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10 Signs and Symptoms of Iron Deficiency

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Iron deficiency occurs when the body doesn’t have enough of the mineral iron. This leads to abnormally low levels of red blood cells. That’s because iron is needed to make hemoglobin, a protein in red blood cells that enables them to carry oxygen around the body. If your body doesn’t have enough hemoglobin, your tissues and muscles won’t get enough oxygen and be able to work effectively. This leads to a condition called anemia.

Here are 10 signs and symptoms of iron deficiency, starting with the most common.

  1. Unusual Tiredness

Feeling very tired is one of the most common symptoms of iron deficiency, affecting more than half of those who are deficient.

This happens because your body needs iron to make a protein called hemoglobin, which is found in red blood cells. Hemoglobin helps carry oxygen around the body. When your body doesn’t have enough hemoglobin, less oxygen reaches your tissues and muscles, depriving them of energy. In addition, your heart has to work harder to move more oxygen-rich blood around your body, which can make you tired.

2. Paleness

Pale skin and pale coloring of the inside of the lower eyelids are other common signs of iron deficiency.

The hemoglobin in red blood cells gives blood its red color, so low levels during iron deficiency make the blood less red. That’s why skin can lose its healthy, rosy color in people with iron deficiency. This paleness in people with iron deficiency can appear all over the body, or it can be limited to one area, such as the face, gums, inside of the lips or lower eyelids and even the nails. 

3. Shortness of Breath

Hemoglobin enables your red blood cells to carry oxygen around the body. When hemoglobin is low in your body during iron deficiency, oxygen levels will also be low. This means your muscles won’t get enough oxygen to do normal activities, such as walking.

As a result, your breathing rate will increase as your body tries to get more oxygen.This is why shortness of breath is a common symptom.

If you find yourself out of breath doing normal, daily tasks that you used to find easy, such as walking, climbing stairs or working out, iron deficiency could be to blame.

  1. Headaches and Dizziness

Iron deficiency may cause headaches.This symptom seems to be less common than others and is often coupled with lightheadedness or dizziness (4).

In iron deficiency, low levels of hemoglobin in red blood cells mean that not enough oxygen can reach the brain. As a result, blood vessels in the brain can swell, causing pressure and headaches. Although there are many causes of headaches, frequent, recurrent headaches and dizziness could be a sign of iron deficiency.

  1. Heart Palpitations

Noticeable heartbeats, also known as heart palpitations, can be another symptom of iron-deficiency anemia. Hemoglobin is the protein in red blood cells that helps transport oxygen around the body. In iron deficiency, low levels of hemoglobin mean the heart has to work extra hard to carry oxygen. This can lead to irregular heartbeats, or the feeling that your heart is beating abnormally fast.

In extreme cases, it can lead to an enlarged heart, heart murmur or heart failure. However, these symptoms tend to be a lot less common. You would have to suffer from iron deficiency for a long time to experience them.

6. Dry and Damaged Hair and Skin

Dry and damaged skin and hair can be signs of iron deficiency. This is because when your body is iron deficient, it directs its limited oxygen to more important functions, such as organs and other bodily tissues. When skin and hair are deprived of oxygen, it can become dry and weak.

More severe cases of iron deficiency have been linked to hair loss. It is completely normal for some hair to fall out during everyday washing and brushing, but if you are losing clumps or much more than normal, it may be due to iron deficiency.

7. Swelling and Soreness of the Tongue and Mouth

Sometimes just looking inside or around your mouth can give you an indication of whether you are suffering from iron-deficiency anemia. Signs include when your tongue becomes swollen, inflamed, pale or strangely smooth .

Low hemoglobin in iron deficiency can cause the tongue to become pale, while lower levels of myoglobin can cause it to become sore, smooth and swollen. Myoglobin is a protein in red blood cells that supports your muscles, such as the muscle that makes up the tongue. Iron deficiency can also cause dry mouth, sore red cracks at the corners of the mouth or mouth ulcers.

  1. Restless Legs

Iron deficiency has been linked to restless leg syndrome. Restless leg syndrome is a strong urge to move your legs at rest. It can also cause unpleasant and strange crawling or itchy sensations in the feet and legs. It is usually worse at night, meaning that sufferers may struggle to get much sleep. The causes of restless leg syndrome are not fully understood.

However, up to 25% of people with restless leg syndrome are thought to have iron-deficiency anemia, and the lower the iron levels, the worse the symptoms.

9. Brittle or Spoon-Shaped Fingernails

A much less common symptom of iron deficiency is brittle or spoon-shaped fingernails, a condition called koilonychia. This often starts with brittle nails that chip and crack easily. In later stages of iron deficiency, spoon-shaped nails can occur where the middle of the nail dips and the edges are raised to give a rounded appearance like a spoon.

However, this is a rare side effect and usually only seen in severe cases of iron-deficiency anemia.

10. Other Potential Signs

There are several other signs that your iron could be low. These tend to be less common and can be linked to many conditions other than iron deficiency.

Other signs of iron-deficiency anemia include:

  • Strange cravings:A hankering for strange foods or non-food items is called “pica.” It usually involves cravings to eat ice, clay, dirt, chalk or paper and could be a sign of iron deficiency. It can also occur during pregnancy.
  • Feeling anxious:The lack of oxygen available to body tissues in iron deficiency may cause feelings of anxiety. However, this tends to improve or resolve as iron levels are corrected.
  • Cold hands and feet:Iron deficiency means less oxygen is being delivered to the hands and feet. Some people may feel the cold more easily in general or have cold hands and feet.
  • More frequent infections:Because iron is needed for a healthy immune system, lack of it may cause you to catch more illnesses than usual.
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