The Centers for Disease Control and Prevention describes iron deficiency as the most common nutritional deficiency worldwide. Though it's more common in developing countries, many Americans suffer from low iron. Because of regular menstrual blood loss, women are especially vulnerable. Economic and nutritional factors place some minority group women at even higher risk for low iron and its associated health consequences. Recognizing the signs and symptoms of low iron can facilitate an accurate diagnosis and appropriate treatment.
What It Feels Like
Low iron usually produces symptoms as it worsens. Symptoms are subjective; people around you may not notice that something is wrong, but you just don't feel right. Mild cases of iron deficiency may not cause obvious symptoms. With more severe iron deficiency, the likelihood of symptoms increases. The most common symptom of iron deficiency is fatigue. Athletic performance may suffer. Other common symptoms include shortness of breath, dizziness, headaches and a feeling of coldness in the hands and feet. An unusual symptom of iron deficiency is a craving for nonfood items such as ice, dirt or paint. This craving is called pica.
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What It Looks Like
Signs of an illness or disease include objective manifestations that you or others can see or measure. When iron deficiency is suspected, look for pale skin, a rapid heart rate, brittle nails, cracks at the sides of the mouth, a swollen tongue and frequent or recurrent infections. Paleness is sometimes more obvious in areas like the inside of the lower eyelid. Women's hearts usually beat 70 to 90 times per minute at rest. A resting heart rate above 100 may indicate iron deficiency, although there are other causes. In mild cases of low iron, there may be no signs of illness.
When It's Bad
Iron is a necessary element for blood production. Much of the iron in the body is contained in hemoglobin, the oxygen-carrying component of red blood cells. Insufficient iron leads to a reduced number of oxygen-carrying red blood cells in circulation. Fewer blood cells carrying less oxygen manifest in the physical signs and symptoms of iron-deficiency anemia. Unchecked, iron deficiency anemia can cause heart palpitations, chest pains or fainting. The immune system can become taxed to the point that infections become severe or even life threatening.
What to Do
A woman can become deficient in iron for many reasons, ranging from poor nutrition to intestinal bleeding. Identifying the underlying cause of low iron will determine the most appropriate course of treatment. Do not take iron supplements based on signs and symptoms alone. Too much iron can also cause problems. Most causes of iron deficiency are not serious and are easily treated. Armed with an accurate diagnosis, your health-care provider can direct you down the right path to recovery.
If you suspect you have low iron, ask your doctor for a blood test. Don't take iron supplements without the approval of your healthcare provider, since excess iron can be toxic. Also, don't discount the possibility of the sleepiness being connected to something else. For example, kidney and liver problems, a chronic infection, and diabetes can all contribute to fatigue.
A serious iron deficiency can cause anemia. According to the National Heart Lung and Blood Institute, fatigue is a very common symptom of anemia. Different people will experience fatigue in different ways. Some might be too tired to exercise, while others might experience mental fatigue. Many will feel sleepy during the day, even if they slept well the night before. Other symptoms of anemia include dizziness, weakness and shortness of breath.
Low iron often occurs because of a dietary deficiency. Vegetarians are at a risk for low iron unless they eat a variety of iron-rich foods such as beans, iron-fortified cereals, green leafy vegetables and dry fruits. Blood loss, heavy menstrual periods and certain health issues such as celiac or Crohn's disease, might affect your iron levels.
Treatment for Low Iron
Your doctor might recommend iron supplements to help normalize your iron levels. However, taking too much iron at once can be dangerous and cause symptoms such as low blood pressure, chills, dizziness and nausea. Liver damage and even coma are possible after very large dosages. This means you will need to take smaller amounts over a long period of time to normalize your iron levels. You can also eat foods that contain vitamin C, since this vitamin improves the absorption of iron. Foods rich in vitamin C include citrus fruits, red and orange fruits, and vegetables, especially the dark green kinds such as broccoli.
Dealing with the Sleepiness
Because it will take some time for iron supplements to make a difference, your sleepiness and fatigue might not go away immediately. To help you deal with it, try getting a consistent amount of sleep every night. Go to bed at about the same time and get eight to nine hours of sleep if possible. If you're still tired during the day, take a couple of 10-minute naps to help you recharge. Lower your intake of caffeine, as this interferes with iron absorption. Skip alcohol and nicotine too if you can, as this can cause tiredness and interrupt sleep.
Is this an emergency? If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911.