Iron Deficiency Anemia: Causes, Symptoms, And Management

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Medical News TodaySubscribeWhat to know about iron deficiency anemia

Medically reviewed by Angelica Balingit, MD — Written by Jenna Fletcher and Mandy French — Updated on April 10, 2024

Definition
Causes
Risk factors
Symptoms
Diagnosis
Treatment
Summary

Key takeaways

Iron deficiency anemia occurs when the body lacks sufficient iron to produce enough red blood cells, which are essential for carrying oxygen throughout the body.
The condition can have many causes, including blood loss, heavy periods, nutritional deficiency, malabsorption, and pregnancy.
Diagnosis involves assessing symptoms, examining physical signs, and conducting blood tests to check iron levels. Treatment typically includes iron supplements or injections and addressing the underlying cause.

The body uses iron to produce red blood cells, which transport oxygen around the body.

Without enough iron, too few healthy red blood cells may carry sufficient oxygen to satisfy the body’s needs, leading to tiredness, shortness of breath, dizziness, and other symptoms.

This article further defines iron deficiency anemia. It also explains the causes, risk factors, symptoms, and treatment for the condition.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Learn more.

What is anemia?

Female lying on her back covering her face with her hands — Fiordaliso/Getty Images

Anemia is a blood condition characterized by a lower number of red blood cells or a lower concentration of hemoglobin within those cells.

Hemoglobin is the part of the red blood cells that binds to oxygen. When the body does not have enough hemoglobin circulating, not enough oxygen gets to all parts of the body. As a result, organs and tissues may not function properly, and a person may feel fatigued.

According to the World Health Organization (WHO), anemia is a serious global health concern. It generally affects children, females who are menstruating, and females who have recently had a baby or recently completed menopause. The WHO estimates that anemia affects around:

30% of females ages 15-49
37% of pregnant people
40% of children ages 6-59 months

Iron deficiency anemia occurs when the body does not have enough iron. It is the most common type of anemia worldwide.

Causes of iron deficiency anemia

Iron deficiency anemia relates directly to a lack of iron in the body. However, the cause of iron deficiency varies based on age, gender, and socioeconomic status.

Some common causes include:

blood loss
diet
decreased ability to absorb iron
pregnancy

Blood loss

One of the most common causes of iron deficiency in adults is blood loss.

There are various causes of blood loss that can lead to iron deficiency. These include:

traumatic injury
surgery
bleeding in the gastrointestinal (GI) tract due to a condition, such as:
- inflammatory bowel disease (IBD)
- ulcer
- colon cancer
- celiac disease
regular use of medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or aspirin
bleeding in the urinary tract
bleeding during childbirth
heavy bleeding during menstruation

Up to 5% of females develop iron deficiency anemia due to heavy bleeding during their periods.

Some less common causes of blood loss that can lead to iron deficiency include chronic nose bleeds and frequent blood donations.

Diet

Iron deficiency may occur due to a lack of iron in a person’s diet. This may be especially true during times that require more iron, such as:

infants
young children
adolescent females
pregnant people

However, in the United States, iron deficiency from consuming too little iron is rare. This is mainly due to supplemental iron being added to various foods.

Foods rich in iron, such as eggs and meat, supply the body with much of the iron it needs to produce hemoglobin. If a person does not eat enough to maintain their iron supply, an iron deficiency can develop.

Decreased ability to absorb iron

There are certain medications, factors, and conditions that can make it more difficult to absorb iron. This can lead to iron deficiency anemia.

Some of these conditions and factors include:

Endurance sports: Athletes who participate in endurance sports may be more likely to lose iron through the GI tract and the breakdown of red blood cells.
Surgery: Surgery on the stomach or intestines, including weight loss surgery, can make it more difficult for an individual to absorb iron.
Digestive and intestinal conditions: Certain conditions may make it more difficult to absorb iron. These include:
- Crohn’s disease
- ulcerative colitis
- celiac disease
- Helicobacter pylori (H. pylori) infection

Pregnancy

Low iron levels are a common issue during pregnancy. This is because the body needs more iron than normal in order to support the developing fetus.

Pregnancy can also cause low iron levels because plasma and blood volumes are increased in the pregnant person during this time.

Learn more about low iron in pregnancy.

Risk factors for iron deficiency anemia

Some groups of people may have a higher risk of developing iron deficiency anemia.

Vegetarians and vegans

People, such as vegetarians or vegans, who eat a plant-based diet, may have low iron levels. This may be at least partially due to the body absorbing iron from vegetables differently from iron from meat and poultry.

It is important for vegetarians and vegans to make sure they are including enough iron in their diet. The Vegetarian Society suggests the following foods:

chickpeas, lentils, and other pulses
tofu
breakfast cereals
kale
cabbage
broccoli
nuts
dried fruits

Individuals can also discuss iron supplements with their healthcare professional.

Females

Pregnancy, menopause, and heavy bleeding during menstruation can all increase the risk of iron deficiency anemia in females.

Blood donors

Regular blood donation can lead to iron deficiency or iron deficiency anemia. According to research from 2022, this is a potential risk of blood donation that individuals should be made aware of.

The research also notes that it may be able to be prevented by limiting the amount of blood that is drawn, screening for iron deficiencies, and extending the amount of time between donations.

Infants and children

Infants and children may be at risk for iron deficiency. By 6-9 months, full-term infants may become iron deficient unless they get enough iron through their diet or through iron-rich formula.

Similarly, children going through growth spurts may have an increased risk of iron deficiency. It is important for children to eat a varied and nutrient-rich diet to help prevent iron deficiencies.

Symptoms of iron deficiency anemia

Iron deficiency anemia often develops slowly. This is partially due to it taking several months for the body to use up its iron reserves.

In some cases, an iron deficiency may improve with no intervention, as a person’s situation changes, such as after giving birth.

However, if a person has any symptoms of iron deficiency anemia, they should speak with a healthcare professional.

A person with an iron deficiency can have some of the following symptoms:

general weakness
dizziness or lightheadedness
extreme fatigue
fast heartbeat
easily broken and brittle nails
paleness
chest pain
shortness of breath
headaches
cold hands and feet
soreness or inflammation of the tongue
cravings for non-nutritive things, such as dirt, starch, or ice
poor appetite, especially in children

Complications

In milder cases of iron deficiency anemia, a person is unlikely to experience complications. However, additional complications can occur if the iron deficiency anemia is left untreated.

Possible complications include:

slow growth and developmental delays in children and infants
heart problems, including heart failure or an enlarged heart due to it compensating for lack of oxygen
pregnancy complications, including low birth weights and an increased risk of premature birth
depression
restless leg syndrome

Diagnosing iron deficiency anemia

Only a healthcare professional can diagnose iron deficiency anemia. It is important for a person to seek advice from a medical professional if they have noticeable symptoms.

It is likely that a healthcare professional will usually begin the exam by asking questions about a person’s general health. They may examine the skin tone, the fingernails, and under the eyelids to look for physical signs of iron deficiency anemia.

A healthcare professional will also generally order blood tests to check complete blood count (CBC), hemoglobin levels, blood iron levels, and ferritin levels.

They may ask further questions or run additional tests to help determine if the iron deficiency anemia is the result of an undiagnosed underlying condition.

These tests may vary, depending on other symptoms a person describes. For example, someone experiencing pain during digestion may require an endoscopy to see if a gastrointestinal disease is the cause of the iron deficiency.

Treatment and self-management

Iron deficiency anemia is usually treated in two ways, which involve increasing iron intake and treating any underlying conditions.

Healthcare professionals may recommend using iron supplements to help correct iron intake levels. Supplements are often available over the counter. It is important to take the supplements as prescribed, because too much iron can be toxic and damage the liver.

Furthermore, large amounts of iron can cause constipation. As a result, a healthcare professional may prescribe stool softeners or laxatives to ease bowel movements.

If an underlying condition is found, further treatment may be needed. Treatments for underlying conditions will depend on the problem but may mean additional medications or surgery.

Self-management can involve adding more iron and vitamin C to the diet.

Foods rich in iron include:

beans
red meat
oysters
liver
dried fruits
iron-fortified cereals
peas

Foods rich in vitamin C include:

citrus fruits
leafy greens
broccoli

It is important to remember that correcting iron deficiency takes time. Treating iron deficiency anemia with supplements typically takes 3-6 weeks and requires continuation for 6 months after blood levels return to normal.

Summary

Iron deficiency anemia is the most common type of anemia. It occurs when there are too few red blood cells in the body due to a lack of iron.

It often occurs during pregnancy, due to blood loss, or due to a decreased ability to absorb iron. Symptoms can include fatigue, pale skin, and shortness of breath.

Treatment for iron deficiency anemia typically involves iron supplements and treating any underlying conditions.

Blood / Hematology
Nutrition / Diet

How we reviewed this article:

SourcesMedical News Today has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Anaemia. (n.d.).https://www.who.int/health-topics/anaemia
Braunstein E M. (2022). Iron deficiency anemia.https://www.msdmanuals.com/en-gb/home/blood-disorders/anemia/iron-deficiency-anemia
Georgieff M K. (2020). Iron deficiency in pregnancy.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7492370/
Iron. (n.d.).https://vegsoc.org/eating-veggie/nutritional-advice/iron/
Iron. (2023).https://ods.od.nih.gov/factsheets/Iron-Consumer/
Iron-deficiency anemia. (2021).https://www.womenshealth.gov/a-z-topics/iron-deficiency-anemia
Iron-deficiency anemia. (2022).https://www.nhlbi.nih.gov/health/anemia/iron-deficiency-anemia
Iron-deficiency anemia. (n.d.).https://www.hematology.org/education/patients/anemia/iron-deficiency
Iron deficiency anemia. (n.d.).https://www.childrenshospital.org/conditions/iron-deficiency-anemia
Mantadakis E, et al. (2022). Iron deficiency and blood donation: Links, risk, and management.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9749410/
Warner M J, et al. (2023). Iron deficiency anemia.https://www.ncbi.nlm.nih.gov/books/NBK448065/

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Medically reviewed by Angelica Balingit, MD — Written by Jenna Fletcher and Mandy French — Updated on April 10, 2024

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