What You Need to Know About Iron Deficiency Anemia
This common condition remains misunderstood and underdiagnosed.
Iron. You know it as a metal—perhaps you first learned about it while memorizing the periodic table in high school chemistry class—but did you know it is also an essential mineral your body needs to function? Iron is used to make hemoglobin, a molecule in red blood cells that transports oxygen to your organs and muscles. And when you’re not getting enough iron in your system, it can result in some pretty crummy symptoms, from fatigue and muscle weakness to headaches and shortness of breath.
“Iron deficiency is a major public health concern across the world,” says, Robert Eisner, D.O., a hematologist at Northwestern Medicine in Chicago. Despite this fact, a new survey from the Get Iron Informed shows how little many of us know about the condition—of 1,000 women, 42% could not identify common risk factors for iron deficiency anemia (IDA), and 62% reported that they’ll only visit a healthcare provider if they have severe bodily symptoms (often brushing off milder ones like headaches and stomach pain).
Experts say this illustrates the need for better education about the condition. “The big thing that I witness in my practice, and that this survey really confirmed, is that women don’t recognize that they could be at risk” for iron deficiency anemia, says Stephanie Martin, D.O., OB/GYN, medical director at Clinical Concepts in Obstetrics in Brentwood, TN (who is affiliated with the campaign). “And even if they have symptoms that are pretty classic for IDA, they don’t recognize that that’s what it could be.”
What Is Iron Deficiency Anemia?
Iron deficiency anemia is the technical term for what happens when you have inadequate levels of iron in your bloodstream. This results in a lack of oxygen delivery throughout the body, which can have wide-ranging effects on your health. IDA causes a decline in energy levels, weak or brittle hair and nails, headaches, muscle weakness, a pounding in the ears, and cravings for non-food items like ice or dirt.
But the condition is slow to develop, so many people don't recognize symptoms until the anemia is very severe. “Because of the insidious onset of iron deficiency anemia, patients do not always realize that they have been having symptoms until we replete the iron stores and they start feeling better again,” Eisner says. Martin echoes this, saying it’s quite common for IDA to be asymptomatic and still wreak subtle havoc on your daily life. Even when someone does have symptoms, it’s easy to mistake them for other things like stress or lack of sleep. “These symptoms can be due to a whole bunch of things,” Martin says. “People don’t consider that it could be iron deficiency anemia that is causing all these problems.”
Who Is at Risk for IDA?
Women are more likely than men to develop IDA. “People at the highest risk include young women due to chronic blood loss in the menstrual cycles and from childbearing,” Eisner explains. If your periods are heavy (lasting more than seven days or requiring you to change your pad or tampon after less than two hours), that’s worth getting checked out—you could be dealing with fibroids, polyps, hormone-related problems, or even uterine cancer.
People with inflammatory bowel disease are also considered higher risk for IDA because of the possibility of gastrointestinal bleeding. Same goes for anyone with a history of gastric bypass surgery, major physical trauma, or peptic ulcer disease. Research also suggests that iron deficiency is widespread among endurance athletes due to increased sweat, blood loss, and exertion associated with intense athletic training.
Diet can also contribute to IDA risk. Vegetarians and vegans tend to eat fewer iron-rich foods (since meat is a big source of iron in the human diet). “The iron that’s in vegetables is called non-heme iron, and it’s not as well absorbed as it is from a meat source,” Martin says. “That doesn’t mean that it’s not valuable, but it does mean you’re less likely to get enough iron in your diet.” Herbivores should pay extra close attention to whether they experience symptoms consistent with IDA.
How to Get Checked for IDA
The best and most reliable way to figure out if you have IDA is to get your iron levels checked through a blood test. “We all have days where we might feel a little more tired or under the weather,” says Sandeep Basu, M.D., a hematologist and oncologist at Mayo Clinic Health System in Eau Claire, WI. “If, however, these symptoms persist, it should prompt a visit to a medical provider for additional testing and evaluation.”
Iron panel testing is not always part of a routine blood draw—make sure you ask for it specifically. “Having a blood count done with an annual physical exam can find iron deficiency before it becomes very severe,” Eisner says. If you’re already experiencing symptoms, that means your IDA has progressed enough that you’ll need treatment. Your doctor may prescribe iron pills or an IV to replenish your iron levels. Then, Dr. Basu explains, comes the crucial step of “evaluating and treating the underlying condition and source for blood loss, such as a tumor or ulcer.” This will prevent you from developing IDA again several months or years later. If your iron deficiency was diet-induced, talk to your doctor about how to get better sources of iron in your diet, whether that means taking a supplement or strategically incorporating meat and fish.
You may not even realize how much IDA is affecting your life until you see what it feels like to have normal iron levels again. (Where did all this energy come from??) “It’s important for women to recognize that they could be at risk, and they don’t have to have severe symptoms to have a significant problem,” Martin says. “We are often afraid to bring it up because we don’t think it’s ‘bad enough.’”
Case in point: The women from the Get Iron Informed survey waited an average of 3.9 years from the start of their symptoms to their official IDA diagnosis. That’s a long time not to feel like yourself. All it takes is a test and a talk with your doctor to be on the road to feeling better.
- Iron: National Institutes of Health. (n.d.) “Iron: Fact Sheet for Consumers.” ods.od.nih.gov/factsheets/Iron-Consumer/
- IDA Survey: Get Iron Informed. (2021.) “Iron Deficiency Anemia.” getironinformed.com/
- IDA Symptoms: American Society of Hematology. (n.d.) “Iron-Deficiency Anemia.” hematology.org/education/patients/anemia/iron-deficiency
- Heavy Menstruation: Centers for Disease Control and Prevention. (n.d.) “Heavy Menstrual Bleeding.” cdc.gov/ncbddd/blooddisorders/women/menorrhagia.html
- Athletes & Iron Deficiency: Medicine & Science in Sports & Exercise. (2019.) “The Impact of Morning versus Afternoon Exercise on Iron Absorption in Athletes.” journals.lww.com/acsm-msse/Fulltext/2019/10000/The_Impact_of_Morning_versus_Afternoon_Exercise_on.20.aspx