How to Spot an Iron Deficiency

Iron deficiency can be a master of disguise, with symptoms such as fatigue, dizziness and irritability often imitating conditions such as stress, sleep disorders or even general burnout. These subtle warning signs might seem inconsequential at first, but they can quietly disrupt your energy levels, focus and overall health. 

Left unchecked, iron deficiency can escalate into more severe problems, such as anemia or delayed development in children. That’s why it’s important to tune into what your body – or your child’s body – might be trying to tell you. By identifying these symptoms early and seeking proper care, you can get ahead of iron deficiency and protect your well-being for the long term. 

We speak to Brandi Bass, MSN, a board-certified family nurse practitioner at INTEGRIS Health Medical Group Downtown, to learn more. 

"If you are experiencing signs of iron deficiency, please see your primary care provider,” Bass says. “They may ask additional questions regarding your symptoms, as well as order testing to determine if low iron is present. Testing can be helpful as there are sometimes other conditions that can have similar symptoms. Once the cause of your symptoms is identified, your primary care provider will determine the most appropriate treatment plan and subsequent follow up."

The importance of iron

The basics: Iron is an essential mineral that plays a critical role in maintaining the body's overall health and functionality. Red meat, poultry, seafood, legumes, leafy greens, nuts and seeds are common sources of iron.

The production of hemoglobin, a protein found in red blood cells, is one of the key jobs of iron.

• Hemoglobin binds to oxygen in the lungs and delivers it to tissues and organs throughout the body.
• Without enough iron, your body can’t produce sufficient hemoglobin, leading to reduced oxygen supply.
• This is why fatigue and weakness are hallmark symptoms of iron deficiency – oxygen is critical for energy and cellular function.

Usable energy is a byproduct of iron converting carbohydrates, fats and proteins.

• Additionally, a related protein called myoglobin, which also relies on iron, ensures that muscles have the oxygen they need to function correctly.

The brain depends on iron for optimal performance. 

• Iron is vital in supporting proper neurological development and cognitive function.
• Adequate iron levels are associated with improved memory, attention and learning abilities, as iron helps maintain healthy blood flow and oxygen delivery to the brain.

Immune system health is boosted by iron consumption.

• Iron supports the activity of white blood cells, which are critical for identifying and fighting off harmful pathogens.
• With insufficient iron, the immune response can weaken, leaving the body more vulnerable to illness.

What causes iron deficiency?

What to know: Without sufficient iron, the production of healthy red blood cells declines, which can lead to a condition known as iron-deficiency anemia. Iron deficiency can develop for various reasons, often tied to either a lack of iron intake or increased demand for iron. 

A diet that lacks iron-rich foods may not give your body the iron it needs to maintain healthy blood levels.

• This is particularly common in those who follow vegetarian or vegan diets, as plant-based iron (non-heme iron) is less readily absorbed by the body compared to iron from animal sources (heme iron).

Blood loss depletes the body’s iron stores, as iron is a key component of hemoglobin in red blood cells. 

• Common sources of blood loss include heavy menstrual periods, frequent blood donations and gastrointestinal bleeding caused by ulcers, polyps or colon cancer.

Pregnant women require more iron to support the growth and development of the baby, as well as to increase their own blood volume. 

• If these heightened needs are not met through diet or supplements, iron deficiency can develop.

Poor absorption of iron can occur with certain medical disorders.

• Celiac disease or Crohn's disease damage the intestines, affecting nutrient absorption.
• Surgeries involving the stomach or intestines, such as gastric bypass, can also limit iron uptake.

During childhood, the body undergoes rapid growth and development, requiring more iron to keep up.

• Dietary habits also play a key role in iron deficiency among children.
• Many young children are picky eaters, often preferring starchy or sugary foods over iron-rich options like vegetables, legumes or meats.

Signs and symptoms to notice

At a glance: Iron deficiency can develop gradually, and its symptoms often start subtly before worsening over time. Recognizing these warning signs early is key to addressing the issue and preventing complications. 

Fatigue and weakness are the two early signs.

• When you don’t produce enough hemoglobin, tissues and muscles don’t receive the oxygen they need, leaving you feeling exhausted and weak.

Pale skin, especially in the face or inside the eyelids, can be a clue. 

• Hemoglobin gives blood its red color and when levels drop, the skin and mucous membranes appear lighter.

Shortness of breath can make everyday activities challenging.

• This occurs because your body works harder, compensating for the lack of oxygen.

Chest discomfort in the form of pain or rapid heartbeat may appear.

• To make up for the lack of oxygen, your heart might pump faster.

Aside from the obvious signs, there are several less common indicators of iron deficiency. 

• Brittle, weak nails and thinning or hair loss can develop over time.
• Limited oxygen delivery impacts circulation – particularly at the extremities – and can cause chronic coldness in your hands and feet.
• When oxygen levels drop, you may experience headaches, lightheadedness and dizziness.
• Low levels of iron can cause difficulty focusing, memory lapses or irritability.
• A swollen, inflamed or unusually smooth tongue (glossitis) can be another sign.
• You might notice cracks, dryness or sores forming at the corners of your mouth (angular cheilitis).

What are characteristics of iron deficiency in children?

Key points: Iron deficiency can affect people of all ages, but the symptoms often manifest differently in children and adults due to physiological and developmental needs. While there are shared signs, some key differences set these groups apart.

Children and adults both experience fatigue, pale skin and heart symptoms, although the impact can vary.

• In children, fatigue may appear as reduced interest in playing or activities, while in adults, it may present as difficulty staying productive or active during the day.
• Lighter skin tone – particularly in the face, lips or inner eyelids – may be harder to notice in children by a parent or caregiver.
• Heart symptoms in children, such as shortness of breath or rapid heartbeat, can make them avoid active play, whereas adults may struggle with household chores or exercising.

Symptoms more common in children include developmental delays and slow growth.

• Iron is essential for cognitive and physical growth in children, so deficiency can lead to slower progress in areas such as motor skills, speech development or academic performance.
• Irritability is more noticeable in children and often results in fussiness, frustration or difficulty calming down.
• Due to their still-developing immune systems, children with iron deficiency may experience more frequent colds or infections compared to adults.
• Children rely on iron for muscle development and weight gain, so iron deficiency may cause them to lag on growth charts.
• A unique symptom often seen in children is pica – the desire to eat substances like dirt, chalk or ice – as the body attempts to fulfill nutritional gaps.

Next steps: If you notice any of the symptoms listed above and believe iron deficiency may be the cause, your primary care doctor can come up with a treatment plan to boost iron levels. In some cases, you may be referred to a hematologist, a type of doctor who specializes in treating blood disorders, including iron deficiency. 

Take Care of You

Your primary care doctor is here for you and all your health care needs. Let us help take care of you. If you don't have a primary care doctor or are looking for a new one, you can schedule an appointment online.

SEE MORE