Role of Hemoglobin and Oxygen Transport
Extreme Fatigue and Physical Weakness The most common symptom of iron deficiency is a sense of extreme fatigue that does not improve with rest. This occurs because your body lacks enough iron to produce hemoglobin, the protein responsible for transporting oxygen to your tissues. When less oxygen reaches your muscles and tissues, you will constantly feel lethargic, weak, and lacking the energy required for daily activities.
Physical Appearance and Skin Changes
The red color of blood is due to the presence of hemoglobin; therefore, low iron levels cause the blood to appear less red. This results in the skin, especially in areas like the face, the inside of the lower eyelids, or the nails, appearing pale or yellowish. This is one of the first signs doctors look for during a clinical examination.
Impact on Cardiovascular Function
When hemoglobin levels are low, the heart must work harder to move oxygen throughout the body. This added pressure can lead to heart palpitations, irregular heartbeats, or a feeling of shortness of breath, even during light activities like a simple walk. In severe cases, this condition can lead to an enlarged heart or heart failure.
Neurological and Temperature Sensations
A lack of oxygen in the brain can cause blood vessels to swell and create pressure, resulting in persistent headaches and dizziness. Additionally, because the body prioritizes sending blood to vital organs, blood flow to the extremities is reduced, causing a person to constantly feel cold in their fingers and toes.
Unusual Cravings and Pica Disorder
One of the strangest signs of iron deficiency is a disorder called Pica. In this state, a person experiences intense cravings for non-nutritional substances such as ice, dirt, chalk, or paper. Craving ice (pagophagia) is a very common sign among those with severe anemia, which usually disappears after treatment and iron replenishment.
Changes in Hair, Nails, and Tongue
Iron is essential for the health of the body's epithelial tissues. A deficiency can cause hair loss, brittle nails, or spoon-shaped nails (koilonychia). Additionally, the tongue may appear swollen, inflamed, or unnaturally smooth, and cracks may develop at the corners of the mouth, making eating and drinking difficult.
Diagnostic Blood Testing
For a definitive diagnosis, a doctor will order a Complete Blood Count (CBC) to check hemoglobin and red blood cell levels. Furthermore, a Ferritin test is vital as it shows the level of the body's iron stores. In the early stages of iron deficiency, hemoglobin may be normal while ferritin levels drop, indicating the depletion of iron stores has begun.
Oral Iron Supplementation
The first line of treatment is usually the use of iron tablets or capsules. These supplements must be taken according to a doctor's instructions. For maximum absorption, it is best to take iron along with Vitamin C (such as a glass of orange juice). Taking iron simultaneously with calcium, tea, or coffee can reduce absorption by up to 50%, so a time gap must be maintained.
Nutritional Strategy and Diet
Alongside medication, consuming iron-rich foods is essential. There are two types of iron: "Heme" iron (found in animal sources like red meat and liver), which has very high absorption, and "Non-Heme" iron (found in plant sources like lentils, spinach, and legumes), which is less easily absorbed. Combining plant sources with citrus fruits or meat can significantly increase the absorption of plant-based iron.
Recovery Timeline and Root Causes
Treating iron deficiency is not a short-term process and usually requires several months to fully replenish the body's stores. If a person cannot tolerate tablets or suffers from severe malabsorption, a doctor may prescribe intravenous (IV) iron. It is crucial to identify and treat the underlying cause (such as stomach bleeding or heavy menstruation) so that the iron deficiency does not recur.
