Lack of iron is the most common known form of nutritional deficiency. Its prevalence is highest among young children and women of childbearing age and pregnant women, the Centers for Disease Control and Prevention (CDC) says.
There are two types of iron – heme and non-heme. The body absorbs between 15 and 30 percent of heme iron, and only 2 to 20 percent of non-heme iron, according to the Office of Dietary Supplements. That’s why you may be eating a lot of iron-rich foods and still not have enough of it.
If you don't have enough hemoglobin-carrying red blood cells, your heart has to work harder to pump more blood and move oxygen-rich blood through your body, according to the National Heart, Lung and Blood Institute. That’s why severe anemia that has been untreated can lead to heart failure, Dr. Priyanka Pathak, oncologist at Geisinger Health System, says. Anemia is found in about one-third of all cases of congestive heart failure, studies show.
Losing more than 100 hairs every time you brush your hair may be a sign you lack iron. “Iron is required for the formation of proteins,” Dr. Pathak says. Hair is a protein thread that grows from follicles found in the skin. The hair follicles in a person with anemia don’t get enough oxygen. The body has prioritized the oxygen it does have for vital functions because it’s in survival mode, Dr. Pathak adds. As a result, the hair falls out.
The nail has raised ridges and is thin and curved inward. This disorder is associated with iron deficiency anemia, according to NIH. The fingernails consist of hardened layers of protein, which protects the soft tissue. When the body is not making enough hemoglobin, the lack of oxygen weakens the nail, causing them to break.
Unexplained cold hands and feet are a common symptom if iron deficiency, according to Iron Disorders Institute. Consuming less than 18 mg for women and 8 mg for men prevents the production of myoglobin and hemoglobin. Blood cells that don’t have enough oxygen get stuck in blood vessels, slowing down circulation, which leads to cold hands and feet.
“This has to do with the heart palpitations,” Dr. Pathak says. Your heart is working harder and you can often heart it, especially if you are laying down on your side. You can also hear it like a “whooshing” sound in your ears.
Less iron means less myoglobin in the blood, which keeps the muscles healthy. Since the tongue is actually a muscle, it will feel sore, smooth, swollen and will have a weird pale color, according to John Hopkins Medicine. Sore and swollen tongue can, as a result, leads to problems with chewing, swallowing and even speaking.
Poor skin tone is common when the body lacks iron. The skin, being the largest organ on the body, will inevitably suffer if there are not enough red blood cells to deliver oxygen to it. Paleness is generally the result of reduced blood flow or a decreased number of red blood cells, Dr. Pathak says. “This is the body’s self-defense mechanism: The blood is going to more important organs such as the brain and kidneys,” she adds.
Lack of iron causes low levels of hemoglobin, which carries oxygen to body cells, Dr. Pathak says. Logically, if the oxygen level in your body is low, you’ll feel out of breath much quicker than normal. “You have less blood which now has to do extra work,” she adds. If you feel like you can’t catch your breath after going up one flight of stairs, you may need to have some iron-rich foods such as liver, meat, beans, nuts, dried fruits, and green vegetables, according to the U.K. National Health Service (NHS).
Headache, especially with activity, can be a sign of iron deficiency. Unfortunately, a headache is also a symptom people often ignore even though it can sometimes be life-threatening. Your body’s priority when it doesn’t have enough oxygen is to get it to the brain before other organs. But even then the arteries can swell, triggering headaches, according to American Society of Hematology.
RLS is condition in which people feel an irresistible urge to move the legs. About 15 percent of people who have RLS also have iron deficiency, according to John Hopkins Medicine. The single most consistent finding and the strongest environmental risk factor associated with RLS is iron insufficiency. The symptoms usually occur at night, preventing patients from getting enough sleep.
Loss of appetite and weight loss is another general symptom of anemia, according to NHS. It usually is a result of other symptoms people are experiencing, Dr. Pathak says. Feeling weak and tired all the time is not something that will stimulate a healthy appetite. “This is just part of how a person wil iron deficiency generally feels,” she adds.
This is a unique symptom of iron deficiency, Dr. Pathak says. The condition is called Pica, and it means a craving for non-nutritive items such as ice, hair, dirt, or laundry starch. It doesn’t happen very often and there is not a clear explanation as to why the disorder develops, she adds.
Fatigue is one of the most common symptoms of iron deficiency, Dr. Pathak says. People are used to being in a hurry all the time so many don’t pay attention when their body feels tired. Lack of iron leads lower counts of hemoglobin, which is the protein that helps red blood cells deliver oxygen throughout your body. This means less oxygen is going to your muscles. As a result, they have no energy, leaving you feeling exhausted.
Lightheadedness starts when blood counts start going low as a result of anemia, since iron is required to make blood, Dr. Pathak says.
Experiencing muscle weakness as well as unexplained muscle pain and aches is a common sign of iron deficiency. The muscles don’t have energy to function properly. A decline in both strength and stamina is a natural result.
“We don’t know exactly how or why that happens,” Dr. Pathak says. Iron is required for the enzymes of every cell, she adds, and oxygen is required for the functioning nearly all cell types. “A mental fog can definitely happen,” she adds. Lack of oxygen, including to the brain, as a result of anemia will slow cognition. When you add heart palpitations to this symptom, you feel anxious and restless.
It is important to recognize that the meat people eat today is not the red meat that existed in previous generations. “For your red meat to be really healthy for you, it must come from cows that eat natural sources of grasses (without GMO's and steroids), not factory-fed and definitely not pumped full of nitrates before being sold to preserve it for longer than is sustainable organically,” Angela Martindale, celebrity nutritionist, says.
“Our bodies need Vitamin C to help absorb iron,” Martindale says. Top Vitamin C foods include lemon, strawberries, sweet potatoes, tomatoes, and broccoli. The trick is to eat them with foods high in iron. The vitamin and the non-heme iron, which is not very well absorbed during digestion, form a new compound that is. That’s why each meal should preferably contain at least 25 mg of ascorbic acid (Vitamin C), according to the Human Vitamin and Mineral Requirements.
Calcium is the only known substance to inhibit absorption of both non-heme and heme iron, according to the Iron Disorders Institute. Calcium in amounts 300-600 mg – or about one cup of skimmed milk – is enough to hinder the process. Eggs contain phosvitin, a protein, which impairs the absorption of iron. Oxalates have the same effect. The presence of oxalates in spinach explains why the iron in spinach is not absorbed. They are also found in beets, chocolate, tea, strawberries, oregano, basil, and parsley.
Raw veggies in their natural form are always better for getting maximum nutritional benefit from them, Martindale says. The best veggies that are high in iron include squash, kale, peas, green leafy vegetables, and nuts. Legumes are excellent sources of iron, too, she adds. You can also choose dried fruits and iron-fortified cereals.
They include apricots, which have more than 7.5 grams (42 percent of DV) in one cup, peaches, prunes, raisins, mulberries (which are also a great summer superfood for weight loss), and coconuts.
Liver has been known to be a great source of iron. No one disputes that, but “liver is a toxin flushing organ and I do not recommend it as a healthy source of iron to my clients,” Martindale says. Pregnant women are advised against eating liver all together because it has a lot of vitamin A which, in large amounts, can harm the baby, according to the U.K. National Health Service (NHS).
The side effects of taking high doses (over 20 mg) of iron include constipation, nausea, vomiting, and stomach pain, the NHS says. Very high doses of iron can be fatal, particularly if taken by children. Excess iron in vital organs increases the risk for liver disease, heart failure, osteoporosis, metabolic syndrome, and hypothyroidism, according to the Iron Disorders Institute.