Your body needs iron to make healthy red blood cells. Iron-deficiency anemia usually develops over time because your body’s intake of iron is too low. Low intake of iron can happen because of blood loss, consuming less than the recommended daily amount of iron, and medical conditions that make it hard for your body to absorb iron from the gastrointestinal tract (GI tract).
When you lose blood, you lose iron. Certain conditions or medicines can cause blood loss and lead to iron-deficiency anemia. Common causes of blood loss that lead to iron-deficiency anemia include:
Iron-deficiency anemia can be caused by getting less than the recommended daily amounts of iron. The recommended daily amounts of iron will depend on your age, sex, and whether you are pregnant or breastfeeding.
Even if you consume the recommended daily amount of iron, your body may not be able to absorb the iron. Certain conditions or medicines can decrease your body’s ability to absorb iron and lead to iron-deficiency anemia. These conditions include:
Other medical conditions that may lead to iron-deficiency anemia include:
Are you curious about how inflammation from chronic diseases can cause iron-deficiency anemia?
When there is inflammation, your liver makes more of a hormone called hepcidin. Hepcidin prevents iron from leaving cells where it is stored or from being absorbed in the duodenum, the first part of the small intestine just beyond the stomach.
You may be at increased risk for iron deficiency at certain ages:
Von Willebrand disease is an inherited bleeding disorder that affects the blood’s ability to clot. This makes it harder to stop bleeding and can increase the risk of iron-deficiency anemia from trauma, surgery, or heavy menstrual periods.
Individuals with a gene for hemophilia, including symptomatic female carriers who have heavy menstrual periods, may be at risk for iron-deficiency anemia.
Certain lifestyle habits may increase your risk for iron-deficiency anemia, including:
Girls and women between the ages of 14 and 50 years need more iron than boys and men of the same age. Women are at higher risk for iron-deficiency anemia under some circumstances, including:
Your doctor may screen you for iron-deficiency anemia if you have certain risk factors, including pregnancy. To prevent iron-deficiency anemia, your doctor may recommend you eat heart-healthy foods or control other conditions that can cause iron-deficiency anemia.
If you have certain risk factors, such as if you are following a vegetarian eating pattern, your doctor may recommend changes to help you meet the recommended daily amount of iron. If you have other medical conditions that cause iron-deficiency anemia, such as bleeding in the digestive or urinary tract or heavy menstrual bleeding, your doctor will want to control these other conditions to prevent you from developing iron-deficiency anemia.
If you are pregnant, talk to your doctor about delayed clamping of your newborn’s umbilical cord at the time of delivery. This may help prevent iron-deficiency anemia in your newborn for both full-term and preterm infants.
Common signs of iron-deficiency anemia include:
Common symptoms of iron-deficiency anemia include:
Undiagnosed or untreated iron-deficiency anemia may cause the following complications:
In people with chronic conditions, iron-deficiency anemia can make their condition worse or result in treatments not working as well.
Iron-deficiency anemia may be detected during routine blood tests when you visit your doctor for a checkup. To diagnose iron-deficiency anemia, your doctor may ask you questions about your risk factors, do a physical exam, or order blood tests or other diagnostic tests.
Your doctor may ask about your medical history and any symptoms you are experiencing, and do a physical exam to look for any of the following signs that may help diagnose iron-deficiency anemia:
Based on results from blood tests to screen for iron-deficiency anemia, your doctor may order the following blood tests to diagnose iron-deficiency anemia:
To help diagnose iron-deficiency anemia, your doctor will consider your CBC, hemoglobin, blood iron levels, MCV, and ferritin levels to determine if you have iron-deficiency anemia or another type of anemia. You may be diagnosed with iron-deficiency anemia if you have low iron or ferritin levels in your blood.
More testing may be needed to rule out other types of anemia.
To see if gastrointestinal bleeding is causing your iron-deficiency anemia, your doctor may order the following procedures to guide treatment.
What if my doctor thinks something else is causing my iron-deficiency anemia?
To find the cause of your iron-deficiency anemia, your doctor may order additional tests:
Treatment for iron-deficiency anemia will depend on its cause and severity. Treatments may include iron supplements, procedures, surgery, and dietary changes. Severe iron-deficiency anemia may require intravenous (IV) iron therapy or a blood transfusion.
Your doctor may recommend that you take iron supplements, also called iron pills or oral iron, by mouth once or several times a day to increase the iron in your body. This is the most common treatment for iron deficiency. It generally takes three to six months to replenish your iron stores.
Iron supplements are sometimes recommended by your doctor during pregnancy. If your condition is caused by certain rare genetic conditions, such as a TMRPSS6 gene mutation, you may not respond to oral iron supplements.
Iron supplements are generally not recommended for people who do not have iron-deficiency anemia. This is because too much iron can damage your organs.
Do not stop taking your prescribed iron supplements without first talking to your doctor. Talk to your doctor if you are experiencing side effects such as a bad metallic taste, vomiting, diarrhea, constipation, or upset stomach. Your doctor may be able to recommend options such as taking your supplements with food, lowering the dose, trying a different type of iron supplement, or receiving intravenous (IV) iron.
If iron supplements alone are not able to replenish the levels of iron in your body, your doctor may recommend a procedure, including:
To help you meet your daily recommended iron levels, your doctor may recommend that you:
If you have chronic kidney disease and iron-deficiency anemia, your doctor may recommend erythropoiesis stimulating agents (esa). These medicines stimulate the bone marrow to make more red blood cells. ESAs are usually used with iron therapy or IV iron, or when iron therapy alone is not enough.
Do not stop taking your prescribed iron supplements without first talking to your doctor. Talk to your doctor if you are experiencing side effects such as a bad metallic taste, vomiting, diarrhea, constipation, or upset stomach. Your doctor may be able to recommend options such as taking your supplement with food, lowering the dose, trying a different type of iron supplement, or receiving intravenous (IV) iron.
You may have fatigue and other symptoms of iron-deficiency anemia until your iron levels return to normal, which can take months. Tell your doctor if you have any new symptoms or if your symptoms get worse, especially if you experience chest pain or feel like your heart is beating irregularly.
Tell any doctors you see for other conditions that you have iron-deficiency anemia. Iron-deficiency anemia can make other conditions, such as HIV, worse or harder to treat. Tell your doctor what medicines you take, even over-the-counter medicines or other supplements. Iron supplements can change how certain medicines work.
Your doctor may suggest check-ups to make sure your iron and hemoglobin levels are improving and staying at healthy levels. Your doctor may:
To prevent complications from iron-deficiency anemia, your doctor may recommend heart-healthy eating and choosing iron-rich foods, especially during certain stages of life when more iron is needed, such as childhood and pregnancy. Good sources of iron are meat, poultry, fish, and iron-fortified foods that have iron added.
Vegetarian diets can provide enough iron if you choose nonmeat sources of iron, including iron-fortified breads and cereals, beans, tofu, dried fruits, and spinach and other dark green leafy vegetables. You can also take an iron supplement.
Follow your doctor’s recommendations and treatments to control any conditions that lead to iron-deficiency anemia to prevent complications such as abnormal heart rhythms and depression.
Tell your doctor if you have any new symptoms or if your symptoms get worse, especially if you experience chest pain or feel your heart is beating irregularly.
Talk to your doctor about returning to everyday activities. Because iron-deficiency anemia can make you feel weak, you should be cautious when resuming certain activities, such as physical activity. Older adults, who are more likely to fall, should be especially cautious when resuming activities.
Learn about the following ways that NHLBI continues to translate current research into improved health for people with iron-deficiency anemia.
In support of our mission, we are committed to advancing research on anemia, in part through the following ways.
Learn about exciting research areas that NHLBI is exploring about iron-deficiency anemia.
We lead or sponsor many studies related to iron-deficiency anemia. See if you or someone you know is eligible to participate in our clinical trials.