From the Guidelines
Iron deficiency symptoms include fatigue, reduced exercise capacity, cardiac palpitations, and dizziness, as well as impaired neurocognitive development and sub-optimal immune responses in young children. These symptoms occur because iron is essential for producing hemoglobin, which carries oxygen throughout the body, and for various other biological processes, including cellular respiration and biosynthesis of Fe/S cluster containing proteins 1. Iron deficiency can also cause tissue damage and increase the risk of preterm birth and low birthweight in pregnant women 1.
Common Symptoms of Iron Deficiency
- Fatigue
- Reduced exercise capacity
- Cardiac palpitations
- Dizziness
- Impaired neurocognitive development
- Sub-optimal immune responses
- Unusual cravings for non-food items like ice or dirt (pica) According to the British Society of Gastroenterology guidelines, iron deficiency anaemia (IDA) can be diagnosed by blood testing and remedied by iron replacement therapy (IRT) using the oral or intravenous route 1. Treatment typically involves iron supplements, such as ferrous sulfate 325mg taken 1-3 times daily, along with dietary changes to include iron-rich foods like red meat, spinach, beans, and fortified cereals. It is also recommended to take iron supplements with vitamin C to enhance absorption, but avoid taking them with calcium, coffee, or tea, which can inhibit absorption.
Importance of Early Detection and Treatment
Early detection and treatment of iron deficiency are crucial to prevent long-term complications, such as impaired neurocognitive development and increased risk of preterm birth and low birthweight in pregnant women 1. If you experience symptoms of iron deficiency, it is essential to see a healthcare provider for blood tests to confirm the diagnosis and receive appropriate treatment.
From the Research
Symptoms of Iron Deficiency
- Fatigue, irritability, depression, difficulty concentrating, restless legs syndrome (32%-40%), pica (40%-50%), dyspnea, lightheadedness, exercise intolerance, and worsening heart failure (HF) are common symptoms of iron deficiency 2
- Nonhematological manifestations of iron deficiency may give rise to unpleasant symptoms such as fatigue, reduced physiological endurance, difficulty in regulating temperature, decreased cognitive performance and many more 3
- Iron deficiency anemia rarely causes death, but the impact on human health is significant, with symptoms including fatigue, weakness, and shortness of breath 4
Diagnosis of Iron Deficiency
- Iron deficiency is diagnosed by low serum ferritin (typically <30 ng/mL) in individuals without inflammatory conditions or by transferrin saturation (iron/total iron binding capacity × 100) less than 20% 2
- Complete blood count (CBC) parameters can be a satisfactory discriminator for iron deficiency anemia, with parameters such as RBC count, mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC), mean corpuscular hemoglobin (MCH), and hematocrit having higher discriminating powers for iron deficiency anemia 5
Treatment of Iron Deficiency
- Oral iron (ferrous sulfate 325 mg/d or on alternate days) is typically first-line therapy for iron deficiency 2
- Intravenous iron is indicated for patients with oral iron intolerance, poor absorption (celiac disease, post-bariatric surgical procedure), chronic inflammatory conditions (CKD, HF, IBD, cancer), ongoing blood loss, and during the second and third trimesters of pregnancy 2
- Iron can be substituted by oral iron preparations or, if indicated, by intravenous iron 3