Anemia occurs when a person has lower-than-normal levels of red blood cells (RBCs) in the blood. According to the American Society of Hematology, there are many factors that can contribute to lower-than-normal RBC counts, including age, viral infections, and certain chronic diseases.
Iron deficiency anemia is the most common type of anemia, which occurs when your body does not have enough of the mineral iron. Your body needs iron to produce a protein called hemoglobin, which is responsible for carrying oxygen to your body’s tissues. Your tissues and muscles need oxygen to function effectively.
Signs of iron deficiency can be very mild at first, and may go completely unnoticed. In fact, most people do not realize they have mild anemia until it is identified in a routine blood test. Here are 12 signs of iron deficiency.
1. Being Exhausted
The most common symptom of iron deficiency, it’s also possibly the most difficult one to detect. “Women are so used to having frenetic lives and feeling tired,” says Nancy Berliner, MD, deputy editor of Blood, the journal of the American Society of Hematology. People often just dismiss being tired as part of life. However, iron deficiency causes less oxygen to reach your tissues, so your body is deprived of the energy it needs.
If your “normal” fatigue is coupled with you feeling, weak, irritable, or unable to focus, iron (or iron deficiency) might have something to do with it. After all, there’s a reason people whose iron deficiency progresses into anemia are often said to have “tired blood.”
2. Craving Clay, Dirt, and Ice
Craving (and actually eating) non-food substances can be an iron deficiency symptom. Iron-deficient people may be tempted to chow down on chalk, clay, dirt, and paper. Luckily, most women opt for ice, says Dr. Berliner, who tells her anemic patients to come back to see her if they start craving ice.
3. Restless Leg Syndrome
Can’t stop fidgeting? About 15% of people with restless leg syndrome have iron deficiency, according to John Hopkins Medicine. The lower the iron levels, the worse the symptoms.
4. Getting Short of Breath Easily
No matter how deeply you breathe, if your oxygen levels are low, you’ll feel out of air, explains Dr. Berliner. If you notice yourself getting out of breath doing things that you’d normally handle just fine, then iron deficiency could be to blame.
5. Being Pale
There’s a reason the words “pale” and “sickly” are often used interchangeably. Hemoglobin gives your blood its red color and, thus, your skin its rosy hue. That means that low levels of the protein can suck the color straight from your skin.
If you have a light complexion, it’s pretty easy to spot. No matter your skin tone, though, if the inside of your lips, your gums, and the inside of your bottom eyelids are less red than usual, low iron levels may be to blame.
6. Hair Loss
Iron deficiency, especially when it progresses into full-blown iron deficiency anemia, can cause hair loss. If you are iron-deficient, your body uses oxygen to support vital functions as opposed to ones like keeping your hair intact. Don’t panic if there are a few hairs in your drain, though. Most scalps lose about 100 hairs on a good day.
7. Pounding Hearts
An overworked heart can end up suffering from irregular heartbeats, heart murmurs, enlargement, and even heart failure. Before you freak out, don’t. For things to get that bad, you would probably have to suffer from iron deficiency anemia for quite some time, suggests a review of cardiomyopathy and iron deficiency in the Texas Heart Institute Journal.
However, if you know you have heart problems, it’s important to get your iron levels checked as iron deficiency can worsen existing heart problems.
8. Feel Anxious
As if your life wasn’t stressful enough, iron deficiency can trick you into feeling even more anxious. A lack of oxygen revs up your body’s sympathetic nervous system, which is kind of like your body’s gas pedal. Plus, since iron deficiency can send your heart racing, it’s easy to feel like you’re in fight-or-flight mode even when you have every reason to feel relaxed.
An iron-deficient body will prioritize getting oxygen to your brain before it worries about other tissues, but even then, your noggin will still get less than it ideally should. In response, the brain’s arteries can swell, causing headaches, according to the National Headache Foundation.
10. Weird Looking Tongue
Besides sapping the color out of your tongue, low iron counts can reduce levels of myoglobin, a protein in red blood cells that supports muscle health, like the muscle that makes up the tongue. As a result, many people who are iron deficient complain of a sore, inflamed, and strangely smooth tongue.
11. Brittle Nails
Even the cutest mani/pedi can’t hide thin, frail fingernails and toenails. Another way your tips can tip you off to a possible iron deficiency: a concave or spoon-shaped depression in the nails.
12. Underactive Thyroid
Iron deficiency slows your body’s thyroid function and blocks its metabolism-boosting effects, according to the National Academy of Hypothyroidism. Hypothyroidism if often missed—60% of people with a thyroid disease don’t know they have it, according to the American Thyroid Association—so if you notice low energy levels, weight gain, or even a lower body temperature, talk to your doctor.