Iron Deficiency

Iron is an essential element required by the body to maintain healthy functions such as the production of the hemoglobin molecule in the blood that helps transport oxygen to all the tissues of the body.

It is also necessary for the maintenance of healthy cells, hair, skin, and nails. Iron is absorbed from your diet into the body by the cells lining the gastrointestinal tract.

It is then released into the bloodstream, where a protein known as transferrin attaches to it and sends it to the liver. The liver, in turn, stores iron as ferritin and releases it when needed to produce new red blood cells in the bone marrow.

When the red cells are no longer functioning after being in circulation for about 120 days, they are re-absorbed into the spleen. The body can also recycle iron from the aged red cells.

Iron deficiency occurs when your body has insufficient amounts of mineral iron. The reduced intake of iron over time may lead to iron deficiency anemia, a common form of anemia.

Anemia occurs when there is a decreased level of hemoglobin in the blood. The body needs iron to produce hemoglobin. When there isn’t enough iron in the bloodstream, the rest of the body cannot get the oxygen it requires.

Although the condition may be a common one, many people are not aware that they are deficient in iron. They could experience symptoms for years without knowing the cause.

Causes of Iron Deficiency

Insufficient intake of iron

Consuming food with little amounts of iron over time can lead to a shortage of the mineral in your body. Food such as eggs, meat, and some green leafy vegetables are rich in iron content.

Due to iron being an essential nutrient for rapid growth and development, pregnant women and young children require even an even more iron-rich diet.

Blood loss from menstruation and pregnancy

When you lose blood, you lose iron. Blood loss during natural events like heavy menstrual bleeding and childbirth are common causes of iron deficiency in women able to bear children. Other conditions that cause blood loss include

  • Bleeding in your GI tract, from an ulcer, polyps in colon or intestine, colon cancer,
  • Urinary tract bleeding
  • Frequent blood donation
  • Frequent blood tests especially in newborns and small children
  • Rare inherited conditions such as hereditary hemorrhagic telangiectasia which causes the bowels to bleed
  • Regular use of certain medication such as aspirin or nonsteroidal anti-inflammatory drugs like naproxen and ibuprofen

Inability to properly absorb iron

Certain health conditions can affect how iron is absorbed by the body. Conditions like celiac disease and intestinal surgery such as gastric bypass, may interfere with iron absorption, limiting the iron intake of the body.

Other medical conditions

Other medical conditions that may cause to iron-deficiency include:

  • Kidney failure: Blood loss during dialysis may lead to iron deficiency anemia. People living with chronic kidney disease also consume other medication like anticoagulants or blood thinners that may cause iron deficiency
  • Obesity: This chronic condition can lead to inflammation that may cause iron deficiency.

Risk Factors

The following groups of people are at the highest risk for iron deficiency:

  • Women who menstruate, especially those that experience heavy blood flow.
  • Pregnant and breastfeeding women
  • People who have undergone major surgery or physical trauma that may have led to blood loss
  • Vegetarians and those who refuse to eat meat, whose diets that although may contain iron-rich foods like green vegetables, is not readily absorbed like iron from meat, fish, and poultry.
  • People with peptic ulcer
  • People with gastrointestinal conditions like celiac disease, and inflammatory bowel disorders such as Crohn diseases and ulcerative colitis

Signs and Symptoms of Iron Deficiency

  • Fatigue
  • Dizziness
  • Shortness of breath
  • Pale skin
  • Heart palpitations due to low hemoglobin levels
  • Dry and damaged skin and hair
  • Inflammation and soreness of the tongue and mouth
  • Tingling in the legs
  • Brittle nails
  • Cold hands and feet
  • Headache
  • Strange cravings for non-food items, a phenomenon known as “pica”
  • The frequent occurrence of infections due to impaired immune system
  • Anxiety

Diagnosis of Iron Deficiency

Iron deficiency is diagnosed using blood tests that include a complete blood count (CBC). Further testing may be required to evaluate other materials such as iron, ferritin, and transferrin.

An anemic patient with iron deficiency may show the following results after being tested:

  • Low ferritin
  • Low hemoglobin
  • Low serum iron
  • High transferrin or total iron-binding capacity
  • Low mean cellular volume
  • Low iron saturation

Other tests that could be included are:

  • Testing for blood in urine samples
  • Testing fecal matter for blood
  • Screening for conditions in women with abnormal or increased menstrual blood losses


The following are the ways by which you can increase your iron intake


Meals consisting of meats, green leafy vegetables are rich in iron. Examples include

  • Leafy green vegetables including broccoli, kale, spinach, turnip greens, and collard greens
  • Meat: beef, pork, or lamb, especially organ meats such as liver
  • Fish, especially shellfish, sardines, and anchovies
  • Poultry: chicken, turkey, and duck, especially liver and dark meat
  • Legumes, including lima beans, peas, pinto beans, and black-eyed peas

Medicinal Iron

This is elemental iron prescribed by a doctor. Since the amount of iron necessary to treat iron deficiency is high than that found in supplements, it is recommended that elemental iron would be administered.

The recommended daily intake of elemental iron is dependent on your doctor’s prescription.  The possible side effects of iron tablets are nausea, vomiting, abdominal discomfort, constipation, diarrhea, and dark stools.

Blood Transfusions

Patients with extreme iron deficiency may require blood transfusions. These patients are actively bleeding or experience symptoms such as fatigue, chest pain, or shortness of breath.

The blood is given to replace deficient erythrocytes and may not correct the iron deficiency completely. This transfusion would only alleviate the condition temporarily.

Intravenous Iron

The patient sometimes may require intravenous iron. This IV iron may be administered to patients who cannot properly absorb iron in the gastrointestinal tract, patient with chronic blood loss or severe iron deficiency, or patients who cannot tolerate oral iron.

Intravenous iron comes in different preparations:

  • Iron sucrose
  • Iron glutamate
  • Ferric dextran

Iron dextran can be given in large doses at once. Ferric gluconate and Iron sucrose require more frequent treatments spread over several weeks.

Some patients may develop allergies to intravenous iron, so a test dose may be administered before the first infusion. Iron dextran is a very common cause of allergies and may require switching to a different preparation.

Other side effects asides allergies include hives, itching, and muscle and joint pain.