How To Detect An Iron Deficiency & What To Do About It

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Disclosure: I am not a doctor, and I cannot diagnose deficiencies. You should not take iron supplements unless your doctor performs a blood test and  diagnoses you with a deficiency. Once an iron deficiency is diagnosed, a Dietitian can help you choose the right foods to manage the deficiency.

This post is about something that has affected me personally– iron deficiency. I will teach you how to listen to your body to detect the signs and symptoms of an iron deficiency and what to do with that diagnosis. Here’s my story…

I have something called Thalassemia trait, which means that I have smaller red blood cells than a normal person. Because of my Thalassemia, I’ve always had low iron stores but I’ve never been concerned with iron deficiency…until recently. About 3 years ago, I noticed that I started feeling different. After a few months of denial, I finally came to terms with the fact that something was wrong. I was pretty confident that I was iron deficient, so I set up an appointment with my doctor.

How to detect iron deficiency (signs & symptoms):

  1. Chewing on ice.  This is actually how I knew that something was wrong.  I started chewing on ice pretty regularly.  At first, I would just eat the ice from my drink.  Then, I would fill full cups with ice and munch on them as a snack. Then, I started thinking about ice when I wasn’t home, aka I was craving ice instead of food. It was a very weird feeling, and I remembered learning that this is a symptom of iron deficiency. When I visited my doctor and told her about the ice chewing,  she said that it’s a classic sign of iron deficiency but doctors don’t know why it occurs.
  2. Extreme exhaustion. Iron carries oxygen throughout the body. When people are iron deficient, they don’t get enough oxygen throughout their body and often feel very fatigued. This is a very hard symptom to recognize because most people feel tired on a daily basis.  Between waking up early, taking care of kids, running errands, working and exercising, we all feel tired at the end of the day.  But if you are iron deficient, the exhaustion is extreme. In other word, it affects your daily life.  For example, I couldn’t schedule dinner dates because I knew I wouldn’t be able to function past 8pm.
  3. Brittle Nails. People with iron deficiency have an abnormally shaped fingernail. The nail is thin and brittle, has raised ridges and curves inward.
  4. Pale Skin.  Because iron deficiency means a lack of healthy red blood cells, you may become very pale.
  5. Lightheadedness & Headaches. This is another symptom that affected me. I would be sitting at my desk and would feel dizzy, or I would wake up with headaches for no reason. The lack of oxygen circulating in the body can cause problems with your brain. If enough oxygen does not get to the brain, you may experience a lightheaded feeling and/or headaches.
  6. Frequent Infections. 
  7. Restless Leg Syndrome. This may be caused from a lack of iron in the brain.

What causes Iron Deficiency? After experiencing so many of these symptoms, I started to wonder why this was happening. These are usually the main culprits for iron deficiency:

  1. Not eating enough iron. Quite simply, vegetarians are at higher risk for iron deficiency because the iron in plants is not as readily absorbed as the iron in meat.
  2. Not absorbing iron properly. People with gastrointestinal disorders may have problems absorbing nutrients. If you have an undiagnosed case of Celiac or Crohn’s Disease, this could cause an iron deficiency.
  3. Heavy bleeding, from heavy menstrual cycles or internal bleeding. A loss of blood equals a loss of iron. It’s as simple as that.

What to do about iron deficiency? If your doctor diagnoses you with an iron  deficiency, there are several things you can do to rectify the problem.

  1. Take iron supplements. If the deficiency is extreme, like in my case, your doctor will prescribe Ferrous Sulfate to take on a daily basis. Luckily, people who are deficient in iron absorb 20-30% of dietary iron compared with the 5-10% absorbed by those without iron deficiency. Therefore, if there aren’t any problems in your digestive tract, you will absorb the supplements easily and the problem will be rectified.
  2. Eat iron rich foods. There are two types of iron: heme and nonheme iron. Heme iron is found in meat, fish and poultry, and it is absorbed better than nonheme iron.  Nonheme iron is found eggs, grains, vegetables and fruits. The nonheme absorption rate is 3-8%.  Good sources of nonheme iron include:
    • Whole grains, like wheat, oats and brown rice
    • Legumes, like lima beans, soybeans, peas, kidney beans
    • Dried fruits, like prunes, raisins, apricots
    • Certain vegetables, like broccoli, spinach, kale, collards and aspragus
    • Nuts, like almonds and brazil nuts

Taking iron supplements or eating iron rich foods in combination with Vitamin C (or foods filled with Vitamin C) will enhance the absorption of iron.  Tea and coffee, or foods with tannins, decrease the absorption of iron.

What should I do if I think I’m iron deficient? If you experience any of these signs and symptoms, call you doctor to get a physical. A simple blood test will diagnose an iron deficiency.  Then, meet with a Dietitian to get advice on adding iron rich foods to your daily diet. Contact me for more info!


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I’m Natalie Rizzo, an NYC-based Registered Dietitian.

My mission is to help everyday athletes fuel their fitness with plants.

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