Iron is an essential nutrient that supports various bodily functions, most notably the production of haemoglobin, a protein in red blood cells that carries oxygen from the lungs to the rest of the body. Iron also plays a role in energy production, immune function, and the synthesis of certain hormones.
Signs and Symptoms of Low Iron
Low iron can result in a wide range of signs and symptoms. These include:
Fatigue: Feeling unusually tired and lacking energy is one of the most common symptoms. This happens because your body is not getting enough oxygen to its cells, making it harder to perform everyday tasks.
Pale Skin: Haemoglobin gives blood its red colour, so low levels can make your skin appear paler than usual. This can be noticeable on the face, the inner part of the lower eyelids, and the nails.
Shortness of Breath: Without sufficient iron, your body struggles to transport oxygen effectively, which can lead to shortness of breath, especially during physical activity.
Heart Palpitations: Iron deficiency can cause your heart to work harder to carry oxygen, which may lead to irregular heartbeats or palpitations.
Headaches and Dizziness: Reduced oxygen delivery to the brain can cause headaches and dizziness.
Cold Hands and Feet: Poor blood circulation due to low iron levels can make your extremities feel cold.
Brittle Nails and Hair: Iron deficiency can affect the health of your hair and nails, making them brittle and prone to breaking.
Sore or Swollen Tongue: A lack of iron can cause your tongue to become swollen, inflamed, or sore. You may also notice changes in its texture.
Restless Legs Syndrome: Iron deficiency has been linked to restless legs syndrome, a condition that causes an uncomfortable urge to move your legs, especially at night.
Cravings for Non-Food Items: Known as pica, this involves cravings for non-nutritive substances like ice, dirt, or starch.
Poor Concentration: Low iron levels can impair cognitive functions, leading to difficulty concentrating and reduced performance at work or school.
Types of Iron Tests
It's important to discuss any signs and symptoms of low iron with your GP who will typically refer you for blood tests. There are several blood tests which are used to assess iron status:
Serum Ferritin Test: Measures the amount of stored iron in your body. Low ferritin levels indicate depleted iron stores and possible iron deficiency.
Haemoglobin Test: Measures the amount of haemoglobin in your blood. Low levels can indicate anaemia, often due to iron deficiency.
Serum Iron Test: Measures the amount of iron in your blood. This test can fluctuate throughout the day and is often used alongside other tests for a comprehensive assessment.
Total Iron-Binding Capacity (TIBC): Measures the blood's capacity to bind iron with transferrin (a protein that transports iron). High TIBC can indicate low iron levels.
Transferrin Saturation: Calculates the percentage of transferrin that is saturated with iron. Low saturation levels can suggest iron deficiency.
People at Risk of Low Iron
Certain groups are more susceptible to iron deficiency:
Vegetarians and Vegans: Plant-based diets contain non-haem iron, which is less easily absorbed by the body compared to haem iron from animal products.
Women of Childbearing Age: Menstruation can lead to significant iron loss.
Pregnant Women: Increased blood volume and the needs of the growing foetus raise iron requirements.
Infants and Young Children: Rapid growth increases their iron needs.
Athletes: Intense physical activity can increase iron loss through sweat and gastrointestinal bleeding.
People with Certain Medical Conditions: Conditions like coeliac disease, Crohn's disease, and ulcerative colitis can affect iron absorption.
Sources of Iron
Animal Sources (Haem Iron)
Red meat, poultry, and fish
Liver and other organ meats
Plant Sources (Non-Haem Iron)
Legumes: Lentils, chickpeas, beans, and soybeans
Nuts and Seeds: Pumpkin seeds, hemp seeds, chia seeds, and cashews
Whole Grains: Quinoa, fortified cereals, oats, and brown rice
Vegetables: Spinach, kale, swiss chard, broccoli, and bok choy
Dried Fruits: Apricots, raisins, prunes, and figs
Other Sources: Tofu, tempeh, and nutritional yeast (fortified)
Tips For Enhancing Iron Absorption
Vitamin C captures non-heme iron and stores it in a form that’s more easily absorbed by your body. Include vitamin C rich fruit and vegetables with meals to enhance iron absorption. Good sources of vitamin C include pepper, broccoli, cabbage, Brussels sprouts, kiwi fruits, oranges, strawberries, pineapple, grapefruit and orange juice.
Avoid drinking tea or coffee with meals or straight after a meal as this can reduce absorption. In one study, drinking a cup of black tea with a meal reduced iron absorption by 60–70%. This is because coffee and tea have a high content of polyphenols which have been shown to inhibit the absorption of non-heme iron.
Calcium-rich foods such as dairy can also reduce absorption. Try and avoid calcium-rich foods in an iron-rich meal.
Bran, grains, legumes, and nuts contain substances known as phytates.
Phytates may interfere with the absorption of iron and other nutrients if consumed in large quantities. However, evidence for this is quite varied and not fully conclusive. Soaking or fermenting phytate-rich foods before eating them may help increase iron absorption.
Cook Vegetables: Cooking foods, especially leafy greens, can reduce oxalate levels, which can inhibit iron absorption.
Iron Supplements
Iron should only be supplemented in the case of a documented deficiency and under professional advice. Ingesting too much iron from supplements can cause health complications and prevent the absorption of other nutrients.
For personalised advice do feel free to get in touch.
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