10 signs that show you may have an Iron Deficiency

Iron is an extremely important nutrient, which is involved in many functions of the human body. It is necessary to maintain its levels at normal values and, in case of insufficiency, to restore its values immediately [1] [2].

Iron deficiency affects a large part of the total population, as it is present in both industrial and developing countries, and occurs mainly in women of reproductive age [1] [2].

Iron deficiency can occur with or without anemia (iron deficiency anemia or IDA). Symptoms vary and usually include fatigue, paleness, shortness of breath, susceptibility to infections and pica syndrome [1] [7].

At younger ages, iron deficiency is associated with reduced cognitive function and learning difficulties, while in infancy and early childhood it disrupts socio-emotional & neurophysiological development. The results in this case may be irreversible [2] [5].

The following are the main signs of iron deficiency:

1. Restless Legs Syndrome (RLS)

Restless Legs Syndrome is an irresistible urge for constant movement of the legs and usually occurs at night or in cases of physical inactivity [4] [20].

This neurological condition significantly reduces quality of life, as it often leads to anxiety and depression, and is associated with an increased risk of cardiovascular disease [4] [20].

There are a number of studies that support the association between low iron levels and the occurrence of RLS [4] [7] [20]. In particular, it has been shown that the prevalence of this syndrome is 4-5 times higher in people with iron deficiency anemia than in the rest of the population, while its manifestation is more intense and potentially harmful [4].

2. Spoon Nails

A significant proportion of people with iron deficiency and/or iron deficiency anemia have brittle nails and, in some cases, spoon nails [5] [7] [21].

Spoon Nails are characterized by abnormal curvature of the nails, which are particularly thin and brittle. This phenomenon can be observed in newborns, children and adults [21].

When a person develops this symptom, it is imperative to look for the cause. Among the many pathological conditions that can lead to abnormally curved and brittle nails, one of the main ones is iron deficiency anemia [21].

3. Pica Syndrome & Ice Pica

Pica disorder is characterized by compulsive and long-term consumption of non-nutrients (geophagy, ice-eating, etc.). It has been strongly associated with iron deficiency and occurs mainly during pregnancy [7] [24].

Numerous scientific studies have shown the increased prevalence of this disorder in people with iron deficiency and/or iron deficiency anemia. The findings concern, almost exclusively, women of reproductive age [24].

One of the forms in which pica disorder manifests itself is ice eating (ice pica). Ice eating, which results from the feeling of need to consume ice, occurs in a large percentage of people with iron deficiency anemia [7] [23] [24].

4. Increased tiredness & shortness of breath

In mild cases of iron deficiency and/or iron deficiency anemia, individuals may be completely asymptomatic. In cases of moderate to severe deficiency, however, one or more symptoms associated with decreased iron levels in the body occur [7] [12].

Unexplained tiredness & shortness of breath are characteristic signs of iron deficiency [6] [7] [8] [9] and, as available research has shown, they usually subside with the restoration of iron levels [6].

Particularly in women of childbearing potential, it appears that non-anemic iron deficiency may be the cause of nervousness, anger, and fatigue [8].

5. Paleness

In people with iron deficiency anemia there is, in most cases, severe pallor on the face and various parts of the body, such as the palms [5] [7] [9].

Particularly in children, the clinical finding of pallor in any part of the body is a reliable indicator of anemia, while pale palms usually indicate significant anemia [9].

6. Headaches – Migraines

Many people with iron deficiency appear to have a high frequency of headaches and, in particular, migraines [7] [10].

A study in people with iron deficiency anemia showed that there may be an association between low iron levels and a high incidence of migraines, especially in the female population [10].

It seems, however, that with improved levels through iron supplementation, these symptoms become less frequent and / or disappear [10].

7. Heart palpitations

A large percentage of people with iron deficiency show symptoms that affect the heart area, with the most common indication being palpitations [5] [11] [12].

Numerous studies have shown that people with iron deficiency anemia have a higher risk of developing heart failure [11] [12].

In some cases, usually due to the severity and duration of the deficiency, dilatation of the heart, left ventricular dysfunction, and heart failure occur [11] [12].

8. Hair loss

The possible link between low iron levels and the occurrence of hair loss has been studied for several decades, mainly in women [7] [13] [14].

In a study on women of childbearing potential with severe hair loss, the majority were found to have low iron stores. Numerous other studies support the above observation, concluding that iron deficiency may be an individual risk factor for the occurrence and/or worsening of hair loss in non-menopausal women [14].

Regarding men, the research that has been done is significantly less. It is possible that there is a correlation between iron deficiency and the occurrence of male patterned hair loss, but further research is definitely needed [14].

9. Discomfort in the oral cavity

Several studies have investigated a variety of symptoms that occur in the oral cavity and may be associated with iron deficiency, with or without anemia [5] [7] [15] [16]. The main ones are atrophic glossitis, generalized atrophy, irritation or burning sensation of the oral mucosa [16].

It has been shown that people with iron deficiency are more likely to experience discomfort in the oral cavity (dry mouth, burning sensation) and, especially, in the tongue (presence of varicose veins, swelling) [15] [16].

10. Increased incidence of infections

Research investigating the possible link between iron deficiency and the prevalence of infections has shown that people with low iron levels or iron deficiency anemia are more likely to get sick than people with normal iron levels [5] [17]. However, the data currently available are insufficient and further research is needed [17].

Iron deficiency: prevention and treatment

Prevention and treatment of iron deficiency should be an important public health goal, especially for women, children and people living in developing countries [3] [18].

Early detection and treatment prevent the increased risk of disease & mortality, preventing the onset of anemia and the onset of all of the above symptoms [3] [19].

Taking oral iron supplementation and restoring its levels in the body seems to be able to completely reverse a significant number of symptoms caused by iron deficiency [1] [5] [22] [23].

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References

1. Guidelines on the diagnosis and treatment of iron deficiency across indications: a systematic review
2. Review on iron and its importance for human health
3. Identification, Prevention and Treatment of Iron Deficiency during the First 1000 Days
4. The prevalence and impact of restless legs syndrome on patients with iron deficiency anemia
5. NCC Pediatrics Continuity Clinic Curriculum: Health Maintenance II – Faculty Guide
6. Iron deficiency without anaemia is a potential cause of fatigue: meta-analyses of randomised controlled trials and cross-sectional studies
7. How we diagnose and treat iron deficiency anemia
8. Iron Deficiency Without Anemia Is Associated with Anger and Fatigue in Young Japanese Women
9. Correlation of pallor with hemoglobin levels and clinical profile of anemia in primary and middle school children of rural Telangana
10. Is There Any Correlation between Migraine Attacks and Iron Deficiency Anemia? A Case-Control Study
11. Iron deficiency in chronic heart failure: an international pooled analysis
12. The Cardiomyopathy of Iron Deficiency
13. Low iron stores: a risk factor for excessive hair loss in non-menopausal women
14. Iron Plays a Certain Role in Patterned Hair Loss
15. Effects of Iron Deficiency on the Oropharyngeal Region: Signs, Symptoms, and Biological Changes
16. Oral manifestations and blood profile in patients with iron deficiency anemia
17. Iron deficiency and susceptibility to infections: evaluation of the clinical evidence
18. Current misconceptions in diagnosis and management of iron deficiency
19. Inpatient iron deficiency detection and management: how do general physicians and gastroenterologists perform in a tertiary care hospital?
20. Restless Leg Syndrome: A Neglected Diagnosis
21. Spoon Nails
22. Craving for ice and iron-deficiency anemia: a case series from Oman
23. Pagophagia in iron deficiency anemia
24.  Pica as a manifestation of iron deficiency