Low iron does not always arrive with a dramatic warning. Sometimes it looks more like needing an extra coffee to get through the afternoon. Or feeling strangely out of breath after climbing a flight of stairs you normally manage without a second thought. Maybe you are constantly cold while everyone else seems perfectly comfortable.
It is easy to blame these things on a busy week, poor sleep or stress. And sometimes, that is exactly what they are. But when symptoms persist, low iron or low haemoglobin may be worth investigating.
Iron plays an important role in helping your body produce haemoglobin, the protein in red blood cells that carries oxygen around the body. When there is not enough iron available, haemoglobin levels can eventually fall, resulting in iron deficiency anaemia.
So, what should you be looking out for?
What is the difference between low iron and low haemoglobin?
Although some people often use the terms interchangeably, low iron and low haemoglobin are not quite the same thing.
Iron is a mineral your body needs to produce haemoglobin. Haemoglobin, meanwhile, is the part of your red blood cells responsible for transporting oxygen from your lungs to the rest of your body. If your iron stores become depleted, your body may eventually struggle to produce enough haemoglobin.
This means it is possible to have low iron before you develop anaemia. That is one reason symptoms and blood test results need to be considered together rather than relying on a single assumption.
1. You Are Tired All The Time.
Everyone gets tired. There is a difference, however, between feeling sleepy after a late night and feeling completely drained despite getting enough rest. Persistent fatigue and a lack of energy are common symptoms associated with iron deficiency anaemia.
If your usual day suddenly feels like it requires significantly more effort, pay attention. Low iron can affect your body’s ability to produce enough haemoglobin, which may reduce how effectively oxygen is transported to your tissues.
Fatigue on its own does not automatically mean an iron problem, but fatigue that sticks around without an obvious explanation deserves a closer look.
2. You Become Short of Breath More Easily.
A short walk should not suddenly feel like a cardio session. When haemoglobin levels are low, less oxygen can be carried around the body. As a result, shortness of breath can occur, particularly during physical activity.
You might notice that you are more winded when walking uphill, exercising or climbing stairs. If this is new for you, especially when combined with tiredness or weakness, low iron may be one possible explanation.
Significant or sudden shortness of breath, however, should not simply be assumed to be caused by iron deficiency. Seek medical attention, particularly if it is accompanied by chest pain or other concerning symptoms.
3. You Feel Dizzy or Light-Headed.
Standing up and suddenly feeling as though the room needs a moment to catch up with you? Dizziness and light-headedness can occur with anaemia. Headaches may also develop.
There are plenty of possible causes for dizziness, from dehydration to changes in blood pressure, so this symptom alone cannot diagnose low iron. If it keeps happening, though, make a note of when it occurs and whether you are experiencing other symptoms. That information can be useful when speaking to your doctor.
4. Your Heart Seems To Be Working Overtime.
Another potential clue is becoming unusually aware of your heartbeat. Iron deficiency anaemia can be associated with noticeable heartbeats or palpitations. You may feel your heart beating faster or more forcefully than usual, particularly during activity.
Persistent palpitations should be discussed with your doctor rather than automatically blamed on low iron, anxiety or too much coffee. There are several possible causes, and identifying the reason matters.
5. Your Skin Looks Paler Than Usual.
Paler-than-usual skin can be another sign of anaemia, although changes may be more or less noticeable depending on your natural skin tone.
Rather than relying on appearance alone, consider whether the change is accompanied by fatigue, weakness, breathlessness or dizziness. And no, checking yourself in questionable bathroom lighting is not a reliable diagnostic test.
6. Your Nails, Hair or Mouth Seem Different.
Some signs of low iron are a little less obvious. Iron deficiency anaemia can be associated with brittle or spoon-shaped nails, a sore tongue, sores around the corners of the mouth and increased hair loss.
None of these symptoms automatically means your iron is low. Hair loss, for example, has many possible causes. But if several changes appear together, especially alongside ongoing fatigue, it is worth mentioning them during your consultation.
7. You Have Some Very Unusual Cravings.
This one tends to catch people by surprise. Iron deficiency can sometimes cause pica, which is a craving for things that are not normally considered food. One commonly reported example is an urge to chew ice, while some people may crave substances such as paper, dirt or clay.
If you suddenly find yourself unusually interested in the contents of an ice tray, do not dismiss it as just another strange habit. Mention it to your doctor.
8. Your Hands and Feet Are Constantly Cold.
Cold hands and feet can also occur with iron deficiency anaemia. Of course, being cold is hardly unusual during a Johannesburg winter. Context matters. But if you are feeling unusually cold alongside exhaustion, dizziness, headaches or breathlessness, low iron could be one of several possibilities to investigate.
Why might my iron levels be low?
Finding low iron is only part of the picture. The next question is: why?
Common reasons include blood loss, heavy menstrual periods, pregnancy, not getting enough iron through food, frequent blood donation or difficulty absorbing iron properly. Bleeding from the digestive system can also lead to iron deficiency.
That is why simply buying an iron supplement and hoping for the best is not always the right move. Iron supplements can be useful when medically appropriate, but taking unnecessary iron can be harmful. A doctor can assess whether your symptoms are actually related to low iron and investigate what may be causing it.
How are low iron and haemoglobin levels checked?
A blood test is usually needed. A full blood count can measure haemoglobin and provide information about your red blood cells. Depending on your symptoms and results, your doctor may recommend additional blood tests to assess your iron stores or investigate other possible causes of anaemia.
This distinction matters because not every case of low haemoglobin is caused by low iron. Vitamin B12 or folate deficiency, chronic health conditions and other causes can lead to anaemia. In other words, symptoms can point you in a direction. Blood tests help provide the actual evidence.
When should you speak to your doctor?
If you are constantly exhausted, becoming breathless more easily, experiencing recurring dizziness or noticing several of the symptoms above, consider booking a wellness medical consultation.
Do not wait until you are completely wiped out before asking what is going on. Iron deficiency can initially be mild and easy to overlook, with symptoms becoming more noticeable as the deficiency progresses.
Your body is very good at dropping hints. Sometimes those hints are subtle. Sometimes they look like falling asleep on the sofa at 7 pm and wondering when exactly you became this tired.
If you are concerned about low iron, low haemoglobin or unexplained symptoms, contact Dr Claire Godwin & Associates to arrange a consultation and discuss whether blood tests or further investigation may be appropriate.
