Iron deficiency anaemia: tiredness, heavy periods and tests
Iron deficiency anaemia is the most common type of anaemia and, according to the NHS, is caused by a lack of iron, most often because of blood loss or pregnancy. Heavy periods are a very common cause in women. It is diagnosed with a full blood count, and treatment is with iron tablets, usually for about 6 months, together with addressing the cause.
- According to the NHS, the most common symptoms are tiredness and lack of energy, shortness of breath, heart palpitations, paler skin and headaches.
- Heavy periods are a very common cause of iron deficiency anaemia and can be treated with medicines.
- It is diagnosed with a full blood count (FBC), which checks the number of red blood cells and also looks for other types of anaemia.
- Treatment with iron tablets usually lasts about 6 months, and the doctor repeats the blood tests to monitor your levels.
- Without treatment, anaemia weakens the immune system and can lead to complications with the heart and lungs.
What are the symptoms of iron deficiency anaemia?
The most common signs according to the NHS are tiredness and low energy, shortness of breath, heart palpitations (a feeling of a fast or strong heartbeat), skin that is paler than usual and headaches. The problem is that many women put tiredness down to a busy daily life, stress or lack of sleep and do not connect it with iron.
Less often there are other symptoms, which the NHS lists: ringing in the ears, food tasting strange, itchy skin, a sore tongue, hair loss, wanting to eat things that are not food (for example paper or ice), difficulty swallowing, sores at the corners of the mouth, spoon-shaped nails and restless legs syndrome.
Why do heavy periods lead to anaemia?
According to the NHS, iron deficiency anaemia is caused by a lack of iron, most often as a result of blood loss or pregnancy. In women, heavy periods are a very common cause – with every heavy period blood is lost, and iron with it. The good news, according to the NHS, is that heavy periods can be treated with medicines, which also removes the cause of the anaemia.
In pregnancy, the deficiency is most often due to not enough iron in the diet. Other causes the NHS lists are bleeding from the gastrointestinal tract – for example from a stomach ulcer, inflammation of the bowel or oesophagus, piles, long-term use of anti-inflammatories such as ibuprofen and aspirin, and less often – bowel or stomach cancer. Any condition involving blood loss can lead to anaemia.
What do the tests for anaemia show?
According to the NHS, the doctor first asks about your lifestyle and medical history, then orders a full blood count (FBC). It checks whether the number of red blood cells is normal and needs no preparation beforehand. The same test also helps to find other types of anaemia – for example with a lack of vitamin B12 or folate.
If the cause of the deficiency is not clear, the NHS states that the doctor may order a test for hidden blood in your poo (FIT) or refer you to a specialist for further tests.
How is iron deficiency anaemia treated?
According to the NHS, treatment has two parts: addressing the cause (for example treating heavy periods or an ulcer) and restoring iron with tablets when the red blood cells are low. The tablets are usually taken for about 6 months, and the doctor repeats the blood tests over the following months to check that your levels are rising.
The NHS mentions that a glass of orange juice after the tablet may help absorption. Common side effects are constipation or diarrhoea, stomach pain, heartburn, feeling sick and darker poo – taking the tablets with or shortly after food can reduce them. Do not stop the tablets on your own because of side effects; follow your doctor's instructions. An important warning from the NHS: iron tablets are dangerous for young children and an overdose can be fatal – keep them out of reach.
What should I eat and what should I limit with iron deficiency?
The NHS recommends including more dark green leafy vegetables, iron-fortified breakfast cereals and bread, meat, dried fruit and pulses. At the same time, some foods and drinks get in the way of iron absorption and it is best to limit them: tea, coffee, milk and dairy products, as well as foods high in phytic acid, for example wholegrain breakfast cereals. If you find it hard to get enough iron from food, your doctor may refer you to a dietitian.
When should you see a doctor?
According to the NHS, you should see your GP if you suspect you have iron deficiency anaemia – especially with a combination of the following signs:
- constant tiredness and lack of energy that your routine does not explain;
- shortness of breath or palpitations with ordinary effort;
- skin paler than usual and frequent headaches;
- heavy periods, especially if they have become heavier recently;
- hair loss, a sore tongue, sores at the corners of the mouth or nails that have changed shape;
- pregnancy with any of the above symptoms.
The NHS warns that untreated anaemia raises the risk of illness and infection, because it weakens the immune system, can lead to complications with the heart and lungs (for example a fast heartbeat or heart failure), and in pregnancy – to a higher risk of complications before and after birth.
Frequently asked questions
Can I take iron on my own, without a test?
The NHS describes treatment as prescribed by a doctor after a blood count that confirms low red blood cells, while at the same time looking for the cause. Self-treatment skips precisely that second step.
How long does it take for iron levels to recover?
According to the NHS, iron tablets are usually taken for about 6 months, and the doctor monitors your levels with repeat blood tests over the following months.
Why shouldn't I take my iron tablet with tea or coffee?
The NHS lists tea, coffee, milk and dairy products among the foods and drinks that make it harder to absorb iron, and recommends limiting them. Orange juice after the tablet, on the other hand, may help.
Sources
- NHS – Iron deficiency anaemia – last reviewed by the NHS: 26 January 2024
Informational article retold in our own words from the sources listed. It does not replace a consultation with a doctor; in an emergency call 112. If you spot an inaccuracy, write to [email protected].