Key Takeaways
- Without enough iron, your body cannot produce enough hemoglobin, the protein that carries oxygen from the lungs to all parts of the body.
- This may cause symptoms such as fatigue, weakness, difficulty breathing, dizziness, and pale skin.
- Experts say low iron levels can be caused by more obvious causes, such as excessive blood loss or not eating enough iron-rich foods, or by more subtle causes, such as certain foods and medications that block iron absorption.
Iron deficiency is very common, affecting nearly 10 million adults in the United States, including 5 million with iron deficiency anemia. Despite this prevalence, many people are unaware that they have low iron levels and may experience certain symptoms for years without knowing the cause.
What are some of the reasons? Even if you take iron supplements or eat plenty of iron-rich foods, many things interfere with iron absorption.
Here's what you need to know about what can cause low iron levels and what you can do about it, according to experts.
What causes low iron levels?
Most of the iron in the body is found in a red blood cell protein called hemoglobin. As a result, chronic blood loss is a major cause of iron deficiency, whether due to heavy menstruation, surgery, use of blood thinners, or medical conditions such as peptic ulcer disease, says Margaret Ragni, MD, MPH, professor of medicine and clinical practice. “It’s a very rare disease,” the medical director of Translational Research at the University of Pittsburgh and the Hemophilia Center of Western Pennsylvania, Pittsburgh, told Ajuwell in an email.
Of course, you can also develop iron deficiency if you don't eat enough iron-rich foods. This is common in vegan or vegetarian diets, which may be deficient in iron found in animal products.
However, some causes of iron deficiency are less clear, including:
chronic disease
Certain medical conditions, such as celiac disease or Crohn's disease, can affect the body's ability to absorb iron from food, Dr. Abayomi Ogunwale, assistant professor of family medicine at McGovern Medical School at UTHealth Houston, told Verywell in an email. . Other chronic conditions, such as kidney disease or cancer, can also interfere with the body's ability to properly use and store iron.
Drinking Certain Beverages
Drinking coffee, tea, or milk may also affect iron absorption. This is especially true if you consume these beverages around the time you take iron supplements.
“Coffee and tea both contain high levels of compounds called oxalates and flavonoids called tannins. Tannins and oxalates combine with iron to form non-nutritive compounds, limiting iron absorption and utilization,” Ogyunwale said. “Milk contains casein and calcium, which directly reduce iron absorption.”
If you take iron supplements, it's best to take them on an empty stomach to ensure there's nothing interfering with absorption, Ogyunwale said.
“It is best to take iron early in the morning on an empty stomach with water or fruit juice (preferably a juice rich in vitamin C, such as orange juice, which aids absorption), 1 to 2 hours before a meal, along with dairy products, tea, coffee and calcium. Best. “It contains supplements,” he said.
taking certain medications
Using certain medications can negatively affect your iron levels.
“NSAIDs affect iron levels, but indirectly. This can irritate the mucosal lining of the upper digestive tract, causing minor or major bleeding, which can contribute to iron deficiency,” Ogyunwale said. He added that some antibiotics can cause hemolysis, or destruction of blood cells, which can also contribute to lower iron levels.
If you take iron supplements, other medications and vitamins may interfere with iron absorption.
Dr. Oh Kyun-Weil said, “Proton pump inhibitors for acid reflux, heartburn, and gastric ulcers, such as esomeprazole, omeprazole, pantoprazole, and dexlansoprazole, inhibit iron absorption, so separate iron supplements from the use of these drugs by at least 2 hours. “It’s best to do it,” he said. . “The same goes for calcium phosphate. “If you take a zinc supplement, it is best absorbed if you take it about an hour before your iron intake.”
running
Strenuous exercise, such as running or walking for long periods of time, especially on hard road surfaces, can contribute to the destruction of red blood cells, called marching hemoglobinuria, Ragni said. This iron depletion phenomenon is also called foot hemorrhage and is thought to be caused by the capillaries in the feet repeatedly pounding the ground.
life stages
Ragni said the body's need for iron may increase due to certain life stages or conditions, including pregnancy, breastfeeding, and rapid growth in children and adolescents.
How do you know if your iron levels are low?
Ragni said the main way to find out if you have low iron levels is through a blood test.
There are several types of iron tests, each with a different range of normal values. However, these ranges may vary slightly depending on the source or specific laboratory and factors such as age, gender, and individual health status.
- all serum iron test It measures the amount of iron circulating in the blood, and low levels may indicate iron deficiency. The normal range is 60 to 170 micrograms per deciliter (mcg/dL).
- all Transferrin test It measures transferrin, a protein that moves iron throughout the body. High transferrin levels may be a sign of iron deficiency anemia. The normal range is 204 to 360 mg per deciliter.
- all Total iron binding capacity (TIBC) It tests how well iron binds to transferrin and other proteins in the blood. A high TIBC level may indicate a lack of iron in the blood due to iron deficiency anemia. The normal range is 240 to 450 mcg/dL.
- all Ferritin blood test It measures how much iron is stored in the body. Low ferritin levels may indicate low iron stores and iron deficiency. The normal range is 30 to 400 nanograms per milliliter (ng/mL) for men and 13 to 150 ng/mL for women.
What happens if your iron levels are low?
Low levels of iron in the body can cause anemia, which is caused by low blood cell counts and low heme levels, Ogunwale said. This happens because iron is essential for producing hemoglobin, a component of red blood cells that carry oxygen throughout the body.
“Humans cannot make the oxygen-carrying protein called hemoglobin without iron,” Ogunwale said. “This can present itself in a variety of ways and severity, depending on a variety of individual clinical factors.”
Symptoms of low iron levels and resulting anemia include:
- fatigue
- headache
- brittle nails
- pale skin
- cracked corners of mouth
- generalized weakness
- shortness of breath
- dizziness
- cognitive impairment
- waterfall
- restless legs
- palpitations
- increased heart rate
- Pica: Cravings for non-nutritive substances such as ice, clay, dirt, or paper.
If anemia persists for a long time, it can lead to more serious consequences, including organ failure, heart failure and kidney failure, Ogunwale said.
What can I do if my iron levels are low?
If you have low iron levels, the first thing you need to do is figure out why your iron deficiency occurred and prevent it from happening again.
“This means going to the doctor’s office for a medical history, physical exam, and lab tests,” Ogunwale said.
You may also want to discuss with your healthcare provider additional ways to increase your iron levels through lifestyle and eating changes, Ogunwale said. For example, you can include iron-rich foods in your diet, such as beef, poultry, pork, lamb, salmon, tuna, sardines, and eggs. Vegetarians can increase their iron intake by eating baked beans, lentils, whole-wheat pasta, bread, nuts, seeds, kale, spinach, broccoli, or tofu.
What this means to you
To determine if you have low iron levels due to a condition, diet, or other lifestyle risk factors, experts recommend visiting your doctor and getting a blood test.