Iron Deficiency in Women: The Causes, Symptoms, and Treatment

Are you constantly exhausted, lethargic, and feeling grey? Many women chalk it up to a busy life, but it could be due to iron deficiency. You might need an iron infusion, either privately or through the NHS. Effect Doctors, a consultant-led boutique medical practice in Soho, London, offers private iron infusions.

Fast and Convenient Testing: Your blood sample can be taken at your home, office, or our clinic, with results available within 24 hours. If your ferritin levels are below 30, we can design a bespoke iron infusion to correct this, as well as address other deficiencies like Vitamin D or B12.

Understanding Iron Deficiency

Iron deficiency, which can lead to iron deficiency anaemia (IDA), affects millions worldwide, particularly women. In the UK, 8% of women are iron deficient, with 1% severely so.

Despite symptoms, the crucial blood test for ferritin is often not requested by doctors. Even ferritin levels in the low normal range (30-80) can cause symptoms.

Impact on Quality of Life

Iron deficiency can severely reduce quality of life, causing symptoms such as thinning hair, low mood/depression, and low energy. This blog will delve into these symptoms, causes, necessary investigations, and treatment options.

Causes of Iron Deficiency:

  1. Menstrual Blood Loss: Women are at a higher risk of developing iron deficiency anaemia due to menstrual blood loss. Heavy menstrual bleeding can deplete iron stores over time.
  2. Pregnancy: Iron requirements significantly increase during pregnancy to support the growing foetus and placenta. If dietary intake doesn’t meet these increased demands, iron deficiency anaemia can develop.
  3. Poor Diet: Inadequate intake of iron-rich foods such as red meat, poultry, fish, lentils, beans, and leafy green vegetables can lead to iron deficiency.
  4. Gastrointestinal Disorders: Conditions such as coeliac disease, inflammatory bowel disease (IBD), and gastrointestinal bleeding can impair iron absorption, leading to iron deficiency.
  5. Blood Loss: Any form of chronic blood loss, such as from ulcers, polyps, or frequent blood donation, can contribute to iron deficiency leading to iron deficiency anaemia in women.

Symptoms of Iron Deficiency:

  1. Fatigue: The hallmark of iron deficiency anaemia is persistent fatigue due to reduced oxygen supply to tissues.
  2. Irritability and mood swings: Changes in neurotransmitter levels due to iron deficiency can affect mood regulation, leading to increased irritability, mood swings, and emotional instability.
  3. Depression: Research suggests a link between iron deficiency and depression. Low iron levels may disrupt the functioning of brain regions involved in mood regulation, increasing the risk of depressive symptoms.
  4. Anxiety: Iron deficiency may exacerbate symptoms of anxiety or contribute to the development of anxiety disorders. Changes in neurotransmitter levels and altered brain function associated with iron deficiency can contribute to feelings of anxiety and nervousness.
  5. Poor concentration and cognitive function: Iron deficiency can impair cognitive function, attention, and memory. Difficulty concentrating and cognitive fog may contribute to feelings of frustration, stress, and decreased overall well-being.
  6. Weakness: Women with IDA may experience weakness, especially during physical exertion.
  7. Pale skin and nail beds: Reduced haemoglobin levels can result in pale skin and nail beds.
  8. Shortness of breath: Insufficient oxygen supply to tissues can lead to shortness of breath, particularly during activities.
  9. Headaches and dizziness: Some women may experience headaches, dizziness, or lightheadedness due to inadequate oxygenation of the brain.
  10. Hair-related issues including:
    1. Increased hair shedding: Women with iron deficiency may notice excessive hair shedding, often characterised by more hair fall during brushing, washing, or styling.
    2. Thinning hair: Iron deficiency can lead to overall thinning of the hair, making the scalp more visible.
    3. Brittle hair: Hair may become dry, brittle, and prone to breakage in individuals with iron deficiency.
    4. Slowed hair growth: Iron deficiency can delay the hair growth cycle, resulting in slower hair growth and difficulty in achieving desired hair length.
    5. Changes in hair texture: Some women may experience changes in hair texture, such as increased frizziness or loss of shine, due to iron deficiency.

How to Diagnose Iron Deficiency:

To check for iron deficiency, healthcare providers typically use a combination of blood tests that provide information about various aspects of iron metabolism and blood cell parameters. Here are the common blood tests used to assess iron deficiency. You could ask your GP to undertake these for you, or private providers such as Effect Doctors can undertake them for you at your earliest convenience.

  1. Full Blood Count (FBC): In particular checking the level of haemoglobin.
  2. Serum Ferritin: This is the most important test to ask for. Serum ferritin levels reflect the amount of iron stored in the body. Low ferritin levels are indicative of iron deficiency, even before anaemia develops. Serum ferritin is considered one of the most sensitive markers for iron deficiency. Ferritin < 30 ng/mL is the cut-off commonly used to diagnose iron deficiency, particularly in the absence of inflammation or other confounding factors.
  3. Serum Iron
  4. Total Iron-Binding Capacity (TIBC)
  5. Transferrin Saturation
  6. Red Blood Cell Distribution Width (RDW)

These blood tests are often interpreted together to provide a comprehensive assessment of iron status and detect iron deficiency at various stages, from early depletion of iron stores to the development of anaemia. It’s important to consult with a healthcare provider for proper interpretation of blood test results and appropriate management of iron deficiency.

Treatments for Iron Deficiency:

  1. Oral iron supplementation: Iron supplements are commonly prescribed to replenish iron stores. It’s important to take these supplements as directed by a healthcare provider to maximise absorption and minimise side effects such as constipation. In certain cases, the iron deficiency is so severe that intravenous iron is required. One issue with oral iron supplementation is the side effects that are sometimes experienced which mean adherence to supplementation is often poor. These include gastrointestinal upset, constipation, stomach cramps and pain, heartburn and acid reflux, metallic taste, staining of the teeth or tongue, and black and smelly stools.
  2. Intravenous (IV) iron infusions are sometimes prescribed to rapidly replenish iron stores in individuals with severe iron deficiency or where oral iron supplementation is ineffective or not feasible. This is not a cheap option (typically prices are around £900) but it will immediately replenish your levels of iron. This also carries risks and side effects and should be done under the direct supervision of a doctor who is an expert in its administration.
  3. Dietary changes: Increasing consumption of iron-rich foods can help prevent and treat iron deficiency anaemia. Incorporating foods such as lean meats, poultry, fish, beans, lentils, tofu, spinach, and fortified cereals into the diet is recommended.
  4. Vitamin C intake: Consuming vitamin C-rich foods or supplements alongside iron-rich foods or supplements can enhance iron absorption.
  5. Addressing underlying causes: Treating underlying conditions contributing to iron deficiency, such as gastrointestinal disorders or menstrual disorders, is crucial for long-term management.
  6. Blood transfusion: In severe cases of iron deficiency anaemia, particularly when accompanied by significant symptoms or complications, blood transfusions may be necessary to rapidly increase haemoglobin levels.

Iron deficiency is a common condition that significantly impacts the health and quality of life of women. Recognising the causes, symptoms, and treatment options is essential for effective management and prevention of complications. Through a combination of dietary modifications, iron supplementation, and addressing underlying factors, women can overcome iron deficiency anaemia and regain optimal health. Regular screening and proactive management are key in ensuring the well-being of women at risk for or affected by this condition.