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8 Signs You May Have An Iron Deficiency

It's more common than you think.

In part one of a two-part series, we look at the telling signs of the most widespread nutritional disorder in the world, iron deficiency.

Facing unintended downtime with fatigue, even after sleeping well, or looking Twilight pale? You may be iron deficient, along with many other people.

"Iron deficiency is the most common nutritional deficiency globally," says Dr Dheeraj Khiatani MBBS (UK) BSc (Hons) (UK), medical director of The Iron Suites Medical Centre. "About one in three women of child-bearing age will develop deficiency at some stage, whilst 75% of women in the third semester of pregnancy will have an absolute iron deficiency, even when taking oral iron supplements."

The risk increases for those aged over 55 years or have concomitant disease or both such as heart conditions, kidney issues, rheumatoid arthritis, gastrointestinal issues or cancer. Women are also more likely than men to have iron deficiency.

It's not inconsequential. Iron produces a protein called haemoglobin that helps red blood cells carry oxygen in your body; vital for energy and mental clarity not to mention other bodily processes and functions.

So how do you know if you are iron deficient or not? Ahead, Dr Dheeraj tells us what to look out for, the common causes and how to combat it.

The symptoms

You suffer from fatigue

You feel mentally or physically exhausted all the time, even after resting. When your body doesn’t have enough iron, less oxygen reaches your tissues and muscles, depriving them of energy.

You've noticed increased hair loss

Iron is found in every cell of the body and is a major nutritional element in the normal hair follicle cycle. Whilst it’s normal to lose about 100 strands of hair per day, excessive hair loss (and it isn't growing back) could be a sign of iron deficiency.

You have brain fog

Iron plays a significant a role in the central nervous system (CNS) of our body, particularly in neuronal and neurotransmitter function. Iron deficiency could lead to decreased ability of our CNS to properly function and consequently, difficulty concentrating.

You're prone to headaches

When deprived of oxygenated blood, the muscles in the face, neck and shoulders may become sore or tense which can result in recurrent and otherwise unexplainable headaches.

You fall sick easily and frequently

An iron deficiency affects the immune system, making it difficult for the body to defend itself against infections and viruses.

You’re always cold

Iron doesn't just help your red blood cells carry oxygen throughout your body. It also brings heat and nutrients to every cell in your system, so without this essential mineral, red blood cells can’t effectively do their job. It may also be the reason you look pale.

You have taste disturbances

You develop unusual cravings for ice and non-food substances, such as clay, dirt, ash and paper.


Whilst it is not the sole cause, you may develop symptoms similar to depression, like headaches, extreme fatigue and mood swings, and which may lead to feelings of sadness and helplessness. Recent studies suggest that iron deficiency is also associated with postnatal depression.


“Iron deficiency is caused either by not enough iron being obtained from our diet and, or, too much iron being lost from our body,” says Dr Dheeraj.

“Heavy menstrual bleeding is the main cause of iron deficiency,” he says. “And the reason why women are most at risk.”

“We have approximately 3000-4000mg iron in our bodies and usually absorb 1-2mg per day (from dietary sources) and lose about 1-2mg (from our gut, sweating and small blood losses). Each 1mL of blood contains 0.5mg iron and hence, blood loss equates to iron loss.”

Poor diet is another factor. "Iron from non-haem (or vegetarian) diets is quite poorly absorbed," says Dr Dheeraj."Whilst a good vegetarian diet can obtain required iron intake, many vegetarians do not follow good diets."

Many products also inhibit absorption of iron from vegetable sources. "For example, tea taken within one hour of a vegetable-based meal will reduce the bodies’ ability to absorb iron by up to 85%, and is one of the key reasons why many Indian women suffer from iron deficiency."

Pregnancy, GI issues and chronic diseases (both can impair iron absorption); endurance running and surgery especially major surgery such as hip replacement, cardio-thoracic and knee reconstruction also contribute to low iron levels.

Whatever the cause, iron deficiency can result in unpleasant symptoms that can affect your quality of life. It also poses a risk to expectant mothers and growing babies, and in some cases, low iron levels lead to severe anaemia which increases risk of cardiac failure.

Take note, there's a difference between iron deficiency and anaemia. “Anaemia is a deficiency in haemoglobin which carries oxygen in the blood whilst iron deficiency is, as the name suggests, a decrease in the iron levels in the body," explains Dr Dheeraj.

Untreated iron deficiency will ultimately lead to anaemia, though it can take up to 10 years, and today accounts for the majority of anaemia that is detected.

How to increase your iron levels

As iron can’t be made by the body – it’s excreted if too much is given – our only sources are external, our diet being the first and usual option. Up your intake of iron-rich foods, such as leafy dark vegetables, red meat (if you're non-vegetarian), beans and lentils.

"Increasing iron levels, beyond food, can be achieved with either oral iron tablets or by injecting iron directly into the vein." Dr Dheeraj says. "Generally speaking, oral iron is our first line of therapy but for some patients IV iron will be preferred route."

Oral iron tablets are often poorly absorbed and may cause side effects; usually nausea, vomiting, diarrhoea or constipation. Some individuals also can't take oral iron, whether it's because of a chronic disease, upcoming surgery, or pregnancy (third trimester). At the Iron Suites, iron deficiency can be corrected in a single visit and in under one hour, inclusive of registration, consultation, administration of iron and a 15 to 30 minute massage.

In any case, he recommends speaking to your doctor and to measure your body’s iron stores first. Too much iron can be harmful to the body, especially for children. The bottomline: Don't self-diagnose and instead get regular checks (every 2 to 3 years), especially if you're 'at-risk', that is, you're a woman of child-bearing age, are pregnant and in your third trimester, or aged above 55.

Dr Dheeraj Khiatani is a GP who graduated from Kings College London School of Medicine (UK). In addition to his MBBS degree, he holds a Bachelor of Science in Psychology. Dr Dheeraj spent his junior doctor years gaining experience in various specialities such as Otolaryngology (ENT), Anaesthesia and Emergency Medicine (A&E),both in hospitals in London under the NHS and in government hospitals in Singapore.

His clinical interests are in the field of Nutritional, Lifestyle and Aesthetic medicine. He believes in integrative and holistic management of his patients and has a special interest in the role of iron to improve physical and mental well-being and overall energy levels of patients.

The Iron Suites Medical Centre (TISMC) is a clinic dedicated to educating, diagnosing and managing iron deficiency with a focus on intravenous iron infusions. Learn more about them here.