Anaemia, iron deficiency 

Introduction 

Anaemia occurs when there is a reduced number of red blood cells. This can be caused by an iron deficiency.

About the blood

Blood contains a fluid called plasma, which includes three different types of cells:

  • White blood cells are part of the body's immune system and defend it against infection.
  • Red blood cells carry oxygen around the body in a substance called haemoglobin.
  • Platelets help the blood to clot.

Haemoglobin

Haemoglobin transports oxygen in the blood. As blood passes through the lungs, the haemoglobin pulls in oxygen molecules and releases carbon dioxide molecules.

After leaving the lungs, haemoglobin delivers the oxygen molecules to the body’s tissue and absorbs excess carbon dioxide molecules to take back to the lungs.

Bone marrow

Red blood cells, which contain haemoglobin, are produced in bone marrow (found inside larger bones). Millions of new cells are produced every day to replace old cells that break down.

Anaemia is a condition where the amount of haemoglobin in the blood is below the normal level, or there are fewer red blood cells than normal.

There are several different types of anaemia and each one has a different cause, although iron deficiency anaemia is the most common type.

Other forms of anaemia can be caused by a lack of vitamin B12 or folate in the body. Read more about vitamin B12 and folate deficiency anaemia.

Symptoms of iron deficiency anaemia

The main symptoms of iron deficiency anaemia are tiredness and lethargy (lack of energy). Other symptoms include:

  • shortness of breath (dyspnoea)
  • changes in your appearance, such as a pale complexion and dry nails

Speak to your GP if you notice any of these symptoms. They will be able to diagnose iron deficiency anaemia with a simple blood test.

However, in most cases there won't be any symptoms at all, particularly if the cause is a slow loss of blood.

What causes iron deficiency anaemia?

Iron deficiency anaemia occurs when there isn't enough iron in the body. Iron is found in meat, dried fruit and some vegetables. Iron is used by the body to make haemoglobin, which helps store and carry oxygen in red blood cells.

This means if there is a lack of iron in the blood, organs and tissues will not get as much oxygen as they usually do.

There are many conditions that can lead to a lack of iron. In men, and post-menopausal women the most common cause is bleeding in the stomach and intestines. This can be caused by:

In women of reproductive age, the most common causes of iron deficiency anaemia are:

Read more about the causes of iron deficiency anaemia.

Treating iron deficiency anaemia

Treatment for iron deficiency anaemia involves taking iron supplements to boost the low levels of iron in the body. This is usually effective and the condition rarely causes complications.

You will need to be monitored every few months to check the treatment is working and your iron levels have returned to normal.

The underlying cause will also need to be treated so anaemia does not come back.

Read more about how iron deficiency is treated.

Iron-rich foods

Foods that contain iron include:

  • dark-green leafy vegetables, such as watercress and curly kale
  • beans
  • nuts
  • meat
  • dried fruit

Some foods and medicines can make it harder for your body to absorb iron. These may include:

  • tea and coffee
  • calcium, found in dairy products such as milk
  • antacids (medication to help relieve indigestion) 

Complications

If iron deficiency anaemia is left untreated it can make you more susceptible to illness and infection, as a lack of iron in the body affects your immune system (the body’s natural defence system).

Severe iron deficiency anaemia may increase the risk of developing complications that affect the heart or lungs such as:

  • tachycardia (an abnormally fast heartbeat)
  • heart failure, when your heart is not pumping blood around your body very efficiently

Pregnant women also have a higher risk of complications before and after birth.

Read more about the complications of iron deficiency anaemia.

Last reviewed: 03/05/2012

Next review due: 03/05/2014

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Comments are personal views. Any information they give has not been checked and may not be accurate.

Mobasshir said on 11 May 2013

Hi Maurizio,

How is your wife? My wife has gone through similar experience. Any advice?

Regards
Mo

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Steve_P said on 21 March 2013

Many thanks for making this problem clear. My GP has no time and is too rushed to listen to her patients or read medical history on screen in front of her.

She sent me for painful and degrading tests when all she needed to do was look and see that I am on medication for acid reflux, due to a hiatus hernia. I even mentioned the medication in my consultation with her.

I also mentioned the negative result for blood in my stools fgrom the bi-annual bowel screening test I had just had that month.

I drink copious amounts of tea and coffee and eat lots of dairy products. Something the GP didn't ask about.

So I thank this NHS site for taking the time to make the reasons clear rather than jumping in with passing me on for hospital tests.

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rosbee said on 09 June 2012

I have anaemia b12 deficiency for which I have 3monthly injections. I now also have anaemia iron deficiency. I am also diabetic. As I mainly eat a vegetarian diet with little or no meat, except for chicken or fish I am wondering what I can add to my diet to help myself maybe improve.

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jomc20 said on 04 September 2011

I think from other comments on this page that people are expecting advice from the NHS. THis is just a forum for patients to comment. I am not a health professional but I can't help wondering if our poor diet is to blame for the many cases of anaemia these days. In other countries parents give their children the best quality food they can afford. Here in Britain they seem to live on fast food and frozen processed food such as chips, pizza, chicken nuggets etc. This cannot be good for growing bones or for the immune system. I am sure this is why an in-law's daughter is thin and sickly and not growing as she should for her age (12). Adults, too, skip meals, are obese and don't cook fresh food. My mother (80) just had major surgery and was anaemic as a result but she is already getting over the anaemia due to iron sulphate tablets (cause bad constipation!) and a healthy diet of fish, red meat and home-grown vegetables.

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cmilnedunn said on 23 April 2011

It may be worth considering an Iron Infusion instead of blood transfusions - or have kidney test (bloods) done to see if these are working property or if you are low in b12? which helps absorption. also heavy periods can cause anemia. what ever problem that you have anaemia can and does make you feel very ill as the levels get lower. excessively tired, palpertations very pale, ulcers etc.
It is worth being persistant with the doctors and although they may prescribe iron tablets/tonic this must be taken and if it does not work, insist that you go and see a specialist and have everything checked out.
It has taken me many years of feeling very sick to finally find the answer. I have been in and out of hospital a&e with them not finding the problems. I have stage 3 Kidney Disease and excessively bad periods (im 46) but once this was diagnosed I had an iron infusion and all the other symptoms dissapeared - and I got my life back for 7/8 months, now Im waiting for another one. its like a miracle and worth the long haul of diagnosis !

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justinagc said on 16 December 2010

my son 5 years old has been sick for all the year past.from nov.2009 until now dec 2010.all the time had an infection ,or tonssilitis inflamated,or get a virus .every mounth during from last year,he get prescription with antibiotics and a lot of paracetamol and nurofen.I ask my doctor why he's geting sick all the time ,and he was telling me i's normal,many children get sick on this age .I ask my doctor for a blood test to many times,and he telling me i's not nesesary.now my son is again sick with prescription of antibiotics,and I deceided to go for a private clinic, to do the blood test. I 've got the result of the blood test and my son had a very low iron and calcium,and now I got the answer. Why my son getting sick all the time!! Why my doctor doesn't refer us for a blood test? What can I do next? Thank you regards Andrew's mum

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TPK said on 19 June 2010

This is for Maurizio:

My partner has similar symptoms and she has been diagnosed 3 days ago with hypothyroidism. I suggest you ask your partner's GP to get her blood tests done for thyroid levels. Hope you nail down the cause.

Regards,
Pav

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maestro40 said on 15 February 2010

My partner has a severe iron deficiency but we struggle to get serious treatment going through the NHS system.
Her symptoms have becoming increasingly alarming
rapid heartbeat, dizziness, headaches, pale skin, hair loss, being very tired all the time and sometimes mentally confused.
Still, every time she sees a GP they find very easy to blame it on heavy periods and refer her to an Haematologyst. The Haematologist cannot find anything and refer her to a Gynaecologist who also cannot find anything and refer her back to an Haematologist. Months go by and she struggle with her day to day life and our children are suffering because of this. Finally last year she was given a 5 session blood transfusion and after that she felt well for 6 months but since December all the symptoms are back again and actually worst then before. Again she had to go through many appointments with GP and specialists to get referred for a blood transfusion (one session only this time) which will probably fix the problem only for a month or two.
My questions are: Can the referral process for getting blood transfusion become faster now that the NHS has a record of her case and can more detailed exams be carried out to find out the source of her problem?
She could have internal bleeding caused by ulcers or at the worst cancer and if that is not going to kill her a heart attack will because she is continually out of breath which for a lean and active woman age 38 is not normal.
We would appreciate your advice as life has been hell for the last 3 years and we don't seem to be taken seriously by the GP's in our surgery.

Faithfully
Maurizio

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