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Iron Deficiency Anemia

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Last updated March 18, 2021

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Iron deficiency anemia occurs when you don’t have enough iron to make red blood cells. The red blood cells are needed to deliver oxygen throughout your body. IDA can make you feel tired.

What is iron deficiency syndrome?

Anemia is when your body doesn’t have enough red blood cells to carry oxygen to your body's tissue. The most common reason for anemia is not having enough iron in your blood. That’s called iron deficiency anemia (IDA).

Your body uses oxygen to make energy. That is why anemia can make you very tired or feel lightheaded. When you exercise, you may become tired faster than usual. If IDA is severe, you may look very pale.

Generally, IDA is easily treated by taking iron supplements. However, it’s important to find out why you developed IDA. Typically, it is caused by excessive menstrual bleeding or blood loss after surgery. But it can also be an early sign of colon cancer.

Most common symptoms of IDA

Dr. Rx

Always ask your physician about what could have caused the iron deficiency in the first place. Treating with iron supplements or transfusion is only one part of treatment. Most important is to learn the cause of iron deficiency anemia— that needs to be treated as well.—Dr. Elloit Stein


People who have IDA often feel very tired and lightheaded. In extreme cases, you may notice your skin is pale particularly in the face, palm, or nail beds.

Anemia can cause chest pain or palpitations. (The feeling that your heart is fluttering or beating hard in your chest.) Especially if you’ve had prior heart conditions.

Main symptoms

  • Feeling tired or weak
  • Pale skin
  • Feeling dizzy or lightheaded
  • Can’t exercise at full strength

Other signs and symptoms

  • Headaches
  • Palpitations (heart fluttering in your chest)
  • Chest pain
  • Cold hands and feet
  • The desire to eat inedible objects such as dirt—your body correcting for the iron deficiency
  • Brittle fingernails and toenails
  • Inflammation or soreness of tongue
  • Poor appetite particularly in kids
Symptoms of iron deficiency anemia.

What causes iron deficiency anemia?

Red blood cells have a molecule called hemoglobin, which transports oxygen throughout the body. Iron is needed to produce hemoglobin. Low iron levels decrease hemoglobin production and therefore red blood cells. You can have low iron for a number of reasons:

You’re not getting enough iron into your body. That’s because you have:

  • A vegetarian or vegan diet
  • Celiac disease
  • Atrophic gastritis (constant inflammation in your stomach)
  • H. Pylori bacterial infection
  • Bariatric surgery
  • Too much calcium, wine, coffee, or tea in your diet, which stops the body from absorbing.

You’re losing too much iron because of:

  • Blood loss (pregnancy, menstruation, trauma, endometriosis)
  • A bleeding disorder
  • Cancer
  • Making frequent blood donations
  • Getting your blood drawn too often (like for blood work)
  • Being on dialysis

Pro Tip

Iron deficiency may need long term iron supplements. It is difficult to remember to take the supplements but one has to stay consistent as it will improve general well-being as well as quality of life.—Dr. Stein

Treatment for iron deficiency syndrome

  • If your hemoglobin (and red blood cell count) is extremely low, you will need at least one blood transfusion to increase it. The transfused blood also contains iron, which can help with the IDA.
  • If your hemoglobin level is moderately low, then you may just get oral iron supplements. You might need iron supplementation for several months or years.
  • For those with very severe IDA, you may need to get iron intravenously. IV iron is more easily absorbed by your body. This is done at an infusion center or hospital over the course of a few days. How often you sleep depends on how fast your blood count goes up.
  • You may be given medication like Senna or Bisacodyl to stop constipation caused by taking iron pills.

If you bleed heavily during your period, birth control can lighten it. And this lowers your chance of developing IDA.

Risk factors for IDA

You’re more likely to be at risk for iron deficiency if you are:

  • Female
  • Black—25% of Black women versus 7% of white women get IDA
  • Mexican
  • Have extremely heavy menstrual bleeding (period)
  • Donate blood more frequently than every 8 weeks
  • Having a baby while being at low-income level
  • Obese
  • Vegetarian (40% of vegans are iron deficient)

Can iron deficiency anemia be cured?

If you notice symptoms, see your doctor. They will do a physical examination as well as a blood test. If you have IDA you need 1) to be given iron and 2) to figure out the cause.

Depending on the severity, your doctor may recommend a blood transfusion (receiving blood intravenously) to increase your red blood cell count.

Among adults over 65 years old with IDA, 9% have cancer in their digestive tract, particularly colon cancer. So it’s important to be screened for cancer if you fall into this age group. You should also get checked at any age if there doesn’t seem to be a reason why you have IDA.

This screening may include colonoscopy to check for colon cancer or bleeding. In certain cases, your doctor may order imaging tests to look for any hidden cancer masses.

Pro Tip

A common misconception among patients is that IDA is not a serious issue. In certain cases, especially in elderly patients, iron deficiency anemia may be the first sign of a hidden cancer particularly colon cancer.—Dr. Stein

Next steps

Your doctor will continue to check your blood count and the amount of iron in your blood. Your doctor wants to make sure the medication is working. And to rule out bleeding.

If your blood count numbers have not gone up, there may be another cause for the anemia.

Preventing IDA

  • If you eat a vegetarian or vegan diet, you may need to eat animal protein sometimes or take iron supplements. Your body absorbs iron from animal protein better than it does from plant-based foods. Sources of iron-rich foods include chicken, mussels, oysters, sardines, turkey, turkey, ham, dark leafy greens, beans, and dried fruit.
  • If you are a pregnant woman and severely iron deficient, your doctor may give you extra iron supplements. Most prenatal supplements contain iron.
  • If your periods are very heavy, your doctor may suggest taking birth control pills to reduce the blood flow.
  • If you bleed easily, tell your doctor. Treating the bleeding or a bleeding disorder can keep IDA from developing.
  • Your doctor may suggest avoiding aspirin, ibuprofen, and naproxen. These medicines can increase the chance of bleeding in the stomach.
Share your story

Elliot Stein is a second-year internal medicine resident at Vanderbilt University Medical Center, and he intends to sub-specialize in cardiovascular disease. He graduated magna cum laude with an undergraduate degree in molecular and cellular biology from Harvard College in 2013. He obtained his MD and Master of Science in Translational Research (MSTR) from the University of Pennsylvania Perelman School of Medicine in 2019. He stayed at the University of Pennsylvania to complete his internship year 2019-2020 at Pennsylvania Hospital. Elliot also served as an emergency medical technician (EMT) in two countries and three US states before beginning his medical career. He joined Buoy Health in 2018 because of its promise to use new technology to deliver higher quality medical information to anyone regardless of ability to access medical care.

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