The signs of iron-deficiency anemia can often be subtle and vague, but it’s the most common form of anemia. In fact, 237,000 visits to the emergency room result in a primary diagnosis of the condition, according to a report by the Centers for Disease Control and Prevention (CDC).
Iron is an essential mineral so if you lack it, your body can’t make enough healthy red blood cells. Those red blood cells carry hemoglobin, an iron-rich protein that delivers oxygen from your lungs to the rest of your body’s tissues.
It’s a good idea to know the symptoms of iron-deficiency anemia especially since they can often take time to develop. Here are 14.
Fatigue is usually the first sign of anemia, but it’s not just that sluggish feeling you get from burning the midnight oil or stress.
“It’s a different kind of fatigue—people will complain about being ‘bone tired,’ ” said Dr. Dana Cohen, an integrative physician with a private practice in New York City.
So if you’re exhausted 24/7, can’t seem to make it past dinner and it’s affecting your quality of life, see your doctor.
One of the best ways to tell if you’re anemic is to look at the mucous membranes of your eyes, also commonly referred to as the water line above your lower lashes. This is a vascular area so if it’s pale, it’s a good sign that you’re not getting enough red blood cells to other areas of your body either. Your face, the palms of your hands and under your nail beds may also look pale, said Dr. Jack Jacoub, a medical oncologist and hematologist at MemorialCare Cancer Institute at Orange Coast Memorial Medical Center in Fountain Valley, Calif.
3. Shortness of breath
If you feel like you can’t catch your breath, especially during exercise, while climbing the stairs or when you’re lifting something, it’s a good sign that your body isn’t getting the oxygen it needs. Feeling faint, lightheaded and dizzy are common too.
3. Heart palpitations
If your heart is racing, you’re having palpitations or hear a whooshing sound in your ears when you lie down, it could mean that your heart is in overdrive.
“You’re pumping faster to try to get more oxygen,” Cohen said.
What’s more, an irregular heartbeat or heart murmur are more pronounced when you’re anemic.
A racing heart can make anyone feel anxious, but if anxiety is new for you, has intensified or there seems to be no other reason for it, it could be a sign that you’re anemic.
Since your body will pull blood from your extremities to feed the places it needs to, you might have a numb or tingling feeling in your hands and feet or you may feel cold all the time, Cohen said.
6. Heavy periods and irregular bleeding
The most common cause of iron-deficiency anemia in women are uterine fibroids, especially those located on the inside of the uterine cavity which can cause heavy, irregular and painful bleeding, said Dr. Kecia Gaither, a maternal fetal medicine specialist and director of perinatal outreach at Montefiore Medical Center and Albert Einstein College of Medicine in New York City. Polyps inside the uterus can cause heavy, painful periods too.
7. Strange cravings
Some people with an iron-deficiency anemia crave and have a habit of chewing ice. It’s not clear why, but a study in the journal Medical Hypotheses suggests that it may give a boost in mental sharpness the same way a cup of coffee does. Some people may even have cravings for paper and clay too.
8. Brain fog
If you’re having trouble concentrating, remembering things or don’t feel as sharp as you did in the past, it might not just be age, but a lack of iron, Jacoub said.
Tension headaches and migraines are common, but if you notice you’re having headaches more often or nothing you do seems to alleviate the pain, see your doctor.
10. Restless Leg Syndrome
It’s estimated that up to 10 percent of people in the U.S. have restless leg syndrome, a neurological disorder that can cause uncomfortable sensations in the legs and other parts of the body and an uncontrollable urge to constantly move. Although the association is not well understood, about 15 percent of people with the condition also have iron deficiency, according to John Hopkins Medicine.
11. Pregnancy risks
Although iron-deficiency anemia is common during pregnancy, left untreated, women have a higher risk for premature and low birth weight babies. The primary reason women are more likely to be iron deficient during pregnancy is due to the normal increase in water in the body.
“Even though you have the same number of red blood cells, there’s more volume for them to circulate around,” Gaither said.
Plus, iron stores can be depleted because they’re needed for the placenta and the baby. If you had an iron-deficiency prior to pregnancy or are having multiples, your risk is even higher.
12. Hair loss
According to the American Academy of Dermatology, 80 million men and women experience hereditary hair loss, or what’s known as male pattern baldness. If you notice more hair in your brush or your hair is thinning, it might be that you’re anemic. It could also be a vitamin deficiency or a hormonal condition like hypothyroidism so bring it up to your doctor.
13. Black stools
Dark, tar-colored stools, blood in the stool or bleeding from the rectum could signal anemia. Yet it could also be a GI condition like Crohn’s disease or stomach or colon cancer so it’s important to see your doctor immediately. Abdominal discomfort or a change in your bowel habits are also important signs to look for.
How to get enough iron.
Experts agree, if you have iron-deficiency anemia, your doctor will likely run more tests and look at your medical history to find the root cause of it.
“Its not enough to know you’re iron deficient, the question is why?” Jacoub said.
If you’re pregnant, be sure to keep your prenatal appointments and always get your blood tests done to make sure your levels are sufficient.
Iron-rich foods including red meat, liver, oysters, beans, dark green leafy vegetables, dried fruit and iron-fortified cereal can give you what you need.
Your doctor may also recommend a daily multivitamin and an iron supplement. There are also food-based iron supplements that are non-constipating and for women, can be taken only around their periods, Cohen said.
Try Traditional Chinese Medicine
Acupuncture and Chinese herbs can also help increase iron levels.
Julie Revelant is a health journalist and a consultant who provides content marketing and copywriting services for the healthcare industry. She's also a mom of two. Learn more about Julie at revelantwriting.com.