
• People with gastrointestinal conditions. Their bowels can’t absorb as efficiently, and they are at higher risk for a nutrient deficiency (Crohn’s, ulcerative colitis, etc.)
• Endurance athletes. They are susceptible to frequent, small bouts of gastrointestinal bleeding and red blood cell breakdown (which contributes to iron loss).

Also, anyone with a restricted nutritional intake may be at risk of a deficiency if they aren’t eating enough iron-rich foods, including anyone with a restrictive eating disorder. 

Iron Deficiency Causes

Several health and lifestyle factors can contribute to an iron deficiency, but there are usually two big-picture causes:

1. You aren’t eating enough iron-rich foods to satisfy your daily requirements. This can easily be modified by learning which foods to eat more often.
2. You’re eating iron-rich foods, but your small intestine struggles to absorb iron efficiently.

It’s possible to be affected by one or both of these causes. Knowing which one affects you is vital for building a treatment plan to raise your iron levels.

If you’re not absorbing iron, you may benefit from consulting a few gut health specialists to determine why. They may recommend an easy-to-absorb supplement to help boost your levels.

How to Test for Iron Deficiency

Your family doctor (or an equivalent healthcare provider) will write a blood requisition to assess your iron levels.

People with low iron levels will usually display these results:

• Low hemoglobin and hematocrit levels
• Low mean cellular volume (MCV)
• Low ferritin
• Low serum iron levels
• Low iron saturation
• High transferrin or total iron-binding capacity

Only a medical professional can interpret your results. If you look at your results online and have concerns, follow up with your physician for their medical opinion.

Iron Deficiency Treatment Options

You can treat an iron deficiency through diet changes, and depending on the severity of your deficiency, you may require a supplement.

It takes time, but you can raise your levels to a healthy range by following a personalized treatment plan. Your physician will tell you what an optimal iron level is for you, but generally, female adults should have a ferritin level between 30 and 307 µg, and males should have a level between 24 and 337 µg. 

We’ve listed evidence-based, practical treatment options to raise your iron levels.

Eat More Iron Rich Foods

Plenty of delicious, iron-rich foods can be added to meals or snacks. You should know that there are two types of dietary sources of iron: heme iron, which is easily absorbed and naturally found in most animal proteins, and non-heme iron, which is found in plant-based foods.

Non-heme iron is harder to absorb, but there are a couple of ways to improve iron uptake.

1. Eat non-heme iron foods with vitamin C. You can drink orange juice, spritz lemon onto salads, or cook bean dishes with tomatoes.
2. Limit your intake of calcium and tannins (natural compounds in tea and wine) while eating non-heme iron foods. Allow forty minutes for digestion, and then enjoy those beverages.

Examples of iron-rich foods include:

• Lean cuts of red meat
• Game (venison, elk, etc.)
• Shellfish
• Fortified grains (in cereals and breads)
• Beans, peas, and tofu
• Leafy vegetables, including spinach, kale, and beet tops
• Nuts and some dried fruits (raisins and dates)

Try an Iron Supplement

You should only take an iron supplement under the guidance of your physician. They’ll recommend an effective dose and specify when to take it, if you should take it with or without food, and for how long.

It’s usually recommended that you take an iron supplement for at least three months, after which your physician will reassess your levels.

These are a few common iron formulations:

Iron Formulation	Description
Ferrous salts	Well absorbed, but often cause gastrointestinal distress such as nausea, diarrhea, constipation, black stool, and abdominal pain. They require Vitamin C for better absorption and are recommended to be taken with meals. Typically, they need to be taken in multiple doses per day.
Polysaccharide iron complex	Well absorbed, with a higher iron content and fewer gastrointestinal events. Can be taken with Vitamin C to enhance absorption, with or without meals. Generally, requires only 1-2 doses per day.
Heme iron	Highly bioavailable and the most absorbed oral iron supplement, derived from animal sources. Does not require Vitamin C and can be taken without food. It’s the most gentle iron supplement on your digestive system.

Medical Treatment Option

An iron infusion is an urgent treatment option for people with dangerously low iron levels.

If you need an iron infusion, your care team will immediately call you after reviewing your blood test results and ask you to visit the closest hospital. The medical staff in urgent care will triage you and administer an infusion.

Depending on your levels, the infusion can take up to an hour. Your hemoglobin should rise within two to three weeks of receiving the infusion, and your doctor will follow up with you to ensure you’re recovering and feeling well.

Other Treatment Options

If you have digestive health conditions that could impact your body’s ability to absorb iron, consider working with a registered dietitian. They’re nutrition experts who can help you build an eating plan to help you feel your best.

How Long Does it Take to Build up Iron Stores?

British Columbia health authorities state that replenishing your iron stores can take up to six months.

Iron is used daily to make new red blood cells, so your body still needs to use iron as you’re trying to replenish your stores. This is why a deficiency can take a long time to rectify.

Final Thoughts

Iron deficiency anemia needs to be addressed by dietary changes (eating more iron-rich foods) and usually supplementation. In advanced cases, people may require an iron infusion which can only be administered in a hospital using IV equipment.

If you ever start to feel tired, sluggish, and always look pale—ask your doctor to assess your iron levels. They’ll help you build a treatment plan so that you feel energetic and healthy.

References

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