The body needs iron to produce hemoglobin—a crucial component of the red blood cells that are needed to supply oxygen to your vital organs. You can develop an iron deficiency if you’re not getting enough iron from your diet, your body is struggling to absorb iron for some reason, or you’re regularly losing blood. If you notice some of these ten warning signs, ask your doctor to test you for iron deficiency so that you can work together to understand the underlying cause.
1. Pale skin
If you have a naturally pale complexion, you’ve probably already had at least one doctor scrutinize you and wonder out loud about anemia. However, if you used to have more color in your cheeks and have recently noticed that you look white or chalky, this could be because of a developing iron deficiency. Hemoglobin is what makes blood red and gives your skin pink undertones, which swiftly disappear as fewer hemoglobin levels drop. In particular, take a look at your gums, lips and the insides of your lower eyelids.
One of the more surprising symptoms of iron deficiency is pica—a strong desire to eat things that aren’t classified as food. Ice is one of the more common objects of this craving, but those with pica can be drawn to consume anything from chalk to paper and even earth. Pica also sometimes appears during pregnancy, or as part of obsessive-compulsive disorder (OCD).
3. Headaches and dizziness
Headaches occur as part of iron deficiency anemia because your brain isn’t getting the ideal amount of oxygen (although it’s getting more than the rest of your body since the brain is always prioritized). Swollen arteries can develop, causing persistent pain. Meanwhile, this lack of oxygen means that mild dizziness is also a frequent complaint. While it won’t have the spinning quality associated with vertigo or labyrinthitis, it can cause you to feel unbalanced or light-headed.
4. Shortness of breath
As you might expect, lack of adequate oxygen circulating around your body can also make you feel out of breath—not just when you’re working out at the gym, but when you’re simply climbing a few stairs or lifting some grocery bags. If tasks that used to be easy are now challenging and leave you puffing for air, have your iron levels checked.
5. Heart palpitations
Is your heart beating faster, or do you have the sense that it’s fluttering or skipping beats? Your heart has to work harder when you’re suffering from iron deficiency, so palpitations are common. If the deficiency is left untreated, you can even develop not just an irregular heartbeat but also thickening or stretching of the heart muscle (i.e. cardiomyopathy). In addition, preexisting heart problems like heart disease or a leaky valve can get worse while you’re not getting enough iron.
6. Mental and emotional changes
Some people with iron deficiency report reduced concentration and focus. Others note heightened anxiety levels, which are thought to result from increased activity in the sympathetic nervous system. The heart palpitations mentioned above can also make you feel anxious since you subconsciously associated a racing heart with danger or nervousness.
7. Heavy menstrual periods
While not a symptom of iron deficiency itself, very heavy menstrual periods are an indicator that you’re at greater risk of developing an iron deficiency. Periods are typically classed as very heavy if they mean you need to change your tampon or pad every 2-3 hours, pass blood clots bigger than a quarter, and experience or worry about leakage.
8. Restless legs syndrome
Interestingly, studies estimate that approximately 15% of those with restless legs syndrome (RLS) is suffering from an iron deficiency, and the condition worsens as iron levels drop further. RLS is characterized by a strong use to constantly move the arms and legs to stop uncomfortable sensations.
9. Hair loss
Iron deficiency is associated with hair loss and reduced hair growth, especially if the deficiency is significant or has been present for a long time. Once again, this relates to your body conserving oxygen for the areas that matter most—and it doesn’t place your hair follicles very high on that list. As a result, clumps may come out when you brush your hair, or you may just notice that your hair isn’t looking as thick as it once was.
Finally, the lack of adequate oxygen supply that comes with iron deficiency means you can also struggle with a distinct lack of energy. Of course, dozens of health problems can cause lethargy, but if you experience excessive tiredness in conjunction with several of the other symptoms mentioned on this list then there’s a good chance you’re deficient in iron.