Iron Deficiency Anemia Symptoms - Healthline

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Evidence Based14 Symptoms of Iron Deficiency Anemia

Medically reviewed by Mia Armstrong, MD — Written by Gavin Van De Walle, MS, RD and Mary Jane Brown, PhD, RD (UK) — Updated on September 4, 2024

Fatigue
Pallor
Shortness of breath
Headaches
Palpitations
Hair and skin damage
Mouth symptoms
Restless legs
Spoon nails
Other symptoms
In children
In older adults
Seeing a doctor
FAQ
Takeaway

Iron deficiency occurs when your body doesn’t have enough iron and can lead to a condition called iron deficiency anemia. Common symptoms include fatigue, pallor, and breathlessness.

Your body needs iron to make hemoglobin, a protein in red blood cells that enables them to carry oxygen through your blood vessels. If your body doesn’t have enough hemoglobin, your tissues and muscles won’t get enough oxygen to be able to work effectively.

Here are 14 signs and symptoms of iron deficiency, starting with the most common. Also, find out how to recognize anemia in children and older adults, and when to see a doctor.

1. Unusual tiredness

Feeling tired is a common symptom of iron deficiency anemia.

Fatigue happens because your body lacks the iron it needs to make hemoglobin, which helps carry oxygen around your body.

Without enough hemoglobin, less oxygen reaches your tissues and muscles, depriving them of energy. Your heart also has to work harder to move more oxygen-rich blood around your body, which can make you tired.

Since tiredness is often part of a busy, modern life, it’s difficult to diagnose an iron deficiency based on this symptom alone.

However, tiredness that occurs with pallor, shortness of breath, and other symptoms may be a sign of anemia.

Learn about other causes of chronic fatigue.

woman yawning while stretching inside — Irina Efremova/Stocksy

2. Skin that’s paler than usual

Skin that’s paler than usual, as well as pale coloring of the inside of the lower eyelids, can also indicate iron deficiency.

The hemoglobin in red blood cells gives blood its red color, so low levels caused by iron deficiency make the blood less red. That’s why skin can lose some of its color or warmth in people with iron deficiency.

A 2023 review of research notes that pallor in the creases of the palms or inside the eyelids is a reliable indicator of anemia. If you pull your lower eyelid down while looking in a mirror, the inside layer should be a vibrant red color. If it’s a very pale pink or yellow, you may have iron deficiency.

In people with darker skin tones, the eyelid may be the only area where this condition is noticeable.

However, other health conditions can cause pallor or skin that appears blue or gray. Only a blood test can confirm a diagnosis of anemia.

3. Shortness of breath

When hemoglobin levels are low with iron deficiency, oxygen levels are also typically low. This means that your muscles won’t receive enough oxygen to do everyday activities, such as walking.

As a result, your breathing rate will increase as your body tries to get more oxygen, resulting in shortness of breath.

If you find yourself out of breath when doing daily tasks that you used to find easy, such as walking, climbing stairs, or working out, it may be due to iron deficiency.

Shortness of breath can also result from other health conditions, so it’s important to talk with a doctor and get tested for iron deficiency anemia.

4. Headaches

Researchers are still examining the link between iron deficiency and headaches. A 2019 study determined a correlation between migraine episodes and iron-deficiency anemia in females.

Several factors may possibly contribute, including altered dopamine function and estrogen levels. Iron deficiency can occur during heavy menstruation, and headaches can also occur due to iron deficiency and menstrual migraine.

A 2023 study found a relationship between iron deficiency anemia and chronic daily headache, a headache condition, with severe iron deficiency worsening symptoms.

Although there are many causes of headaches, frequent, recurrent headaches may happen due to an iron deficiency.

Read about different types of headaches.

5. Heart palpitations

You may have noticeable heartbeats, or heart palpitations, if you have iron deficiency anemia.

Low blood oxygen levels from iron deficiency anemia may lead to heart palpitations, tachycardia (a fast heart rhythm), and chest pain.

Hemoglobin is the protein in red blood cells that helps transport oxygen around your body. In iron deficiency, low hemoglobin levels mean the heart has to work extra hard to carry oxygen.

This may lead to irregular heartbeats or the feeling that your heart is beating abnormally fast.

Consequently, iron deficiency may worsen heart conditions, such as heart failure and coronary heart disease, and reduce the ability to exercise.

Note that heart palpitations can also have other causes, including anxiety, caffeine use, and dehydration.

6. Dry and damaged hair and skin

Dry or damaged skin and hair can occur with iron deficiency anemia. Nutritional deficiencies can deprive hair and skin of the nutrients and blood flow they need to grow.

Iron deficiency is also associated with hair loss, and some research suggests it may be a cause.

Hair often falls out during everyday washing and brushing. But, significant hair loss may be a symptom of iron deficiency.

Get some tips on preventing hair loss.

7. Swelling and soreness of your tongue or mouth

Sometimes, changes inside or outside of your mouth can indicate iron deficiency anemia. Symptoms include:

a swollen, inflamed, pale, or smooth mucus membrane
burning tongue
dry mouth
a burning feeling in your mouth
sore, red cracks at the corners of your mouth
mouth ulcers

What else can cause tongue swelling and soreness?

8. Restless legs

Iron deficiency can lead to restless leg syndrome, as it can cause a drop in dopamine in your blood.

This condition involves a strong urge to move your legs while they’re at rest. It may also cause unpleasant crawling or itching sensations in your feet and legs. It’s usually worse at night and can make it difficult to sleep.

The causes of primary restless leg syndrome are not fully understood. However, it can stem from various medical conditions, including iron deficiency anemia.

What are the best treatments for restless leg syndrome?

9. Brittle or spoon-shaped fingernails

Spoon-shaped fingernails, also called koilonychia, are another symptom of iron deficiency anemia.

Usually, the first indicator is brittle nails that chip and crack easily.

In the later stages of iron deficiency, the nails can become spoon-shaped, meaning that the middle of your nail dips and the edges raise to give a rounded appearance like a spoon.

This is a rare side effect and is usually reversible with treatment to boost the body’s iron levels.

What do brittle, discolored, and weak nails say about your health?

10 to 14. Other symptoms of iron deficiency anemia

You may also have other symptoms of iron deficiency. These tend to be less common and may be linked to many conditions other than iron deficiency.

Other signs of iron deficiency anemia include:

Cold hands and feet: Iron deficiency means less oxygen delivery to your hands and feet. Some people may feel the cold more easily in general or experience cold hands and feet.
Strange cravings: A craving for strange foods or non-food items is called pica. A person may crave ice, clay, dirt, chalk, or paper. It can occur during pregnancy and may indicate iron deficiency.
Feelings of depression: There may be a link between iron deficiency anemia and depression in adults, including during and after pregnancy.
More frequent infections: Iron is needed for a healthy immune system, and a lack of iron may increase your risk of infections.
Low appetite: Iron deficiency is linked to low appetite due to changes in the hunger hormone ghrelin.

Symptoms of anemia in children

Children with iron deficiency anemia may:

have pale skin
appear irritable or fussy
lack energy
tire quickly
have a rapid heart rate
have a sore or swollen tongue
have an enlarged spleen, just below the ribs
show signs of pica, such as wanting to eat ice

How does anemia affect children?

Symptoms of anemia in older adults

Anemia is common in older adults, but it can be hard to identify, as some of the symptoms are common as people get older.

Symptoms include:

fatigue
difficulty thinking and focusing
depression
muscle weakness
frailty

Compared with younger people, older adults are more likely to have conditions associated with iron deficiency anemia, such as chronic kidney disease, inflammation, and nutritional deficiencies.

Older adults are also more likely to use certain medications, like non-steroidal anti-inflammatory drugs (NSAIDs), anticoagulants, and proton pump inhibitors over a long period, which may cause blood loss in the stomach or reduce iron absorption.

Learn more about how anemia affects older adults.

When to see a doctor

Talk with a doctor if you have symptoms of iron deficiency.

Iron deficiency anemia can cause complications, such as:

heart problems
depression
a higher chance of infections
pregnancy issues

People who are pregnant or have heavy menstrual periods have a higher risk. Consider talking with a doctor about testing for iron deficiency anemia.

If a doctor confirms that you have iron deficiency, typically via a blood test, they can develop a treatment plan to improve your iron levels.

They may recommend:

increasing your intake of iron via your diet
taking supplements
IV iron infusions

However, if the doctor suspects anemia stems from gastrointestinal problems, they may recommend further tests and procedures, including upper and lower endoscopies.

If you think you have iron deficiency anemia, consult with a doctor before changing your diet or taking supplements.

If you need help finding a primary care doctor, then check out our FindCare tool here.

Frequently asked questions

How will I feel if my iron is low?

Some people experience no symptoms of iron deficiency anemia. In time, however, you may notice that the insides of your eyes are paler than usual, and you may feel tired and short of breath.

How can I increase my iron level quickly?

Eating an iron-rich diet can help boost iron levels. If your levels are very low, a doctor may recommend iron supplements. In some cases, you may need treatment for an underlying condition.

What causes iron levels to drop?

Low iron levels are common causes, including nutritional choices, underlying conditions, bleeding, and the use of certain medications.

Learn more about the causes and treatments of anemia.

Takeaway

Symptoms of iron deficiency anemia can depend on the severity of the anemia. In the early stages, there may be no symptoms.

Common symptoms include fatigue, paleness, shortness of breath, and dry or damaged hair and skin.

If you think you have symptoms of iron deficiency, talk with a doctor. They may recommend dietary changes or medication. They may also do tests to see if an underlying condition needs addressing.

Just one thing

Try this today: If you’re a vegetarian but still interested in increasing your iron intake, check out our article on iron-rich plant foods.

Read this article in Spanish.

How we reviewed this article:

SourcesHistoryHealthline 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.

Ahmed T, et al. (2023). The association between anemia and depression in older adults and the role of treating anemia.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10175994/
Arshad H, et al. (2023). Psychiatric manifestations of iron deficiency anemia-A literature review.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10595923/
Causes: Restless legs syndrome. (2022).https://www.nhs.uk/conditions/restless-legs-syndrome/causes/
Cheng Z, et al. (2023). Exploring the relationship between anemia and postpartum depression: Evidence from Malawi.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9966145
Hanif N, et al. (2023). Chronic iron deficiency.https://www.ncbi.nlm.nih.gov/books/NBK560876/
Ganesan PR, et al. (2023). The association between pica and iron-deficiency anemia: A scoping review.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10199804/
Ghrayeb H, et al. (2020). Appetite and ghrelin levels in iron deficiency anemia and the effect of parenteral iron therapy: A longitudinal study.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7272047/
Iron deficiency anemia. (n.d.).https://www.hematology.org/education/patients/anemia/iron-deficiency
Iron deficiency anemia. (2022).https://www.nhlbi.nih.gov/health/anemia/iron-deficiency-anemia
Iron deficiency anemia in children. (2022).https://www.nationwidechildrens.org/conditions/health-library/iron-deficiency-anemia-in-children
Neidlein S, et al. (2021). Iron deficiency, fatigue and muscle strength and function in older hospitalized patients.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7943415/
Oyedeji CI, et al. (2024). How I treat anemia in older adults.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10808247/
Restless legs syndrome. (2024).https://www.ninds.nih.gov/health-information/disorders/restless-legs-syndrome
Romano AD, et al. (2020). Molecular aspects and treatment of iron deficiency in the elderly.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7313036/
Salinas M, et al. (2020). Alopecia and iron deficiency: An interventional pilot study in primary care to improve the request of ferritin.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7471793/
Sari US, et al. (2024). Association between anemia severity and migraine in iron deficiency anemia.https://www.europeanreview.org/article/35335
Singer CE, et al. (2023). Role of iron deficiency in heart failure—clinical and treatment approach: An overview.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9857585/
Singh RK, et al. (2023). Association between iron deficiency anemia and chronic daily headache: A case-control study.https://journals.sagepub.com/doi/full/10.1177/03331024221143540
Tayyebi A, et al. (2019). Is there any correlation between migraine attacks and iron deficiency anemia? A case-control study.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6801325/
Rathod DG, et al. (2023). Spoon nails.https://www.ncbi.nlm.nih.gov/books/NBK559311/
Velliyagounder K, et al. (2024). Iron deficiency anemia and its impact on oral health—A literature review.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11202564/
Vyas N, et al. (2023). The accuracy of physical examination to diagnose anemia among patients five years or older: A systematic review.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9868202/
Warner MJ, et al. (2023). Iron deficiency anemia.https://www.ncbi.nlm.nih.gov/books/NBK448065/
Zhu X-Y, et al. (2020). Correlates of nonanemic iron deficiency in restless legs syndrome.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7205016/

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Evidence Based

This article is based on scientific evidence, written by experts and fact checked by experts.

Our team of licensed nutritionists and dietitians strive to be objective, unbiased, honest and to present both sides of the argument.

This article contains scientific references. The numbers in the parentheses (1, 2, 3) are clickable links to peer-reviewed scientific papers.

Medically reviewed by Mia Armstrong, MD — Written by Gavin Van De Walle, MS, RD and Mary Jane Brown, PhD, RD (UK) — Updated on September 4, 2024

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