Iron Deficiency and Anemia

Iron deficiency anemia is a common type of anemia—a condition in which the blood doesn't have enough healthy red blood cells. Red blood cells carry oxygen to the body's tissues. Not getting enough iron can cause iron deficiency. So can losing blood from having periods or bleeding inside the body. Without iron, the body can't make enough of the part of red blood cells that lets them carry oxygen, called hemoglobin.

Iron-deficiency anemia is the most common type of anemia, affecting millions of people worldwide. The condition can develop gradually over time and may initially be so mild that symptoms go unnoticed. Women are at higher risk due to menstrual blood loss, while children, elderly adults, and people with certain dietary restrictions may also be more susceptible. The good news is that taking iron supplements most often can correct iron deficiency anemia, and with proper testing and treatment, most people can successfully restore their iron levels and energy.

Blood loss is a major cause of iron deficiency. Blood contains iron within red blood cells. So if you lose blood, you lose some iron. Women with heavy periods are at risk of iron deficiency anemia because they lose blood during menstruation. Slow, chronic blood loss within the body — such as from a peptic ulcer, a hiatal hernia, a colon polyp or colorectal cancer — can cause iron deficiency anemia. Gastrointestinal bleeding can result from regular use of some over-the-counter pain relievers, especially aspirin.

A lack of iron in your diet can also lead to deficiency. Your body regularly gets iron from the foods you eat. If you consume too little iron, over time your body can become iron deficient. Examples of iron-rich foods include meat, eggs, leafy green vegetables and iron-fortified foods. Additionally, an inability to absorb iron can cause problems. Iron from food is absorbed into your bloodstream in your small intestine. An intestinal disorder, such as celiac disease, which affects your intestine's ability to absorb nutrients from digested food, can lead to iron deficiency anemia. If part of your small intestine has been bypassed or removed surgically, that may affect your ability to absorb iron and other nutrients.

Testing for iron deficiency and anemia may be beneficial for individuals experiencing persistent fatigue, weakness, or other symptoms that interfere with daily life. Women are at greater risk due to blood loss during menstruation, particularly those with heavy or prolonged periods. People following vegetarian or vegan diets, those with a history of gastrointestinal conditions, or individuals taking medications that can cause stomach bleeding should also consider testing.

Additionally, testing can be valuable for pregnant women, growing children and adolescents, frequent blood donors, and those with family histories of anemia or blood disorders. At first, iron deficiency anemia can be so mild that you don't notice it. But as the amount of iron gets lower and the anemia gets worse, the symptoms get worse as well. Early detection through lab testing allows for prompt treatment before symptoms become severe.

Lab results for iron deficiency anemia typically show several characteristic patterns. Lower than standard hemoglobin levels mean anemia. Experts define the hemoglobin range as 13.2 to 16.6 grams (g) of hemoglobin per deciliter (dL) of blood for adults assigned male at birth and 11.6 to 15.0 g/dL for adults assigned female at birth. With iron deficiency anemia, red blood cells are smaller and paler than usual. Low hemoglobin/hematocrit with low ferritin strongly suggests iron deficiency anemia. Low serum iron with elevated TIBC often supports diagnosis.

It's important to understand that it is possible to be anemic, but not iron deficient, and vice versa. In fact, iron deficiency without anemia (normal hemoglobin levels and low ferritin levels), is nearly twice as common as iron deficiency with anemia (low hemoglobin levels and low ferritin levels). Not all anemia cases are caused by iron deficiency, and a hemoglobin test alone is insufficient to suggest iron deficiency and may result in a missed diagnosis. Healthcare professionals can interpret these results in context with symptoms and medical history to determine the most appropriate treatment approach.

Managing iron levels often involves dietary modifications and lifestyle adjustments. Examples of iron-rich foods include meat, eggs, leafy green vegetables and iron-fortified foods. Plant-based iron sources like spinach, lentils, and fortified cereals can be enhanced by consuming them with vitamin C-rich foods such as citrus fruits, tomatoes, or bell peppers. Take iron tablets with vitamin C. Vitamin C might help the body take in iron. Try taking iron tablets with a glass of orange juice or with a vitamin C supplement.

Certain substances can inhibit iron absorption and should be avoided around meal times, including coffee, tea, dairy products, and calcium supplements. Don't take iron with antacids. Medicines that quickly relieve heartburn can keep the body from taking in iron. Take iron two hours before or four hours after you take antacids. Regular physical activity can also support overall health, though individuals with severe anemia should consult healthcare providers about appropriate exercise levels during treatment.