Iron deficiency - Causes, Symptoms, Prevention and Diagnosis

Vitamins, mineral

Minerals are essential for good health of human being. Minerals help our body to develop and function normally.

The essential minerals for health include calcium, phosphorus, potassium, sodium, chloride, magnesium, iron, zinc, iodine, chromium, copper, fluoride, molybdenum, manganese and selenium.

Iron is an essential mineral required by our body. It is important for many complex processes and functions of the body.

Functions of Iron

Red blood cells

The main function of iron is to transport oxygen in the blood through hemoglobin and hence oxygenates the blood.

  • Iron also helps to convert blood sugar to energy.

  • Iron aids in functioning of the mental processes.

  • Iron boosts the immune system.

  • Iron supports healthy skin, hair and nails.

  • DNA synthesis, cell proliferation and energy production needs iron content.

Iron is not produced by our body and is also lost in many ways like menstruation, urine, sweat, defecation and exfoliation of dead cells. About two - third of iron is stored in haemoglobin and the remaining is stored as ferritin and hemosiderin in the liver and reticuloendothelial system. Total 3 to 4 g of iron is present in the body, out of which 1- 2 mg iron is lost daily and an additional 1 mg is lost during menstruation. Iron can be consumed by means of supplements or nutritional diet.

Don't like reading, watch a quick video instead

OR Continue reading below

Iron deficiency

Iron deficiency means that there is very less iron in the body to be healthy. There is a decrease in number of red blood cells (RBC's) or amount of haemoglobin in the blood. The most common micronutrient deficiency in the world is the iron deficiency and hence has to be consumed in sufficient amounts as a part of a healthy balanced diet.

Causes of Iron Deficiency:

Common causes of iron deficiency include inadequate iron intake due to poor diet, inflammatory bowel disease, increased requirements during pregnancy and blood loss through heavy periods or internal bleeding. About 20% of women have iron deficiency in their reproductive years.


Often when we choose the nutrients to be consumed, iron is consumed less as its a micronutrient needed by the body.

Blood Loss

Blood loss usually during menstruation in women leads to iron deficiency. Other causes of blood loss can be childbirth, uterine fibroids, stomach ulcers, urinary tract bleeding, colon cancer, etc.


If iron is not absorbed by the body through the foods especially if you are suffering from digestive tract diseases, gastric bypass surgery or if there is any ongoing blood loss due to other health condition, also gives rise to iron deficiency.

Children and pregnant women

Children growing rapidly and pregnant women need extra iron content in the body.

Parasitic disease

Parasites in the body cause inflammation and chronic blood loss in the body by binding to the human's small intestinal mucosa.

Blood donation

Frequent blood donors are also at risk with iron deficiency whereas those who donate platelets or WBC's are do not have the risk of losing iron. When whole blood is donated, approximately 200 mg of iron is also lost from the body.

Symptoms of Iron deficiency

Iron deficiency often results in unpleasant symptoms which affects our life. The symptoms vary with respect to severity of iron deficiency, age and current health condition. In some cases there are no symptoms at all. Some of the common symptoms are:


Body needs iron to make haemoglobin. Iron deficiency means body doesn't have enough haemoglobin due to which less oxygen reaches tissues and muscles which deprive us from energy. Heart has to work harder to move more oxygen-rich blood around your body, which can make you tired leading to fatigue and weakness.


The first thing doctor notice for as a sign of iron deficiency is paleness of face, gums, inside of the lips or lower eyelids and even the nails. This is caused due to less haemoglobin caused due to iron deficiency, the result of which makes the blood less red.


Haemoglobin transports oxygen all over the body. Iron deficiency leads to low levels of haemoglobin due to which heart has to work extra hard to pump the blood. This results in abnormal heart beats called palpitations. In extreme cases, it leads to enlarged heart and heart failure.

Headache, dizziness or lightheadedness

Low levels of oxygen due to iron deficiency results in enough oxygen not reaching the brain which gives rise to headache, dizziness or lightheadedness. Frequent, recurrent headaches and dizziness are some of the signs of iron deficiency.

Dry and damaged hair and skin

Deprivation of oxygen due to iron deficiency leads to dry skin and hair loss.

Inflammation or soreness of tongue

Due to iron deficiency, along with low levels of haemoglobin, there exists low levels of myoglobin. Lower levels of myoglobin cause tongue to become sore, smooth and swollen, inflamed, pale or strangely smooth due to iron deficiency. Iron deficiency also causes dry mouth, sore red cracks at the corners of the mouth or mouth ulcers.

Restless legs

Unpleasant strange crawling or itchy sensation in the feet and legs are a result of iron deficiency. 25% of people with restless leg syndrome are thought to have iron-deficiency, and the lower the iron levels, the worse the symptoms.

Brittle or spoon shaped finger nails

A condition called koilonychia which often starts with brittle nails that crack and chip easily. In severe stages of iron deficiency, spoon shaped nails can occur where middle of the nail dips and edges are raised to give rounded appearance which looks like a spoon.

Lack of immunity

Iron is necessary for proper immune system, lack of which leads to low immunity and we get prone to diseases easily.

Cold hands and feet

Due to availability of less oxygen some tend to feel their hands and feet cold.


Unusual cravings for non-nutritive substances, such as ice, dirt, chalk or paper occurs due to iron deficiency. This is observed more in pregnant women with iron deficiency.

Poor Appetite

Due to iron deficiency poor appetite is observed especially in infants and children.



To prevent iron deficiency foods rich in iron and vitamin C should be consumed. Mothers have to feed breastmilk or iron fortified milk formula to babies. Pregnant women are given iron supplements to help improve the iron content in the body. When extra iron in conditions as pregnancy and breastfeeding is needed, iron supplements are given in a dose of 60 mg iron/day. Iron supplements also given to adolescence girls and low birth weight babies.

Foods rich in iron are meat, beans, pumpkin, leafy green such as spinach, raisins, dry fruits, eggs, seafood, iron fortified dry and instant cereals.

Foods rich in vitamin C are fruits like oranges, strawberries, kiwis, guavas, melons etc. Broccoli, bell pepper, cauliflower, tomatoes and leafy greens are also rich in vitamin C. Vitamin B12 and folic acid are also necessary for production of red blood cells.


To diagnose the iron deficiency in the body doctor first does a physical exam after asking your medical history by checking your lower eyelids, skin and nails for pale color, asks if there is any bleeding, checks the heartbeat if there are any palpitations, checks the abdomen to know the size of liver and spleen.

To confirm with the same doctor advises to have a complete blood count (CBC). In the CBC, wide range of disorders are identified. Some of them are:

RBC size and color

The red blood cell often has a smaller size and is pale in color than the normal if there is iron deficiency.


A ratio of volume of red blood cells to the volume of all other components in the blood is called hematocrit. It is expressed as a fraction or percentage. The hematocrit reflects both RBC's and their volume.

The number of RBC's rise as the hematocrit value increases and vice versa. Generally, normal levels are 38.3 to 48.6% in adult men and 35.5 and 44.9 % in adult women. 38.3% means that 38.3 milliliters of RBC's in 100 milliliters of whole blood.


Lower hemoglobin levels indicate anemia. The normal hemoglobin range is generally defined as 13.2 to 16.6 grams (g) of hemoglobin per deciliter (dL) of blood for men and 11.6 to 15. g/dL for women.


Ferritin is a protein which helps to store iron in our body, and a low level of ferritin usually indicates a low level of stored iron.


Often bleeding from a hiatal hernia, ulcer or stomach leads to iron deficiency and to diagnose these problems, doctor performs endoscopy. In endoscopy, a thin, lighted tube equipped with a video camera is passed down the throat to the stomach.

This allows doctor to view the tube that runs from the mouth to your stomach (esophagus) and your stomach to look for sources of bleeding.


Apart from bleeding due to ulcers hernia or stomach, other internal bleeding such as in lower intestinal sources of bleeding is diagnosed using a procedure called colonoscopy.

Serum Iron Test

The serum iron test measures the amount of iron in the liquid portion of blood.

Transferrin and Iron binding capacity (TIBC)

Total amount of iron that can be bound by proteins in the blood. Transferrin is a iron binding protein.

Unsaturated Iron binding capacity (UIBC)

The test determines the portion of transferrin that has not been saturated by the blood.

After diagnosing, treatment will depend on the cause and severity of the condition.

Doctor may recommend healthy eating changes, iron supplements, intravenous iron therapy for mild to moderate iron-deficiency or red blood cell transfusion for severe iron-deficiency.

If iron-deficiency is not diagnosed or untreated, it can cause serious complications, including heart failure and development delays in children.


Iron deficiency in a preliminary stage can be treated at home with proper diet but sometimes it has adverse effects and there is a rise in iron content which is also harmful for the body.

Increase in content leads to constipation; diarrhea, nausea, vomiting, heartburn, stomach upset, dark colored stools, temporary teeth staining, headache, unpleasant taste in mouth, etc.

Hence, its always better to consult a doctor before taking any measures, as it is quoted,

" Prevention is better than cure."