Do I Have Low Iron? Iron Deficiency Symptoms

Each year, iron deficiency remains one of the most widespread and under-recognised nutritional concerns across all age groups. Affecting more than 1.2 billion people worldwide, iron deficiency, and its more severe form, iron deficiency anaemia, continues to impact daily life, energy levels, and long-term health outcomes (Camaschella, 2019).

It is especially common in women of reproductive age, teenagers, pregnant individuals, and children, but also affects men; particularly those with gastrointestinal disorders, restrictive diets, or high physical demands. Despite its prevalence, symptoms are often overlooked or mistaken for general fatigue or stress.

Recognising the signs early and understanding what causes low iron can make a significant difference. In this article, we explore the most common symptoms, the causes of iron deficiency in both men and women, and how a simple iron blood test can help you take back control of your health.

What is Anaemia?

Iron plays a key role in the body’s ability to make haemoglobin, a protein found in red blood cells that carries oxygen to muscles, tissues, and vital organs. When iron stores are too low, your body produces fewer and smaller red blood cells. The result? Less oxygen reaches where it’s needed and your body begins to struggle.

This condition is known as iron deficiency anaemia. It can cause symptoms such as:

• Persistent tiredness

• Difficulty concentrating

• Shortness of breath

• Dizziness or headaches

  
  

But even before full-blown anaemia develops, people may experience subtle warning signs due to low iron stores. According to a review by Leung et al. (2024), these non-specific symptoms often go unnoticed, delaying diagnosis and treatment. These early signs can include persistent fatigue, poor concentration or brain fog, feeling cold more often than usual, low mood or increased irritability, brittle nails or hair thinning, and trouble sleeping or restless legs at night. Individually, these symptoms may seem minor, but together they can significantly impact daily life and often indicate the need for an iron blood test.

What Causes Low Iron?

Low iron, also referred to as iron deficiency, occurs when your body doesn’t have enough iron to support its normal functions. This can result from a variety of causes:

• Blood loss: This includes heavy or prolonged periods, internal bleeding (such as from ulcers or haemorrhoids), or surgery.

  
  

• Low dietary intake: Diets low in iron-rich foods, common among vegans, vegetarians, or people with disordered eating, can lead to deficiency.

  
  

• Poor absorption: Conditions like coeliac disease, inflammatory bowel disease (IBD), or chronic diarrhoea can reduce the body’s ability to absorb iron from food.

  
  

• Increased iron needs: Growing children, adolescents, and pregnant women need more iron due to rapid physical development or foetal demands.

  
  

As noted in a 2024 review by Cohen and Powers, adolescents and young adults, especially those with menstrual losses or restrictive diets, are at significantly increased risk of iron deficiency. Even without anaemia, low iron can impair physical and cognitive performance (Cohen & Powers, 2024).

The Most Common Symptoms of Low Iron

Iron deficiency symptoms vary depending on how low your iron levels are and how quickly the deficiency develops. While not everyone experiences every symptom, these are some of the most common:

1. Tiredness and Lack of Energy

Fatigue is one of the earliest and most common symptoms of low iron. Iron is essential for making haemoglobin, the protein in red blood cells that transports oxygen around the body. When iron levels are low, oxygen delivery to tissues and muscles is reduced, making even routine activities feel draining. This can result in persistent tiredness that doesn’t improve with rest or sleep. You may find yourself waking up already feeling exhausted or lacking the energy to get through the day.

For many, this leads to difficulty concentrating at work or school, reduced productivity, and a general sense of mental and physical slowdown. Over time, this ongoing fatigue can begin to affect emotional wellbeing, sometimes contributing to feelings of irritability or low mood.

2. Shortness of Breath

As the body receives less oxygen due to reduced haemoglobin levels, it tries to compensate by increasing breathing rate. This often results in shortness of breath, even with minimal exertion. People with iron deficiency may notice themselves becoming breathless during simple activities like walking upstairs, carrying shopping bags, or going for a short stroll. In more advanced cases, breathlessness might occur at rest or during sleep.

This symptom can be particularly frustrating for people who were previously active, as it limits mobility and makes exercise or daily chores more difficult. If left unaddressed, this reduced physical capacity can contribute to a more sedentary lifestyle and diminished cardiovascular fitness.

3. Heart Palpitations

Another symptom that can be both uncomfortable and alarming is heart palpitations. With less oxygen available in the bloodstream, the heart must work harder to circulate what is there, often beating faster and with more force. This extra effort can lead to a noticeable pounding or fluttering sensation in the chest. Some people describe it as their heart ‘racing’ unexpectedly, even while resting.

These episodes can be unsettling and sometimes misinterpreted as anxiety or a heart condition. While palpitations themselves are not usually dangerous in mild iron deficiency, they are a sign that the cardiovascular system is under strain, and should not be ignored.

4. Pale Skin

One of the physical signs of iron deficiency is a noticeably paler complexion. Haemoglobin not only carries oxygen but also gives blood its characteristic red colour. When haemoglobin is low, blood becomes less vibrant, and the skin, particularly on the face, inside the lower eyelids, or under the nails, may appear unusually pale. This can make people look tired or unwell, and often friends or family may notice it before the individual does.

In some cases, this paleness is accompanied by other symptoms like cold hands and feet or a general feeling of being chilled, which reflects how the body is prioritising blood flow to essential organs over extremities.

5. Headaches and Dizziness

Low iron levels can also affect the brain. With reduced oxygen delivery, the brain’s ability to function optimally is compromised. This may cause frequent headaches, often described as dull and persistent, and sometimes accompanied by dizziness or light-headedness. These symptoms can interfere with concentration, make working or studying difficult, and in severe cases, lead to fainting spells.

For individuals with demanding jobs or caregiving responsibilities, this can significantly reduce quality of life and overall functioning. While these symptoms can have many causes, they are common in people with iron deficiency — especially if other symptoms are also present.

Other, less common symptoms include:

• Cold hands and feet

• Brittle nails or hair loss

• Restless legs syndrome

• Craving non-food items (such as ice or chalk), known as pica

Low Iron Symptoms in Women

Women of childbearing age are particularly vulnerable to low iron due to menstrual blood loss. According to Camaschella (2019), even moderate period-related bleeding over months can deplete iron stores (Camaschella, 2019).

Pregnancy further increases iron needs due to blood volume expansion and the demands of the growing foetus. Without adequate dietary intake or supplementation, many pregnant women experience iron deficiency - sometimes without realising it.

Common signs in women include:

• Heavier than usual periods

• Tiredness that worsens premenstrually and during menstruation

• Hair thinning

• Lower mood or irritability

  
  

If you’re unsure whether your fatigue is hormonal, lifestyle-related, or something more, a simple iron blood test can help clarify the cause.

Low Iron Symptoms in Men

Although less discussed, iron deficiency in men can also have a significant impact on wellbeing. When present, it may indicate an underlying health issue - especially gastrointestinal bleeding or chronic inflammation.

Common signs in men include:

• Exercise intolerance

• Low stamina or reduced gym performance

• Pale skin tone

• Increased sensitivity to cold

• Mental fog or concentration difficulties

  
  

As Cohen and Powers (2024) explain, iron deficiency in men, particularly athletes, can go undiagnosed due to a lack of routine screening, despite its impact on energy and endurance (Cohen & Powers, 2024).

How to Test for Low Iron

Diagnosing low iron typically involves a simple blood test that measures several key indicators related to your iron levels and red blood cell health. The main tests include haemoglobin, which shows the amount of oxygen-carrying protein in your blood; serum iron, which measures the actual iron circulating in your bloodstream; and ferritin, which reflects your body’s iron stores. Sometimes, additional tests like transferrin saturation or total iron-binding capacity (TIBC) may be included to provide a fuller picture of your iron status.

These blood tests are straightforward and usually require only a small blood sample, often taken from a vein in your arm. Generally, you do not need to fast beforehand unless your healthcare provider specifies otherwise. This makes the test convenient and easy to fit into your schedule.

Once the sample is collected, results are typically available within 1 to 2 working days, allowing for prompt diagnosis and treatment planning. If you are in the Coventry area, Health Klinix offers fast, reliable blood testing services, and you can book a test online or speak to their team if you have concerns about your iron levels.

If low iron or anaemia is confirmed, your healthcare provider will discuss the next steps, including possible treatments and follow-up testing to monitor your progress.

Book a test today with Health Klinix Blood Tests. For local services, you can easily arrange a Coventry blood test through our clinic.

Book a Blood Test in Coventry

If you’re experiencing fatigue, breathlessness, or other low iron symptoms, don’t ignore them. The expert team at Health Klinix offers quick and reliable blood tests for iron and full anaemia screening.

• Book a Men’s Blood Test

• Book a Women’s Blood Test

  
  

Regular health checks, especially for those with risk factors or persistent symptoms, are a powerful way to protect your wellbeing.

How is Low Iron Treated?

Treatment depends on the cause and severity of the deficiency:

• Dietary changes: Increase iron-rich foods like red meat, lentils, spinach, chickpeas, pumpkin seeds, fortified cereals, and tofu.

  
  

• Oral supplements: Most people with low iron will be prescribed iron tablets. The dose and duration vary, but they are typically taken for at least 3 months to fully replenish stores (Leung et al., 2024).

  
  

• Intravenous iron: In severe cases, or where oral supplements are poorly tolerated, IV iron may be used, offering quicker correction (Camaschella, 2019).

  
  

• Treating the underlying cause: Whether that’s managing heavy periods, treating coeliac disease, or addressing gastrointestinal bleeding, the root cause must also be tackled to prevent recurrence.

  
  

As emphasised by Clay T. Cohen and Jacquelyn M. Powers in their 2024 review, effective iron therapy also includes advice on when and how to take supplements—such as avoiding calcium-rich drinks and taking iron on an empty stomach to maximise absorption (Cohen & Powers, 2024).

References

1. Camaschella, C. (2019). Iron deficiency. Blood, 133(1), 30–39.

2. Leung, A. K. C., et al. (2024). Iron Deficiency Anemia: An Updated Review. Current Pediatric Reviews, 20(3), 339–356.

3. Cohen, C. T., & Powers, J. M. (2024). Nutritional Strategies for Managing Iron Deficiency in Adolescents. Advances in Nutrition, 15(5), 100215.

Written by:

James Hadland, MPhil Graduate, University of Cambridge

Approved by:

Dr Ravi Gowda, Consultant Physician, MBBS, MRCP(UK), DTM&H, MRCGP, DCH, DRCOG, DFFP