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Anaemia (Iron Deficiency)

The most common nutritional deficiency worldwide — and one of the easiest to fix once found.

Anaemia means a reduced red-blood-cell count or haemoglobin level, so the body carries less oxygen. Iron deficiency is the most common cause globally — from diet, blood loss, pregnancy, or malabsorption. Treatment addresses both the low iron and the reason it got low in the first place.

Causes & risk factors

  • Low dietary iron intake
  • Menstrual blood loss, especially heavy periods
  • Gastrointestinal blood loss (ulcers, haemorrhoids, bowel cancer)
  • Pregnancy and lactation (increased demand)
  • Poor absorption (coeliac disease, gastric surgery)
  • Chronic kidney disease reducing erythropoietin

Symptoms

  • Persistent tiredness, especially on exertion
  • Pale skin, nail beds, and inner eyelids
  • Breathlessness and a fast heartbeat
  • Headache and poor concentration
  • Brittle nails and hair loss
  • Restless legs, especially at night

How it's diagnosed

  • Full blood count (low haemoglobin, low MCV in iron deficiency)
  • Ferritin (best marker of iron stores) and transferrin saturation
  • Endoscopy/colonoscopy in men and post-menopausal women to find a bleed source
  • Coeliac screen when malabsorption is suspected

Evidence-based treatment

  • Oral iron supplements — typically 3–6 months to refill stores
  • Take with vitamin C; avoid tea/coffee within an hour
  • IV iron if oral isn't tolerated or stores need rapid repletion
  • Treat the underlying cause — heavy periods, GI bleed, diet
  • Transfusion only for severe symptomatic anaemia

Prevention

  • Iron-rich diet: red meat, legumes, dark leafy greens, fortified cereals
  • Vitamin C with plant-based iron sources
  • Manage heavy periods with a doctor
  • Screen during pregnancy as per antenatal guidelines

Anaemia (Iron Deficiency) — FAQ

How long does it take to recover from iron-deficiency anaemia?

Haemoglobin usually rises within 2–4 weeks of starting iron, but replenishing stores takes 3–6 months of continued treatment.

Is it safe to self-diagnose with iron tablets off the shelf?

Taking iron without a confirmed deficiency can mask more serious causes of fatigue — and iron overload has its own risks. Get a blood test first.