Patient education: Low iron (The Basics)

Why do I need iron? — 

The body needs iron to make certain proteins. The main one is called "hemoglobin." This helps red blood cells carry oxygen to all parts of the body.

If the body does not have enough iron, it is called "iron deficiency." It can lead to problems, including "iron deficiency anemia." Anemia is when there is too little hemoglobin in the blood, so the body might not get all the oxygen it needs.

Why might I have low iron? — 

You might not have enough iron if:

●You lost a large amount of blood – This can happen slowly over time, or all of a sudden. It is the most common cause of iron deficiency anemia.

Menstrual periods and pregnancy are common reasons to lose blood. Pregnancy also uses a lot of iron to support the developing fetus. Intense athletic activity can also cause you to lose blood, and you can lose iron through heavy sweating.

Bleeding from the digestive tract it also common. In older people, tumors in the intestine can bleed. Sometimes, bleeding happens so slowly you do not see the blood in your bowel movements.

●Your body cannot absorb enough iron from food – This can happen if you had surgery on your stomach or intestines. It can also happen if you have a condition like celiac disease that affects your intestines.

●You do not get enough iron in your food – This can be a problem in infants who do not get enough iron from formula, food, or supplements. It can also happen in parts of the world where people do not get enough iron in their diet.

What are the symptoms of low iron? — 

Some people have no symptoms. People who do have symptoms might:

●Feel irritable

●Feel tired or weak, especially if they try to exercise or walk up stairs

●Have headaches

●Have hair loss

●Have chest pain or trouble breathing, if they have severe anemia

●Have abnormal cravings that make them want to eat ice or substances like clay or wallpaper

●Have "restless legs syndrome," where the legs feel like they need to keep moving, especially at night

Is there a test for low iron? — 

Yes. Your doctor or nurse can order blood tests to check for low iron and anemia:

●The main test to see if the body has enough iron is called "ferritin." Another test that might be used is called "transferrin saturation," or "TSAT." There is also a test to measure iron in the bloodstream, but this does not measure how much iron is in the body.

●The test to check for anemia is called "hemoglobin." This is part of a test called a "complete blood count," or "CBC." Anemia can happen when iron is very low. There are many other causes of anemia besides low iron.

How is low iron treated? — 

It is treated with extra iron. Eating foods that have iron in them is not enough. If you have severe anemia, you might need a blood transfusion. You might also need treatment for the cause of bleeding.

If you need treatment with iron, you should know:

●Iron comes as pills, or as a liquid you can get through a thin tube that goes into a vein, called an "IV." Your doctor or nurse will talk with you about which is best for you.

●If your doctor prescribed iron pills, make sure you know the strength and how often to take them. The best way to take iron is once a day, once every other day, or Monday, Wednesday, and Friday of each week. Keep track of when to take the iron. You might have to take the pills for a few months. Do not take more iron pills than your doctor says to. Large amounts of iron can be harmful. Iron works better (and faster) if you take it no more than once a day.

●Take iron on an empty stomach. Some foods might make iron pills not work as well. These include eggs, whole-grain bread, cereal, dairy products, coffee, and tea. Vitamin C from supplements or orange juice can make iron pills work better.

●Store your iron pills safely. Make sure children cannot get them. A child can get seriously poisoned if they take iron pills by accident. If a child swallows iron pills, call a poison center right away.

●Iron pills often cause side effects such as nausea and constipation. They can also cause bowel movements to turn black, green, or tar colored.

●Some people cannot get enough iron from pills. This might be the case if you had weight loss surgery, have a condition called "inflammatory bowel disease," or are nearing the end of pregnancy.

●If you have side effects or cannot get enough iron from pills, there are things you can do to reduce these side effects. Or you might switch to IV iron.

It is also important to find out why your iron was low. If it was caused by blood loss, the cause of bleeding needs to be found. Other causes also have important treatments. For example, if you have heavy menstrual periods, your doctor might do tests to find out why. There are medicines that can make your period lighter or stop it completely. Follow all instructions about testing and treatment.

If you have questions about your care, or want to know more about your options, talk to your doctor or nurse. They can help.

More on this topic

Patient education: Low iron in adults – Discharge instructions (The Basics)
Patient education: Low iron in children – Discharge instructions (The Basics)
Patient education: Anemia overview (The Basics)
Patient education: Good food sources of iron (The Basics)
Patient education: Ferritin test (The Basics)
Patient education: Iron studies panel (The Basics)
Patient education: Hemoglobin and hematocrit tests (The Basics)
Patient education: Restless legs syndrome (The Basics)
Patient education: Heavy periods (The Basics)

Patient education: Anemia caused by low iron in adults (Beyond the Basics)
Patient education: Heavy periods (Beyond the Basics)