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What are the symptoms of iron deficiency? What happens when iron is very low?

According to the World Health Organization (WHO), approximately 600-700 million people worldwide are subject to iron deficiency. In Italy, approximately 7.1% of women and 2.8% of men suffer from iron deficiency for diet-related reasons. Given the importance of iron for the proper performance of many physiological functions, it is important to keep the normal values of this nutrient under control. When the values are lower than physiological values, typical symptoms of iron deficiency may occur.

Iron deficiency symptoms: let’s learn to recognise them

Iron is an essential nutrient for the normal course of many metabolic processes. For example, it plays a role in the formation of haemoglobin, myoglobin and certain enzymes (cytochromes), contributes to normal cognitive functions and the normal functioning of the immune system

The amount of iron in the body is measured through specific diagnostic tests such as sideremia, transferrinemia and ferritinaemia. These values contribute, together with other tests that investigate the total iron binding capacity (TIBC) and transferrin saturation, to define the blood iron levels, i.e. to have a picture of the metabolism and balance of iron in the body. Diagnostic tests to assess the amount of haemoglobin in the blood and haematocrit values (test indicating the percentage of blood volume occupied by red blood cells) may also be useful to investigate the severity of a possible iron deficiency

When we are faced with an iron deficiency, some typical symptoms or disorders may occur. Symptoms of iron deficiency include:

  • General physical and mental fatigue (asthenia);
  • Pale skin and mucous membranes;
  • Headaches and migraine;
  • Difficulty breathing and shortness of breath, even at rest;
  • Irritability;
  • Insomnia and difficulty in resting normally;
  • Tachycardia;
  • Difficulty concentrating;
  • Dizziness;
  • Greater fragility of skin, nails and hair.

The more significant the deficiency, the more the symptoms of iron deficiency intensify. In the extreme case in which iron values are very low, extreme thirst, a state of confusion and fainting can also occur. 

In general, the severity of symptoms depends on the rate at which iron deficiency sets in. An iron deficiency caused by an insufficient intake of this nutrient through food, related to absorption disorders or related to physiological factors (pregnancy, breastfeeding, menstrual cycle, growth of the body during childhood and adolescence) sets in over a long time and therefore the symptoms are less serious than an iron deficiency caused by a significant loss of blood resulting from trauma, surgery or intestinal bleeding. 

Iron deficiency without symptoms

Iron deficiency that sets in slowly over time is sometimes difficult to identify. Especially when it is moderate, the symptoms of iron deficiency can be very mild and not lead to obvious disorders. It is therefore not uncommon to discover an iron deficiency in asymptomatic people. In these cases, the deficiency is identified by routine blood tests or performed to investigate problems that have nothing to do with sideropenic anaemia

What you should do when iron deficiency symptoms occur 

If you are subject to iron deficiency, or if you experience any of the symptoms described above, you should talk to a doctor. The doctor, through blood tests, will identify a possible iron deficiency. Depending on the outcome, the doctor will propose the most suitable therapy to restore iron values in the body to normal levels.
In general, the doctor will recommend a diet with iron-rich foods and a possible iron-based nutritional supplement. Depending on whether you are an adult or a child, your doctor or paediatrician will assess the most appropriate remedies and dietary supplements to combat deficiencies or increased bodily requirements for this essential nutrient.

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