Iron deficiency anaemia
Iron deficiency anaemia is caused by lack of iron, often because of blood loss or pregnancy. It’s treated with iron tablets prescribed by a GP and by eating iron-rich foods.
Check if you have iron deficiency anaemia
Symptoms can include:
- tiredness and lack of energy
- shortness of breath
- noticeable heartbeats (heart palpitations)
- pale skin
Less common symptoms of iron deficiency anaemia
Less common symptoms of iron deficiency anaemia (that are not usually connected to pregnancy) include:
- hearing ringing, buzzing or hissing noises inside your head (tinnitus)
- food tasting strange
- feeling itchy
- a sore tongue
- hair loss - you notice more hair coming out when brushing or washing it
- wanting to eat non-food items (for example, paper or ice) - called pica
- finding it hard to swallow (dysphagia)
- painful open sores (ulcers) in the corners of your mouth
- spoon-shaped nails
- restless leg syndrome
See a GP if you have symptoms of iron deficiency anaemia
A simple blood test will confirm if you’re anaemic.
What happens at your appointment
Your GP will ask you about your lifestyle and medical history. If the reason for the anaemia is not clear (like pregnancy) your GP might order some tests to find out what might be causing the symptoms. They might also refer you to a specialist for further checks.
Blood tests for iron deficiency anaemia
Your GP will usually order a full blood count (FBC) test. This will find out if the number of red blood cells you have (your RBC count) is normal.
You don’t need to do anything to prepare for this test.
A normal RBC count is:
- women - 4.2 to 5.4 million cells per microlitre (cells/mcL)
- men - 4.7 to 6.1 million cells/mcL
Iron deficiency anaemia is the most common type of anaemia. There are others, like vitamin B12 and folate anaemia, which the blood test will also check for.
Treatment for iron deficiency anaemia
Once the reason you have anaemia has been found (for example, an ulcer or heavy periods) your GP will recommend treatment.
If your blood test shows your red blood cell count is low (deficient) you’ll be prescribed iron tablets to replace the iron missing from your body.
The prescribed tablets are stronger than the supplements you can buy in pharmacies and supermarkets.
You’ll have to take them for about 6 months.
Drinking orange juice after you’ve taken them may help your body absorb the iron.
Some people get side effects like:
- constipation or diarrhoea
- tummy pain
- feeling sick
- black poo
Try taking the tablets with or soon after food to reduce the chance of side effects. It’s important to keep taking the tablets even if you get side effects.
Keep iron supplement tablets out of the reach of children. An overdose of iron in a young child can be fatal.
Your GP may carry out repeat blood tests over the next few months to check that your iron levels are back to normal.
Things you can do yourself
If your diet is partly causing your iron deficiency anaemia, your GP will tell you what foods are rich in iron so you can eat more of them.
Eat and drink more:
- dark green leafy vegetables like watercress and curly kale
- cereals and bread with extra iron in them (fortified)
- pulses (beans, peas and lentils)
Other foods that are a good source of iron.
Eat and drink less:
- milk and dairy
- walnuts and almonds
Large amounts of these food and drinks make it harder for your body to absorb iron.
If you’re finding it hard to include iron in your diet you might be referred to a specialist dietician.
Causes of iron deficiency anaemia
If you’re pregnant iron deficiency anaemia is most often caused by a lack of iron in your diet.
Heavy periods and pregnancy are very common causes of iron deficiency anaemia. Heavy periods can be treated with medication.
For men, and for women whose periods have stopped, iron deficiency anaemia can be a sign of bleeding in the stomach and intestines caused by:
- taking non-steroidal anti-inflammatory drugs (NSAIDs) (ibuprofen and aspirin)
- stomach ulcers
- swelling of the large intestine (colitis) or of the food pipe (oesophagus)
- less often - cancers of the bowel or stomach
Any other conditions or actions that cause blood loss could lead to iron deficiency anaemia.
If you leave your iron deficiency anaemia untreated
Untreated iron deficiency anaemia:
- can make you more at risk of illness and infection, as a lack of iron affects the immune system
- may increase your risk of developing complications that affect the heart or lungs, such as an abnormally fast heartbeat (tachycardia) or heart failure
- in pregnancy can cause a greater risk complications before and after birth
If you can’t speak to your GP or don’t know what to do next.