What are the symptoms of iron deficiency (ID) or hypoferremia?

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From the Guidelines

Low iron, or iron deficiency, can cause a range of 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 like ice or dirt (pica). If you suspect iron deficiency, consult a healthcare provider who can order blood tests to check your iron levels.

Common Symptoms of Iron Deficiency

  • Fatigue
  • Weakness
  • Pale skin
  • Shortness of breath
  • Dizziness
  • Headaches
  • Cold hands and feet
  • Brittle nails
  • Hair loss
  • Unusual cravings for non-food items like ice or dirt (pica) Treatment typically involves iron supplements such as ferrous sulfate (325 mg), ferrous gluconate (300 mg), or ferrous fumarate (200 mg) taken 1-3 times daily, usually for 3-6 months to replenish stores, as recommended by the British Society of Gastroenterology guidelines for the management of iron deficiency anaemia in adults 1.

Important Considerations for Iron Supplementation

  • Take iron supplements on an empty stomach with vitamin C to enhance absorption
  • Avoid taking them with calcium, coffee, tea, or antacids which can reduce absorption Increasing dietary iron from sources like red meat, spinach, beans, and fortified cereals can help, but supplements are often necessary to correct deficiency, especially in adults with a new diagnosis of IDA without obvious explanation, where GI investigation on an urgent basis should be considered 1. It is also important to note that iron deficiency can be caused by a range of GI pathologies including cancer, and so a thorough investigation should be conducted to rule out any underlying conditions, as suggested by the British Society of Gastroenterology guidelines 1.

From the Research

Low Iron Symptoms

  • Fatigue, hair loss, and restless legs are some of the manifestations of iron deficiency, in addition to anemia 2
  • Iron deficiency can cause clinical and functional impairments, even in the absence of anemia 3
  • The lack of iron can have various effects on the body, including protean manifestations beyond anemia 2

Diagnosis and Treatment

  • The most efficient test for the diagnosis of iron deficiency is the serum ferritin 2
  • Oral iron therapy is the first line of treatment in most cases of iron deficiency 4, 5, 3
  • Intravenous iron therapy can be used when oral iron supplementation is contraindicated or not effective 4, 5, 3

Prevention and Management

  • Iron-fortified foods can be an effective method for preventing iron deficiency, especially in low-income countries 6
  • Screening for iron deficiency should be done in certain populations, such as pregnant women and children 5
  • Underlying causes of iron deficiency should be sought and treated, including gastrointestinal bleeding and coeliac disease 5, 3

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Iron Deficiency Anemia.

The Medical clinics of North America, 2017

Research

Iron deficiency.

Lancet (London, England), 2021

Research

Iron deficiency anemia: evaluation and management.

American family physician, 2013

Research

Iron supplementation and iron-fortified foods: a review.

Critical reviews in food science and nutrition, 2022

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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