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Feeling drained? It could be an iron deficiency

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What is it?SymptomsRisk factorsProfessional adviceTreatmentSummary
Low iron from anemia can leave you feeling tired or weak. This is because your blood doesn’t receive enough oxygen. Iron tablets can help treat it.
Medically reviewed by Megan Soliman, MD
Written by Lily Ferguson
Updated on November 13, 2023

Feeling tired or run-down could have several reasons, but a common one is iron deficiency anemia.

But what exactly is anemia? This condition happens when you can’t make enough healthy red blood cells. The red blood cells contain hemoglobin that carries oxygen throughout your body.

Low iron has a link with anemia. Your body relies on iron to make hemoglobin, so when iron is low, you can become anemic. Your cells don’t receive enough oxygen, and you feel tired.

Fatigue is a very common symptom of iron deficiency anemia. But there are lots of reasons why you might be tired. You might have a viral infection, such as flu, or another infection. You could have thyroid problems or simply aren’t getting enough quality sleep.

In other words, don’t just assume you’re anemic. The only way to know for sure is with a blood test. But to decide if you need one, learning more about the symptoms can help.

What is iron deficiency anemia?

A person looking exhausted on a couch. They're tired from low iron.
Photography by Thai Liang Lim/Getty Images

Anemia is a medical term for when your body doesn’t produce enough red blood cells that function as they should. This means your body can’t get enough oxygen from your blood, which can lead to fatigue. It’s very common, affecting about 3 million people in the United States.

Iron deficiency anemia is the most common form of anemia. True to the name, it happens when your body doesn’t have enough iron. Many different factors can cause this. You can have low iron if you’ve lost blood, perhaps through an injury or a heavy menstrual period.

Certain conditions like Crohn’s disease may cause low iron levels that make it difficult for your body to absorb iron properly. Not getting enough iron from your diet can cause low iron levels, particularly if you’re vegan or vegetarian.

Symptoms of low iron levels

For some people, anemia symptoms come on quickly. For others, they sneak up gradually. Sometimes, iron deficiency anemia happens over a long period of time. With some conditions, you might be losing microscopic blood cells very slowly, and you won’t notice any symptoms at first.

According to the American Society of Hematology, you might not even know you have anemia until you take a blood test.

Depending on the cause of anemia, your iron levels could fall to dangerously low levels. This could happen if you were losing blood from bleeding in your stomach or intestines, for example. You might even feel dizzy or pass out.

Anemia involves the following symptoms :

  • extreme fatigue
  • weakness
  • pale skin
  • shortness of breath
  • dizziness or lightheadedness
  • cold hands and feet
  • brittle nails
  • unusual food cravings
  • restless leg syndrome

Other anemia risk factors

With iron deficiency anemia, the basic cause is always the same: low iron in your blood. However, a doctor will want to know why the problem exists so that they can prescribe an appropriate treatment. They will likely ask you the following questions:

Are you pregnant, or did you recently give birth? Your unborn baby needs hemoglobin, too. The extra demand might have reduced your iron supply. It’s also possible that you’ve lost a lot of blood while giving birth.

How’s your diet? One of your best sources of iron comes from the foods you eat. If you haven’t been eating the same as usual, or your diet is less varied, your iron levels could be dipping.

Do you have tummy troubles? Gastrointestinal problems, such as Crohn’s or celiac disease, may limit your ability to absorb nutrients from food or other possible digestive causes, such as ulcers, polyps, or colon cancer.

Have you recently donated blood? That’s a good thing. But if you do it too often, or if your blood donations are too close together, your iron levels could decline as you’re losing blood.

Are your menstrual periods heavy? Extra blood loss can deplete your iron supplies.

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Seeking professional advice

Usually, a doctor will examine your complexion to see if you’re looking pale. They might also look at your eyelids and your gums. If they’re pale or light pink in color, this could be a sign of anemia.

This is because hemoglobin gives your blood its bright red color. When levels dip, you can lose your rosy glow.

If your doctor suspects iron deficiency anemia, it’s time to roll up a sleeve. You’ll have blood drawn for a simple test called a complete blood count, or CBC. The lab report will show your levels of iron and other minerals. They will examine the number, size, and shape of the red blood cells in your sample.

Treating low iron anemia

If your doctor decides you have an iron deficiency, treatment is the next step. Here’s what you can expect.

Iron supplements

Iron supplements are the most common treatment, and you might take them for up to six months to replenish your iron levels. They’re usually in the form of an oral tablet that you can take.

Different kinds of supplements that contain different levels of iron are available. Examples include ferrous sulfate, ferrous fumarate, and ferrous gluconate.

These supplements may come with some side effects, particularly in your digestive system. However, experts find that taking the supplements every other day instead of every day can reduce these side effects without reducing how effective they are.

If you experience severe side effects or oral supplements aren’t working, doctors might recommend intravenous iron, which they will give through your veins. This can increase your iron levels more quickly than oral iron.

Medications

In some rare cases of refractory iron deficiency anemia, a specific, inherited type of iron deficiency anemia that may not respond to traditional treatments, doctors might prescribe other medications to help. These include erythropoietin-stimulating agents like epoetin (Epogen) and darbepoetin (Aranesp).

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Diet

What you eat has a big effect on your health. Nutrition is a great way to boost your iron, and these foods are among good sources:

  • meat such as beef, pork, and lamb (liver and dark meat have the most iron)
  • poultry (chicken and turkey)
  • leafy green vegetables (kale, spinach, broccoli, and Brussels sprouts)
  • beans (including peas and lima beans)
  • iron-fortified pasta, rice, and cereal

Summary

If you’ve been feeling weak, tired, and generally run down, you might have iron deficiency anemia. This is where low levels of iron in your body affect your blood cells, leading to a lack of oxygen in your blood.

If you have a heavy menstrual period or if you donate blood regularly, you may have low levels of iron. Low iron levels can also be due to a lack of iron in your diet or certain conditions that make it difficult for your body to absorb iron from food.

The most common treatment is iron supplements. But you can also always try to eat foods that are rich in iron, like meat and leafy greens, to increase your iron levels.

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