Iron Deficiency
Iron deficiency is the most common nutritional deficiency worldwide. Even before anaemia develops, low iron levels cause fatigue, brain fog, hair loss, and reduced exercise tolerance. A blood test confirms the diagnosis and treatment is straightforward — but identifying the underlying cause is essential.
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This page provides general health information only. Do not self-treat with iron supplements without a blood test — excess iron can be harmful.
What is iron deficiency?
Iron is essential for producing haemoglobin — the protein in red blood cells that carries oxygen around the body. Iron deficiency occurs in stages: first iron stores are depleted (ferritin falls), then transport iron decreases, and finally haemoglobin falls — producing iron deficiency anaemia. Symptoms can begin at the depleted stores stage, well before anaemia develops.
It is particularly common in women of reproductive age due to menstrual blood loss, in pregnant women, in vegetarians and vegans, and in those with conditions affecting iron absorption such as coeliac disease or inflammatory bowel disease.
Symptoms
- Persistent fatigue and low energy — the most common and debilitating symptom
- Brain fog, difficulty concentrating, and poor memory
- Hair loss or thinning, brittle nails, and dry skin
- Shortness of breath on exertion
- Palpitations and rapid heartbeat
- Pale skin, pale inner eyelids, and pale gums
- Restless legs syndrome — an uncomfortable urge to move the legs at rest
- Cravings for non-food substances such as ice, chalk, or dirt (pica)
Causes
- Heavy menstrual bleeding — the most common cause in women of reproductive age
- Inadequate dietary iron — particularly in vegetarians, vegans, and those with restricted diets
- Poor iron absorption — coeliac disease, H. pylori infection, or after gastric surgery
- Blood loss from the gastrointestinal tract — peptic ulcers, bowel polyps, or cancer
- Pregnancy — significantly increased iron demand
- Frequent blood donation
In men and post-menopausal women, iron deficiency without a clear dietary cause always requires investigation for gastrointestinal blood loss, including bowel cancer screening where appropriate.
When to see a doctor
See a doctor before taking iron supplements — a blood test is needed to confirm deficiency and establish the cause. Self-treating with iron without identifying the source of deficiency can mask a serious underlying condition.
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Treatment options
- Oral iron supplements — ferrous sulphate or ferrous fumarate; taken with vitamin C to improve absorption
- Intravenous iron — for those who cannot tolerate oral iron or need rapid repletion
- Dietary optimisation — increasing red meat, legumes, leafy greens, and iron-fortified foods
- Treatment of the underlying cause — managing heavy periods, H. pylori, or coeliac disease
- Monitoring — repeat blood tests to confirm iron stores have normalised
How eMedClinic can help
Our doctors request and interpret iron studies (ferritin, serum iron, TIBC, and full blood count), prescribe appropriate supplementation, investigate the underlying cause, and monitor treatment response. We take low ferritin seriously even when haemoglobin is still normal.
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