Iron deficiency anaemia

Iron deficiency anaemia is caused by lack of iron, often because of blood loss or pregnancy. It can be treated with iron tablets prescribed by a GP and by eating iron-rich foods.

Check if you have iron deficiency anaemia

Symptoms can include:

• tiredness and lack of energy
• shortness of breath
• noticeable heartbeats (heart palpitations)
• pale skin

Less common symptoms of iron deficiency anaemia (that are not usually connected to pregnancy) include:

• headaches
• hearing ringing, buzzing or hissing noises inside your head (tinnitus)
• food tasting strange
• feeling itchy
• a sore tongue
• hair loss – you notice more hair coming out when brushing or washing it
• wanting to eat non-food items, such as paper or ice (pica)
• finding it hard to swallow (dysphagia)
• painful open sores (ulcers) in the corners of your mouth
• spoon-shaped nails
• restless legs syndrome

See a GP if you have symptoms of iron deficiency anaemia. A blood test will confirm if you're anaemic.

What happens at your appointment

Your GP will ask you about your lifestyle and medical history.

If the reason for the anaemia isn't clear, they might order tests to find out what might be causing the symptoms.

They might also refer you to a specialist for further checks.

Blood tests for iron deficiency anaemia

Often, the first test a GP uses to diagnose iron deficiency anaemia is a full blood count (FBC). The FBC measures many parts of your blood. The test checks your haemoglobin. Haemoglobin is the iron-rich protein in red blood cells that carries oxygen to the body.

You don't need to do anything to prepare for this test.

Iron deficiency anaemia is the most common type of anaemia. There are others, like vitamin B12 and folate anaemia, which the blood test will also check for.

Treatment for iron deficiency anaemia

Once your GP knows the reason for your anaemia, they will recommend treatment.

If a blood test shows a low red blood cell count (deficient), you'll be prescribed iron tablets. These will replace the iron missing from your body.

These tablets are stronger than the ones you can buy in pharmacies and supermarkets.

You'll have to take them for about 6 months. Drinking orange juice after you've taken them may help your body absorb the iron.

Some people get side effects like:

• constipation or diarrhoea
• tummy pain
• heartburn
• feeling sick
• black poo

Try taking the tablets with food or soon after food to reduce the chance of side effects.

Keep taking the tablets even if you get side effects.

Your GP may carry out repeat blood tests over the next few months to check that your iron levels are back to normal.

Things you can do yourself

If your diet is a cause of your anaemia, your GP will tell you what foods are rich in iron so you can eat more of them.

Meats, pulses, cereals and dark-green, leafy vegetables are good sources of iron.

Large amounts of certain foods and drinks make it harder for your body to absorb iron. Drink less tea and coffee and eat less dairy.

Foods with high levels of phytic acid can stop your body absorbing iron. For example wholegrain cereals.

You might be referred to a specialist dietician if you're finding it hard to include iron in your diet.

Causes of iron deficiency anaemia

If you're pregnant, iron deficiency anaemia is most often caused by a lack of iron in your diet.

Heavy periods and pregnancy are very common causes of iron deficiency anaemia. Heavy periods can be treated with medication.

Iron deficiency anaemia can be a sign of bleeding in the stomach and intestines. It can happen in men and women whose periods have stopped.

It can be caused by:

• taking non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and aspirin
• stomach ulcers
• swelling of the large intestine (colitis) or of the food pipe (oesophagus)
• piles
• cancers of the bowel or stomach – but this is less common

Any other condition or action that causes blood loss can lead to iron deficiency anaemia.

If you leave your iron deficiency anaemia untreated

Untreated iron deficiency anaemia can:

• make you more at risk of illness and infection – a lack of iron affects the immune system
• increase your risk of developing heart or lung complications (such as heart failure)
• cause a greater risk of complication before, during and after pregnancy