Iron deficiency and anaemia

Heavy periods can leave you short of iron. Pregnancy is another common cause of anaemia from low iron. If tiredness or breathlessness is becoming part of everyday life, talk to a GP or doctor about both the symptoms and the bleeding.

How iron deficiency can lead to anaemia

Your body uses iron to make haemoglobin. This is the protein in red blood cells that carries oxygen around the body. Iron deficiency anaemia happens when there isn’t enough iron. Your iron stores can run low before you notice any symptoms, so how you feel can’t tell you the whole story.

Anaemia can also have causes other than low iron, such as low vitamin B12 or folate. Feeling tired doesn’t always mean you need iron. Blood tests help your clinician check the possible causes.

Symptoms to describe at an appointment

Call 999 now (UK) or 911 (US), or your local emergency number, if you have severe difficulty breathing, can’t get words out, or your chest feels tight or heavy.

Contact NHS 111 today (UK), or your doctor or urgent care service (US or elsewhere), if you are more short of breath than usual.

Anaemia from low iron can cause tiredness, low energy, shortness of breath, a heartbeat you can feel, headaches and skin that looks paler than usual. Some people with mild or moderate anaemia have no symptoms. Symptoms alone can’t confirm the condition or rule it out.

Less common symptoms include a sore tongue, hair loss, restless legs, or wanting to eat things that aren’t food, such as paper or ice. Mention these if you have them, even if they seem to have nothing to do with your periods. Tell your clinician what has changed, even if you’re not sure which symptoms matter most.

Finding out why iron is low

Losing blood takes iron out of the body. Heavy periods may be the reason, but bleeding from the stomach or bowel is another possibility. Some conditions that affect the gut, including coeliac disease, can stop your body taking in iron properly. A clinician may need to look at more than your diet.

During pregnancy, you need more iron for you and the growing baby. Tell your midwife or doctor about any tiredness, what you eat and any supplements you already take. WHO recommends iron and folic acid during pregnancy to help prevent anaemia and other problems. Ask your maternity team how this fits your local pregnancy care plan.

What the blood tests are looking for

The NHS describes a full blood count (FBC), which looks at your blood cells. In US information it’s called a complete blood count (CBC). Other tests can include haemoglobin, iron in the blood and ferritin, which shows how much iron is stored. Your clinician will explain what the results mean alongside your symptoms and history.

If the reason for anaemia isn’t clear, you may need more checks. These could include a test of your poo for blood, or seeing a specialist. Ask what each test is checking and when you’ll get the result. If heavy periods are part of the cause, ask about treatment for the bleeding as well as replacing iron.

Food and prescribed treatment

Foods rich in iron include beans, lentils, dark green leafy vegetables, fortified cereals and bread, dried fruit and meat. Foods rich in vitamin C, such as oranges, strawberries and tomatoes, help your body take in iron. You can ask for food ideas that fit your budget and the way you eat.

If you’re diagnosed with anaemia from low iron, it’s often treated with iron tablets while the cause is dealt with. Some people need iron given through a vein. Your doctor or pharmacist can advise about the medicine and how to take it. You may have more blood tests to check it’s working.

Ask for advice about supplements

Too much iron can be harmful, and supplements can interact with medicines. If you keep taking supplements for tiredness without getting checked, the cause may be missed. Ask your GP or doctor about tests and a plan to review things. Don’t stop prescribed treatment without talking to the prescriber. If iron gives you side effects, talk to your doctor or pharmacist.

Keep iron tablets out of children’s reach, because an overdose can kill. When you book a GP appointment in the UK, or see your doctor in the US or elsewhere, bring the supplement packet. Describe any heavy bleeding as well as the symptoms that made you seek help.