Am I Iron deficient? And why should I care?


The most common symptom of iron deficiency is tiredness, but other symptoms include weakness, light headedness, fainting, shortness of breath, mouth ulcers, and heart palpitations. Sometimes people might get brittle nails or cravings for unusual non-nutritive foods such as dirt.


Iron deficiency itself is not a diagnosis, it is a symptom.


It is a sign that you are either not getting enough iron into your body, you are not absorbing iron properly or you are losing too much iron.


The most obvious cause of not getting enough iron into your body is by having insufficient iron in your diet. E.g., if you are a vegan or a vegetarian.


The most common reason someone might not be absorbing iron properly may be if they have Coeliac disease, or a gluten allergy causing damage to the lining of the gut and an inability to absorb iron.


The most common reason someone might be losing too much iron might be via heavy periods, slow loss of blood from a small polyp in their colon or a bacterium in their stomach such as Helicobacter Pylori which causes inflammation of the lining of the stomach and loss of iron.


It is important to know what the cause of your iron deficiency is so that your doctor can help you correct the cause of your deficiency and prevent recurrent iron deficiency rather than just replace the iron. Not often, but sometimes your iron deficiency can be a sign that something is very wrong such as a bowel cancer which is slowly bleeding and causing you to lose iron. Simply taking an iron tablet will mean that this important diagnosis which can be curable when diagnosed early

will be missed.


So how is iron deficiency diagnosed?


Iron deficiency is easy to diagnose with a blood test from your doctor who can also help assess the severity. Iron deficiency when severe and prolonged can develop into iron deficiency anaemia where your body does not make enough red blood cells and they are small and pale. This is usually when the symptoms of iron deficiency become much more noticeable.


There are two aspects to treating iron deficiency.


Firstly, treating the cause of the deficiency and secondly treating the iron deficiency itself.


Treating the cause obviously depends on what the cause is. It may involve increasing the iron content of your diet if a vegetarian diet is the cause of the deficiency, if coeliac disease is the diagnosis, it will involve cutting gluten completely from your diet and linking in with a gastroenterologist, if heavy periods are the diagnosis there are lots of different treatment options you can discuss with your GP.


Treating the iron deficiency itself initially will involve increasing the iron content of your diet with iron rich foods such as red meat, and green leafy vegetables, and having iron rich foods with vitamin C. e.g., a glass of orange juice. If you are a vegetarian and eating red meat is not an option or it is simply not possible to get enough iron from your diet, iron supplements might be recommended by your doctor. In general, they will recommend 100mg of elemental iron per day.


Common side effects of iron supplements are turning your stool black (don’t panic! we, expect this), nausea and constipation. It is also important to take iron supplements on an empty stomach and not eat for 1 hr afterwards so that absorption is not impaired. Other medications should not be taken with iron supplements either. Some iron supplements are less likely to have these side effects (ask your doctor about these).


If you are unable to tolerate oral iron supplements due to side effects or if on repeat blood tests your iron levels have not come up enough, you may be eligible for an iron infusion. This can be done with your local GP.


Helpful Resources

1. Health Direct: Iron deficiency – symptoms, causes, treatment & prevention <03/07/2022 > (http://www.healthdirect.gov.au/iron-deficiency)


2. Baird-Gunning, J & Bromley J. Correcting Iron Deficiency, Australian Prescriber, 19/12/16. <03/07/2022> (Correcting iron deficiency - Australian Prescriber (nps.org.au))