Though not uncommon, iron deficiency can be difficult to identify. Here are some sneaky iron deficiency symptoms to look out for.

Brierley Horton, M.S., R.D.
February 28, 2020

Iron deficiency is—surprisingly—not uncommon. Your risk of developing it is higher if you're a pre-menopausal woman, a child or elderly. Your risk of having iron deficiency also goes up if you fall into one of these categories and are African American, Hispanic or vegetarian.

The thing about iron deficiency is that it isn't the easiest to ID, unless, of course, you get your blood levels measured. The symptoms can come on slowly as your iron levels begin (and continue) to dip—especially as you move from mildly deficient to marginally deficient to iron-deficiency anemia, which is the most severe.

"I have seen people have iron-deficiency anemia for years before it starts to inhibit their day-to-day life," says Thomas DeLoughery, MD, MACP, FAWM, professor of medicine at Oregon Health and Science University.

Read the list of sneaky signs below, and you'll realize it's easy to blame the symptoms on something else (for example: "I'm cold-blooded" or "I have small children, of course I'm tired all the time"). Here's what to look for if you think you might have iron deficiency—plus, what to do about it.

1. You're tired all the time.

This is the most common symptom of iron deficiency—and, in fact, it can appear with even a mild dip in iron stores. But also, it's pretty hard to notice. Not only is it hard to get the recommended amount of sleep but life usually has us being pulled in different directions (between work, kids, your significant other and a social calendar) that feeling tired is, unfortunately, all too common.

Still, if your level of exhaustion has changed recently, or it's accompanied by one of these other symptoms, your iron levels could be low and worth getting checked.

2. You're cold, even when others aren't.

An intolerance to cold temperatures is another common symptom of iron-deficiency anemia and also sometimes simply just iron deficiency. One possible explanation is that your thyroid needs iron to function, so a lack of iron hinders thyroid efficiency, and thyroid hormones help regulate your body temperature.

Related: Try These Iron-Rich Recipes

3. You're easily short of breath.

If your endurance seems to be slipping, despite keeping up with your regular workouts, it could be that you're low in iron. Iron helps to shuttle oxygen throughout your body and without enough of it, it's harder for your body to keep up with your cardio routine.

4. Your irritability or anxiousness has ramped up.

Being a bit more "sensitive" to annoyances is a symptom you often see listed with iron deficiency. And there is some research (although it's limited) that suggests you could be more anxious. For example, in one study, the parents and teachers of kids who were severely and chronically iron deficient in infancy reported an increased concern about the kids' anxiety (among other behaviors) years after their iron deficiency was remedied.

5. Your hair is thinning or noticeably more brittle.

It's women who say they lose their hair with iron deficiency, according to research. But perhaps that's because it's not all that common for men to have low iron stores. Because your hair is constantly growing, it depends on a healthy blood supply and when you're low on iron you're shorting your hair a key nutrient.

6. You're depressed.

Iron has a role in making dopamine—a chemical that sends signals from your body to your brain and plays a big role in your mental wellbeing. In depression, dopamine levels are low. Also, research suggests that iron deficiency is about 15 percent more common in depressed people and a few studies have found that supplementing with iron decreased depression.

Getty / Martin Dimitrov

Related: Try These 12 Best Food Sources of Iron

7. You have celiac disease or IBD.

Both celiac disease and IBD can hinder nutrient absorption and specifically, how much iron is absorbed from food in your small intestine. But they're also inflammatory conditions and chronic inflammation encourages the overproduction of a compound called hepcidin. At "healthy" levels, hepcidin helps your body maintain a just-right level of iron. But too much hepcidin can lead to iron deficiency. So if you have an inflammatory bowel condition, you may want to talk to your doctor about your iron levels.

What to Do if You Have Iron Deficiency

If you think you could be iron deficient, the good news is it's fairly easy to test: the best measure is a simple blood test administered by your doctor. Plus, it's important to work with a medical professional to find out why you are iron deficient, create a course of treatment to remedy the deficiency and also be mindful of other conditions you may have.

Sometimes ramping up the iron-rich foods in your diet is sufficient; sometimes an iron supplement is needed; and for some, an iron prescription may be needed.

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