Iron deficiency and anaemia

Heavy periods can leave you short of iron. Pregnancy is another common cause of iron deficiency anaemia. If tiredness or breathlessness is becoming part of everyday life, talk to a GP or doctor about both the symptoms and the bleeding.

How iron deficiency can lead to anaemia

Your body uses iron to make haemoglobin, the protein in red blood cells that carries oxygen. Iron deficiency anaemia develops when there is not enough iron. Iron stores can be used up before there are obvious symptoms, so how you feel cannot tell you the full story.

Anaemia also has causes other than iron deficiency, including vitamin B12 or folate deficiency. Tiredness does not always mean you need iron. Blood tests help your clinician check the possible causes.

Symptoms to describe at an appointment

Call 999 now (UK) or 911 (US), or your local emergency number, if you have severe difficulty breathing, cannot get words out, or your chest feels tight or heavy.

Contact NHS 111 today (UK), or your doctor or urgent care service (US or elsewhere), if you are more short of breath than usual.

Iron deficiency anaemia can cause tiredness, low energy, shortness of breath, noticeable heartbeats, headaches and skin that looks paler than usual. Some people with mild or moderate iron deficiency anaemia have no symptoms. Symptoms alone cannot confirm or rule out the condition.

Less common symptoms include a sore tongue, hair loss, restless legs or wanting to eat non-food items such as paper or ice. Mention these if they occur, even if they seem unrelated to your periods. Tell your clinician what has changed, even if you are unsure which symptoms matter most.

Finding out why iron is low

Blood loss removes iron from the body. Heavy periods may be the explanation, but bleeding from the stomach or bowel is another possibility. Conditions affecting the gut, including coeliac disease, can interfere with iron absorption. A clinician may need to investigate more than your diet.

During pregnancy, you need more iron to support you and the developing baby. Tell your midwife or doctor about tiredness, your food intake and any supplements you already use. WHO recommends iron and folic acid supplementation during pregnancy to help prevent anaemia and other complications; ask your maternity team how this fits your local pregnancy-care plan.

What the blood tests are looking for

The NHS describes a full blood count, or FBC, which looks at blood cells. In US information this is called a complete blood count, or CBC. Other tests can include haemoglobin, blood iron and ferritin. Your clinician will explain what the results mean alongside your symptoms and history.

If the reason for anaemia is unclear, further checks may be needed, including a stool test for blood or specialist assessment. Ask what each proposed test is checking and when you will hear the result. If heavy periods are contributing, ask about treatment for the bleeding as well as replacing iron.

Food and prescribed treatment

Iron-rich foods include beans, lentils, dark-green leafy vegetables, fortified cereals and bread, dried fruit and meat. Vitamin C-rich foods such as oranges, strawberries and tomatoes help the body absorb iron. You can ask for food suggestions that fit your budget and the way you eat.

Confirmed iron deficiency anaemia is often treated with iron tablets while its cause is addressed. Some people need iron through a vein. Your doctor or pharmacist can advise about the medicine and its instructions. Repeat blood tests may be used to check the response.

Ask for advice about supplements

Too much iron can be harmful, and supplements can interact with medicines. If you keep taking supplements for tiredness without getting checked, the cause may go unexplored. Ask your GP or doctor about testing and a review plan; do not stop prescribed treatment without speaking to the prescriber. If iron causes side effects, discuss them with your doctor or pharmacist.

Keep iron tablets out of children’s reach: an overdose can be fatal. When you book a GP appointment in the UK, or see your doctor in the US or elsewhere, bring the supplement packaging and describe any heavy bleeding as well as the symptoms that prompted you to seek help.