Low Iron Is Easy to Miss

Iron deficiency is one of the more common nutritional deficiencies in Australia, and one of the most frequently explained away. The symptoms are unremarkable on their own — the kind of thing you attribute to work, or poor sleep, or getting older.

What it can look like

• Tiredness that rest does not fix

• Feeling breathless doing things that never used to cause it

• Trouble concentrating, or a general mental fogginess

• Looking pale

• Headaches, dizziness

• Brittle nails or hair loss

• Restless legs

• Unusual cravings for things that are not food, such as ice

None of these is proof of anything by itself. Together, and persisting, they are worth a conversation.

Why iron runs low

Iron deficiency generally comes down to one of three things: not taking enough in, not absorbing what you take in, or losing more than you take in.

The last one is the one that matters most to look into, because blood loss can be slow and unnoticed. Heavy periods are a common cause. So is bleeding in the digestive tract, which can happen without any obvious sign — one of the reasons persistent unexplained iron deficiency in some people prompts a GP to look further rather than simply prescribing a supplement.

Higher demand also plays a part: pregnancy, growth spurts, and endurance training all increase what the body needs. People eating vegetarian or vegan diets can be more at risk, because iron from plant sources is absorbed less readily than iron from meat.

Finding out

A blood test is how it is confirmed. It usually looks at both haemoglobin and ferritin — the second being a measure of iron stores, which can fall well before anaemia shows up. That is the reason people can feel flattened for months while a basic blood count still looks normal.

Treating it

Where diet is the issue, iron-rich foods help: red meat, poultry and fish, plus legumes, tofu, wholegrains and leafy greens. Vitamin C eaten alongside plant sources improves absorption, while tea and coffee with a meal reduce it.

Beyond that, iron supplements are the usual next step, and for some people an iron infusion — iron given directly into a vein — is appropriate. That is a decision made with a doctor.

A word of caution about supplements. Iron is not a harmless thing to take on a hunch. Too much causes real problems, some people have conditions that make iron loading dangerous, and supplementing without testing can mask the underlying cause rather than treat it. It is worth getting the blood test before the supplement, not after.

If the list at the top of this article sounds familiar, it is worth raising at your next appointment.

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Source: healthdirect Australia, Iron deficiency.