If you’re wondering whether you might have low iron, several common signs and steps can help you assess the situation, but keep in mind only a blood test can confirm iron deficiency. Here’s a practical guide to what to look for and what to do next. Key signs that could suggest low iron
- Fatigue or persistent tiredness that isn’t explained by sleep or stress
- Pale skin or pale inside of the lower eyelids
- Brittle or spoon-shaped nails, and hair that’s become dry or thinning
- Shortness of breath or dizziness with mild activity
- Restless legs or unusual craving for non-food items (pica) in some people
- Cold hands and feet or feeling unusually cold
- Headaches or difficulty concentrating
Less common symptoms (especially with more severe deficiency)
- Chest pain, fast or irregular heartbeat
- Glossitis or a sore, swollen tongue
- Mouth sores or cracks at the corners of the mouth
- Poor immune function, leading to more frequent infections
What to do if you suspect low iron
- Review risk factors with a clinician: heavy menstrual bleeding, pregnancy, vegan/vegetarian diets without careful iron planning, gastrointestinal disorders affecting absorption, or recent blood loss.
- Consider discussing with a healthcare provider about getting a blood test. A typical evaluation may include:
- Complete blood count (CBC) to look at red blood cells and hemoglobin
- Serum ferritin to assess iron stores
- Serum iron and total iron-binding capacity (TIBC) or transferrin saturation
- Keep a symptom diary: note fatigue levels, breathlessness, dizziness, nail changes, and any pica or tongue changes to share with your clinician.
Interpreting results (high-level, not a substitute for professional care)
- Low ferritin with low iron and low hemoglobin generally points to iron deficiency anemia.
- Ferritin can be influenced by inflammation or chronic illness, so doctors may interpret ferritin alongside iron studies and clinical context.
- A normal ferritin doesn’t completely rule out iron deficiency if inflammation is present; further testing may be needed.
Treatment basics (what to expect if iron deficiency is confirmed)
- Iron supplements are commonly prescribed, taken with vitamin C or citrus to improve absorption; avoid taking with high-calcium products at the same time.
- Dietary adjustments to include iron-rich foods (heme iron from animal sources like red meat, or non-heme iron from plant sources like beans, lentils, fortified cereals) and to enhance absorption (vitamin C-rich foods with iron-rich meals).
- In some cases, doctors may investigate and treat underlying causes (for example, heavy menstrual bleeding, GI tract issues, or malabsorption).
When to seek urgent care
- If you experience chest pain, severe shortness of breath, fainting, or feel like your heart is racing unusually fast, seek immediate medical attention.
If you’d like, tell me your age, sex, any pregnancy status, and any symptoms you’re experiencing. I can help tailor the signs to watch for and outline a conversation to have with a healthcare provider. I can also provide a simple at-home checklist to prepare for a clinic visit.
