13 Signs of Iron Deficiency You Might Be Ignoring

Iron deficiency is often underdiagnosed—and undiscovered. Watch out for these signs that you've developed iron deficiency anemia

Why iron levels can drop

Thankfully iron deficiency is relatively uncommon, but certain people are at higher risk, warn the experts at the National Heart, Lung, and Blood Institute. Infants, teens, and the elderly can all have specific growth or health issues that can lead to falling short; women who have heavy periods or are pregnant can also need more of the mineral; vegans and vegetarians may come up short if they’re not careful with their diet. Here are the signs to keep an eye out for.

You feel tired and weak

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Fatigue is probably the symptom most commonly associated with iron deficiency. The reason for the exhaustion? A lack of oxygen flowing through your body. “When you have anemia, you have fewer blood cells to carry oxygen to vital organs of the body,” says Ian Tong, MD, chief medical officer at Doctor On Demand. “This oxygen deficit is global and can cause vague symptoms like fatigue, headache, and weakness.” 

You’re even more short of breath when you exercise

When you have iron deficiency, it’s hard for your body to get the oxygen it needs when it’s active. That’s why one of the more common signs of iron-deficiency (and its more serious form, anemia) is the decreased ability to exercise, explains Marc J. Kahn, MD, the Peterman-Prosser professor and senior associate dean at Tulane University School of Medicine in New Orleans. So if you now find yourself short of breath during a brisk walk that was a piece of cake a few months ago, see your health provider. 

You develop restless leg syndrome

A disorder called restless leg syndrome creates a “pins and needles” feeling and prompts an unconscious urge to move your feet. This can disturb your sleep. It’s one of the more unusual symptoms of iron deficiency, according to Dr. Tong.

Your hands and feet may feel cold

The old saying may be “cold hands, warm heart,” is true—your body is shunting the fewer red blood cells into the places that count, like your heart, brain, and liver, says Dr. Katz. So cold extremities (and skin in general) is a sign you may be iron-deficient. In fact, there are many surprising conditions your hands might predict.

You may feel dizzy

Feeling dizzy or light-headed? Iron deficiency anemia could be to blame. “Dizziness or chest pain can also result because your body is trying to tell you to lie down and let more oxygen get to the heart or brain,” Dr. Tong says. Here are some other reasons you might be feeling dizzy.

You might develop heart conditions

Because a loss of iron affects your red blood cell count, a shortage could cause your heart to work harder to deliver oxygen throughout the body—and cause you to develop heart murmurs or an enlarged heart. For those who already have cardiovascular disease, low iron levels could prove deadly. “People with diseases of the heart or blood vessels—also called cardiovascular disease—could suffer a heart attack or stroke if they develop iron deficiency,” Dr. Tong says. 

You might crave weird things

The desire to eat weird things, known as pica, isn’t an uncommon sign of anemia. Unusual things people may suddenly crave if they’re not getting enough iron: clay, ice, and dirt. “As a hematologist, I would say they’re iron deficient until proven otherwise,” says Dr. Katz.

You may become more irritable

 If you’re getting more irritated at things that used to roll off your back you may be in need of an iron supplement. “Irritability is more common with iron deficiency,” explains Dr. Katz, adding that it’s not really that well understood why this might be so. “Probably because iron is used in several pathways in the body—most notably, it’s used in hemoglobin, which red cells need to deliver oxygen. So irritability might have to do with decreased oxygen delivery,” he says. If you’re suddenly snapping, time to load up on the best sources of iron you’re probably missing. 

Your mouth may hurt

Your tongue and mouth can be a good indicator of what’s going on in your body (which is why dentists want you to check in every six months!). Ulcers in your mouth and cracks at the side of your mouth are fairly common signs of iron deficiency, says Dr. Katz: “It probably has to do with decreased blood flow to the mucosa of the mouth.”

Your skin may turn pale

Your body needs iron to make hemoglobin, a protein in red blood cells that carries oxygen throughout the body. If you have an iron deficiency, your hemoglobin levels drop and, as a result, you look paler than normal, says Dr. Katz. But your skin isn’t the only part of you that can turn a shade lighter. Your gums, the inside of your eyelids or lips, and your nails can also turn a lighter hue.

You might develop headaches

If you find yourself popping pain killers for headaches on a regular basis, iron deficiency anemia could be to blame. “When you have anemia you have fewer blood cells to carry oxygen to vital organs of the body,” Dr. Tong says. “This oxygen deficit can cause vague symptoms like headaches.” If your head bothers you on a regular basis, definitely tell your provider.

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Your nails may change

Another not uncommon side effect of iron deficiency is called koilonychia, says Dr. Katz. It causes nails to turn brittle and chip easily, and eventually, it can alter the shape of the nails. Another tell-tale sign: Your nails have lines in them.

Your hair might change or fall out

Why would hair fall out because you’re not getting enough iron? “It probably has to do with blood flow to the hair follicle,” says Dr. Katz. Yes, alarming, but it’s not a very common symptom (whew!). However, your hair and other parts of you can be good indicators about the state of your health, so don’t miss these signs your body is running low on key vitamins.