Ultimate guide to Iron deficiency anemia – causes and symptoms

June 18, 2025June 18, 2025

Iron deficiency anemia (IDA) is a decrease in the level of hemoglobin and red blood cells in the blood due to a lack of iron. IDA can occur for various reasons, including poor nutrition, chronic diseases, and metabolic disorders.

In this article, we will look at the main causes and signs of iron deficiency anemia (anemia) , as well as methods of diagnosis, prevention and treatment of this disease.

Iron deficiency anemia – what is it?

Iron deficiency anemia, as the name suggests, is caused by a lack of iron, which results in insufficient production of hemoglobin, the substance that gives blood its red color and is responsible for carrying oxygen. IDA (Iron deficiency) can lead to oxygen starvation in the body’s tissues, fatigue, and shortness of breath.

Iron deficiency conditions of the population are found in many countries. If in Western Europe and the USA the issues related to iron deficiency are largely resolved thanks to the implementation of the World Health Organization (WHO) program “Hemoglobin improvement of the population”, then for Russia and some other countries iron deficiency remains a serious medical and social problem.

Despite the increased interest of doctors and a large arsenal of drugs for the treatment of iron deficiency anemia, the number of patients is steadily growing. In 2021, scientists studied the global incidence of anemia and compared it with the 1990 figures. According to this study, about 1.92 billion people in the world suffer from this condition, which is almost 25% of the world’s population. The absolute number of people with anemia increased from 1.5 billion in 1990 to 1.92 billion in 2021, which scientists attributed to the growth of the world’s population.

In all regions and age groups, the prevalence of anemia in men was lower than in women: among people of all ages, it was 17.5% in men and 31.2% in women.

Causes of Iron Deficiency Anemia

The main causes of IDA:

Insufficient iron intake from food: fasting, vegetarianism, or a diet low in iron and protein ;
Congenital iron deficiency in the body (iron deficiency in the mother);
Impaired iron absorption. Occurs with enteritis, chronic duodenitis, gastritis and other damage to the gastrointestinal mucosa, hereditary diseases;
Hidden and obvious bleeding;
Alcohol abuse;
Increased need of the body for nutrients (growth period in adolescents, pregnancy).
Intense physical activity, such as professional sports.

Blood loss

Iron is found in hemoglobin, a complex protein that carries oxygen in the body and is part of red blood cells. Any loss of blood can cause iron deficiency anemia, but chronic conditions are especially dangerous.

A common cause of iron deficiency anemia is gastrointestinal bleeding. It can be cause by:

taking nonsteroidal anti-inflammatory drugs (NSAIDs) , such as ibuprofen and aspirin;
stomach ulcers;
inflammation of the intestines or esophagus (esophagus);
polyps, hemorrhoids;
In rare cases – bowel or stomach cancer.

Women are more prone to anemia because of menstruation and pregnancy are common causes of this condition. During pregnancy, iron deficiency anemia is most often cause by a lack of iron in the diet.

Unbalanced diet

Iron comes into our body from food. A person whose diet lacks iron-rich foods may suffer from iron deficiency anemia. Malnutrition can lead to the development of iron deficiency anemia in both children and adults.

Poor absorption of iron

Iron from food is absorb into the blood in the small intestine. Various intestinal diseases affect the absorption of nutrients and can cause anemia .

Symptoms of Iron Deficiency Anemia

Iron deficiency is dangerous because the signs of a lack of this microelement do not appear immediately. At the initial stages, the body uses internal reserves and tries to cope with the disease itself.

The symptoms are so diverse that they affect almost every functional system of our body.

Their severity depends on the degree of decrease in the level of hemoglobin and ferritin – another complex protein that acts as a depot of iron in humans. Therefore, correct interpretation and comparison of existing symptoms and laboratory diagnostic data will allow eliminating IDA at the earliest stages.

Signs of iron deficiency:

stress;
frequent infectious diseases;
chronic inflammation.

Iron deficiency anemia is characterize by:

pale skin;
cold extremities;
hair loss;
cracks in the corners of the mouth;
irritability, fatigue, lethargy, drowsiness;
memory and concentration impairment;
developmental delay in children;
muscle weakness;
shortness of breath during physical exertion;
low pressure;
spots before the eyes, dizziness;
frequent yawning, feeling of shortness of breath;
addiction to specific smells and tastes.

Iron performs important functions in our body, here are some of them:

cleansing the body;
providing tissues with oxygen and producing energy;
support of hormonal function;
thyroid gland function – it determines the condition of the entire organism;
production of sex hormones;
adrenal function;
immunity;
brain function;
muscle activity

Stages of anemia

In clinical practice, according to severity (hemoglobin level), there are 4 degrees of iron deficiency anemia with the following hemoglobin levels :

I – hemoglobin less than 120 g/l, but more than 100 g/l;
II – the blood hemoglobin value is in the range from 80 to 99 g/l;
III – the hemoglobin level is 65-79 g/l;
IV – blood hemoglobin less than 65 g/l.

Depending on the degree of iron deficiency anemia, appropriate treatment is prescribe.

Diagnostics

Since there are many causes of iron deficiency, the list of tests for diagnosis and understanding of these causes can be quite significant. It will depend on the initial complaints, anamnesis, assessment of nutritional status, examination by related specialists and other factors.

The following tests are recommend as basic tests:

Hemoglobin (shows whether the tissues are receiving enough oxygen);
Erythrocytes (participate in the transportation of oxygen to cells and organs and remove carbon monoxide from the body);
Mean corpuscular volume MCV (allows to determine the nature of anemia and micronutrient deficiency);
Mean corpuscular hemoglobin content;
MCH (how much hemoglobin is containe in one red blood cell);
Mean concentration of hemoglobin in erythrocytes MCHC (reflects how saturated the erythrocyte is with hemoglobin. Necessary to identify the type of anemia);
The width of the distribution of erythrocytes by volume (reflects how many of the total number of erythrocytes are altere, defective erythrocytes);
Hematocrit (shows the ratio of the volume of red blood cells to the total volume of blood);
Serum iron (reflects the concentration in the blood serum);
Ferritin (reflects iron reserves in body tissues);
Transferrin (iron carrier protein);
Total protein (plasma protein concentration);
LJSS (reflects the potential ability of serum to bind iron).

Treatment and prevention

The best prevention of iron deficiency anemia is a balanced diet that includes foods rich in iron.

But if there is already a deficiency, it is important to understand the cause, since a balanced diet alone may not solve the problem.

If you suspect that you have an iron deficiency, consult a doctor. The specialist will prescribe the appropriate tests and, if iron deficiency anemia is detect, prescribe the necessary medications .

Treatment usually involves treating the underlying condition and taking iron supplements. Iron is often take orally, but in some cases it may need to be give intravenously.

Rules for taking iron supplements:

You should not take iron if you have inflammation;
Liquid forms should be drink through a straw to prevent staining of tooth enamel;
Do not wash down with drinks, only water;
Vitamin C increases the absorption of iron, it can be take at any meal, but it is better after lunch, closer to the time of iron intake;
The tablet must not be divide;
Take 1-2 hours before dinner and avoid foods containing calcium, coffee, tea, milk, nuts and chocolate;
When taking iron, it is necessary to pay attention to other vitamins and minerals that help iron to be absorb. If they are in deficiency (assessed by tests), then take them additionally, if they are not include in the iron complex.

Some people may experience side effects when taking iron supplements, such as constipation or diarrhea, abdominal pain, heartburn, feeling unwell, and dark stools. To reduce the risk of these symptoms, it is recommend to take the tablets with or immediately after meals.

Despite possible side effects, it is important to continue taking the drug, as this helps to normalize iron levels in the body.

Your doctor may order additional blood tests after a few months to check if your iron levels have returned to normal.

Complications

Consequences of long-term iron deficiency in the body:

Hypoxia of organs and tissues and, accordingly, worsening of manifestations of secondary immunodeficiency ;
Progression of manifestations of visceral syndrome: disruption of the cardiovascular system, decreased muscle tone, gradual development of muscle atrophy;
Disruption of the digestive tract;
Menstrual cycle disorders in women, risk of miscarriage and premature birth in pregnant women;
Disruption of the nervous system: sudden mood swings, anxiety, increased excitability;
Chronic iron deficiency anemia : the body’s synthesis of iron is disrupted, which leads to a disruption in the supply of oxygen to tissues.

Nutrition for iron deficiency anemia

The main rule of the diet for iron deficiency anemia is the optimal amount of easily digestible protein. Pay attention to the following products:

offal – liver is rich in heme iron;
egg whites, such as in omelettes;
seafood: squid, shrimp, mussels;
meat, particularly beef;
fish.

Protein is necessary for better absorption of iron, formation of red blood cells and formation of hemoglobin compounds.

When correcting iron deficiency, it is important to exclude sugar and simple carbohydrates from the diet.

It is recommended to increase the consumption of hematopoietic microelements – vitamin C and B vitamins, by including foods rich in these vitamins in the diet.

The importance of individual foods for solving the problem of anemia depends not only on the amount of iron in these foods, but also on the degree to which it is absorbed by the body.

Iron from food is partially absorbed from the intestines into the blood. Iron is best absorbed from animal protein – offal, red meat, bone broth.

The glycine found in bone broth increases iron levels in the blood, preventing anemia and helping the blood carry oxygen better.

In case of iron deficiency, it is necessary to include a glass of broth in the daily diet, before the main meal. You can serve it with greens and egg, or cook a side dish (for example, buckwheat) in bone broth.

The amino acid glutamine will help heal the intestinal mucosa, which will ensure better absorption of iron.

How to make bone broth?

Bone broth is a real superfood. You can use any tubular bones as a basis: chicken, turkey, beef, fish heads will also do. The richest broth is obtained from joint beef bones.

Proportions: 500-600 g of bones are needed for 3-4 liters of water.

You can add a spoonful of apple cider vinegar or lemon juice and the required amount of sea or Himalayan salt. Bring to a boil and reduce heat to low. Cook until the water is on the verge of boiling, but not bubbling. Cook for 8-14 hours. Tubular bones of cattle are cooked for up to 24 hours.

When cooking, you can also add onions, carrots, and bay leaves, but then remove them.

The finished broth can be divided into portions and frozen. It keeps well and can be quickly reheated if necessary.

It is important to provide the body not only with iron, but also with vitamins that facilitate the absorption of iron from food or food supplements. Here are some of them:

Vitamin C. Contained in sauerkraut (especially if it is with cranberries), citrus fruits, bell peppers, rose hips, sea buckthorn, black currants, kiwi, parsley.
Vitamin B12 . Found in liver, herring, mackerel, mussels, beef, turkey, shrimp, eggs.
Vitamin B9 . Contained in offal, legumes, spinach, asparagus.
Copper . Found in liver, meat, legumes, buckwheat.
Zinc : Can be found in beef, liver, seafood (oysters, clams, herring), wheat germ, rice bran, oatmeal, carrots, peas, onions, spinach, and nuts.

Iron from foods is divided into two types:

Heme iron (Fe2+) is found in animal products (offal, meat, fish, seafood, bone broth) and makes up 17-22% of the total iron content in the diet. The bioavailability of heme iron is about 15-20%, for example, if a person consumes 10 mg of iron with food, then 1.5-2 mg is absorbed into the blood.

Non-heme iron (Fe3+) is found in plant-based foods (legumes, greens and vegetables, cereals and pseudo-cereals). The bioavailability of non-heme iron is 1-5%, for example, if a person consumes 10 mg of non-heme iron with food, only 0.1-0.5 mg enters the blood.

It is important to remember that there are substances that interfere with the absorption of iron, and to reduce their consumption:

Polyphenols (found in red wine, dark chocolate, tea);
Phytates (found in grains, seeds, nuts, legumes, coffee beans);
Phosphates: E340 (potassium phosphates) and E452 (sodium, calcium, potassium polyphosphates): found in ham, sausages, hot dogs, chips, confectionery products, instant coffee in bags; E339 (sodium phosphates): found in frozen instant products, baked goods, sweets, dry cream and dry milk, cheese, sauces; E341 (calcium orthophosphate): found in sweet soda, sports drinks, processed cheeses, store-bought canned vegetables and fruits.
Oxalic acid (found in spinach, rhubarb, sorrel, cocoa and chocolate).
Tetracyclines (found in bacteriostatic antibiotics).

Dietary supplements for iron deficiency anemia

Nutraceutical support depends largely on the cause of the iron deficiency (if the problem is parasites, then you need to focus on eliminating them first):

The importance of protein has already been mentioned above; its deficiency should be excluded; for this purpose, protein, collagen and amino acids can be used.
It is necessary to replenish iron cofactors – those vitamins and minerals that help absorb iron. These include: vitamin C, zinc and B vitamins.
Adequate amounts of copper are required for normal iron metabolism and red blood cell production. Copper can be obtained from liquid chlorophyll .
Third-generation iron preparations in the form of chelated forms of iron bisglycinate (iron bound to the amino acid glycine) have high bioavailability and good tolerability.

Iron deficiency anemia is a common and serious syndrome that can significantly worsen a person’s quality of life. This condition requires careful diagnosis and treatment, as it is not always easy to notice right away.

Timely visit to the doctor, correct diagnosis and compliance with recommendations for treatment and prevention will help to avoid serious complications and restore good health.

Remember that health is a priceless gift, and taking care of it must be constant and conscious.