Anaemia iron deficiency living in adults

Overview

Anaemia is a condition where your blood doesn't have enough healthy red blood cells to carry oxygen around your body. Iron deficiency anaemia is the most common type, caused by low levels of iron in the body. Iron is needed to make haemoglobin, the part of red blood cells that carries oxygen.

Yes, iron deficiency anaemia is one of the most common nutritional deficiencies worldwide. In the UK, it affects about 1 in 20 men and 1 in 8 women at some point in their lives.

It can affect anyone, but it is more common in women who have heavy periods, pregnant women, people on restrictive diets (like vegans or vegetarians without careful planning), people with conditions that cause blood loss (such as stomach ulcers or bowel problems), and older adults who may have poor nutrition or absorption issues.

Symptoms

Common symptoms

• Feeling very tired and lacking energy
• Shortness of breath, even with mild activity
• Pale skin, lips, and inner eyelids
• Cold hands and feet
• Headaches and dizziness
• Heart palpitations (feeling your heart pound or race)
• Brittle nails or a sore tongue
• Unusual cravings for non-food items like ice, dirt, or starch (a condition called pica)

Symptoms in children

• In children, symptoms can include tiredness, irritability, poor appetite, and slower growth and development.

Symptoms in older adults

• In older adults, symptoms may be less obvious and can be mistaken for normal aging. They may include confusion, weakness, falls, and worsening of other health conditions like heart failure.

Causes

Main causes

• Blood loss: This is the most common cause in adults, especially from heavy periods (menorrhagia) or slow, hidden bleeding in the stomach or bowel (such as from ulcers, polyps, or colon cancer).
• Poor iron intake: Not eating enough iron-rich foods, especially in restrictive diets or in older adults with poor appetite.
• Poor iron absorption: Conditions like coeliac disease, Crohn's disease, or after gastric surgery can prevent the body from absorbing iron from food.
• Increased iron needs: Pregnancy and breastfeeding increase the body's need for iron.

Risk factors

• Being a woman of childbearing age (especially with heavy periods)
• Having a diet low in iron (e.g., vegan or vegetarian without enough iron sources)
• Having a gastrointestinal disorder that affects absorption
• Regular use of medications like aspirin or ibuprofen that can cause stomach bleeding
• Being over 65

When to see a doctor

See a doctor urgently if:

• If you have symptoms of anaemia and you are also pregnant or have a history of heart disease.
• If you notice any unexplained bleeding (from bowel, vomit, or heavy periods).
• If your symptoms are severe, such as fainting or severe shortness of breath.

Book a routine appointment if:

• If you have been feeling tired or weak for several weeks without a clear reason.
• If you have noticed changes in your skin colour, have brittle nails, or have unusual cravings for non-food items.
• If you are at higher risk (e.g., heavy periods, vegetarian diet) and want to check your iron levels.

Diagnosis

Your doctor will ask about your symptoms, diet, and any history of bleeding. They will also perform a physical examination, looking for signs of anaemia like pale skin and a fast heart rate. The main way to diagnose iron deficiency anaemia is through a blood test.

Tests that may be done

• Full blood count (FBC): This checks your red blood cell count and haemoglobin levels.
• Iron studies: Blood tests that measure your iron levels, ferritin (iron storage), and transferrin (a protein that carries iron). Low ferritin usually means iron deficiency.
• Other tests: Your doctor may recommend tests to find the cause, such as a stool test for hidden blood, an endoscopy (camera test to look at the stomach and bowel), or a test for coeliac disease.

What to expect at your appointment

A blood test is quick and simple. Your doctor may take blood from a vein in your arm. Results usually come back within a few days. If you are diagnosed with iron deficiency anaemia, your doctor will work with you to find the cause and start treatment. They may refer you to a specialist if they suspect an underlying condition.

Treatment

Treatment for iron deficiency anaemia focuses on increasing your iron levels and treating the underlying cause. Most people will be prescribed iron supplements and advised to eat more iron-rich foods. It is important to take supplements exactly as directed and to continue them even after you feel better, to fully replenish your iron stores. Your doctor will monitor your blood counts to check progress.

Self-care at home

• Eat a balanced diet with plenty of iron-rich foods like red meat, beans, lentils, fortified cereals, and dark leafy greens.
• Eat vitamin C rich foods (like oranges, peppers, tomatoes) with iron-rich meals to help absorption.
• Avoid drinking tea or coffee with meals, as they can reduce iron absorption.
• If you take iron supplements, take them on an empty stomach if possible, but with food if they upset your stomach.

Medical treatments

Your doctor may prescribe iron supplements (usually tablets) to take at home. These come in different strengths and formulations. You may need to take them for several months. If you cannot tolerate oral iron or have very low levels, you may need iron given through a drip (intravenous iron) in the hospital. Your doctor will decide the best approach for you based on the severity of your anaemia and your overall health.

Living with this condition

Living with iron deficiency anaemia can be challenging, especially when you feel very tired and short of breath. It is important to listen to your body and rest when needed. Once you start treatment, your energy levels should improve gradually over a few weeks. Keep taking your supplements as prescribed and attend follow-up appointments to monitor your recovery.

Lifestyle tips

• Try to pace yourself and avoid overexertion until your energy returns.
• Plan your meals to include iron-rich foods and pair them with vitamin C to improve absorption.
• If you smoke, consider quitting, as smoking worsens the effect of anaemia on your heart and lungs.
• Stay active with gentle exercise like walking or yoga, as your energy improves.

Diet and exercise

Eat a varied diet that includes good sources of iron. Aim for two servings of red meat a week if you eat meat, or more plant sources like beans, lentils, tofu, spinach, and fortified breakfast cereals. Pair these with foods rich in vitamin C. As you recover, gentle physical activity can help rebuild strength, but do not push yourself too hard. Speak to your doctor before starting a new exercise program.

Mental health and emotional wellbeing

Feeling constantly tired and unwell can take a toll on your mood and mental health. You may feel frustrated, anxious, or low. It is normal to feel this way, but if it persists, talk to your doctor or a mental health professional. You are not alone, and support is available. If you have thoughts of harming yourself, please call your local emergency number or a crisis helpline immediately.

Prevention

In many cases, iron deficiency anaemia can be prevented by eating a balanced diet rich in iron and vitamin C, especially if you are at higher risk. People with heavy periods or conditions that cause blood loss should have regular check-ups and may need supplements. However, some causes, like inherited conditions, cannot be prevented, but early detection helps.

Complications

If left untreated

• Heart problems: Anaemia makes your heart work harder to pump oxygen, which can lead to an enlarged heart, irregular heartbeat, or heart failure.
• Increased risk of infections: Normal immune function depends on adequate iron.
• Pregnancy complications: Untreated anaemia in pregnancy increases the risk of premature birth, low birth weight, and postpartum depression.
• Growth and development issues in children.
• Restless legs syndrome and pica (cravings for non-food items).

Long-term outlook

For most people, iron deficiency anaemia is easily treated and does not cause long-term harm. Once the cause is found and corrected, and iron levels are restored, symptoms usually go away completely. It is important to stay in touch with your doctor and take your treatment seriously. With proper care, you can feel well and healthy again.

Find support

Local organisations

• NHS ↗ · UK

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