From the Guidelines
Iron deficiency presents with several recognizable signs and symptoms, including fatigue, weakness, pale skin, shortness of breath, dizziness, headaches, cold hands and feet, brittle nails, hair loss, and unusual cravings for non-food items (pica) 1. These symptoms develop because iron is essential for producing hemoglobin, which carries oxygen throughout the body. When iron levels are low, tissues and organs don't receive adequate oxygen, causing these various symptoms. Some people may experience a sore or smooth tongue, cracks at the corners of the mouth, or difficulty swallowing. In severe cases, chest pain, rapid heartbeat, and increased susceptibility to infections can occur. Iron deficiency develops gradually, so symptoms may appear slowly and worsen over time.
Common Signs and Symptoms
- Fatigue
- Weakness
- Pale skin
- Shortness of breath
- Dizziness
- Headaches
- Cold hands and feet
- Brittle nails
- Hair loss
- Unusual cravings for non-food items (pica)
Causes of Iron Deficiency
Iron deficiency can result from a poor dietary intake, failure to absorb dietary iron, or chronic blood loss, which can be caused by various gastrointestinal pathologies or menstrual bleeding 1.
Importance of Iron
Iron is indispensable for the normal development and function of all tissues in the human body, and approximately two-thirds of the human body iron is localized inside the erythropoietic system and red blood cells 1.
Diagnosis and Treatment
If you suspect iron deficiency, it's essential to consult a healthcare provider for proper diagnosis through blood tests before starting supplements, as excessive iron can be harmful. Treatment typically involves iron supplements, such as ferrous sulfate, ferrous gluconate, or ferrous fumarate, taken 1-3 times daily, ideally on an empty stomach with vitamin C to enhance absorption 1. Dietary changes to include iron-rich foods like red meat, spinach, beans, and fortified cereals can also help. In some cases, especially in adults over 50, iron deficiency anemia may be a sign of an underlying bleeding abnormality, and further investigation, such as endoscopy or CT scanning, may be necessary to determine the cause 1.
From the Research
Signs and Symptoms of Iron Deficiency
The signs and symptoms of iron deficiency can be diverse and affect various aspects of an individual's health. Some of the common manifestations include:
- Fatigue and reduced physiological endurance 2, 3
- Difficulty in regulating temperature 2
- Decreased cognitive performance 2
- Hair loss 3
- Restless legs 3
- Anemia, which is one of the most prevalent consequences of iron deficiency 2, 3, 4
Diagnosis and Treatment
Diagnosis of iron deficiency is typically done through serum ferritin tests 3, 4. Treatment options include oral iron supplements and intravenous iron therapy, with the choice depending on the severity of the deficiency, patient tolerance, and specific clinical circumstances 2, 3, 5, 6, 4.
Oral vs. Intravenous Iron Therapy
Both oral and intravenous iron therapies have their own efficacy and safety profiles. Oral iron is often the first line of treatment but may have limitations such as lower absorption efficiency, especially during inflammation 4. Intravenous iron, on the other hand, allows for rapid and safe total-dose iron replacement but is associated with risks such as infusion reactions and, in some cases, hypophosphatemia 5, 6.
Importance of Identifying Underlying Causes
It is crucial to investigate and address the underlying causes of iron deficiency, as it is often a symptom of an underlying disorder rather than a disease itself 2, 4. This includes screening for conditions like coeliac disease and investigating for gastrointestinal bleeding in certain patient groups 4.