Feeling Fatigued? It Might be Low Iron
Fatigue is one of the most common complaints in healthcare, yet one of the most overlooked causes is iron deficiency anemia (IDA). As the most widespread nutritional deficiency in the world, iron deficiency affects an estimated 25% of the global population, with higher rates among women of childbearing age, pregnant women, adolescents, and individuals with chronic health conditions. In the United States alone, iron deficiency anemia impacts millions—often silently—until symptoms become disruptive to daily life.
Iron plays a critical role in producing hemoglobin, the protein in red blood cells responsible for carrying oxygen throughout the body. When iron stores are low, hemoglobin production drops, oxygen delivery decreases, and the result is profound fatigue. This isn’t simply feeling “tired”—it’s a deep, persistent lack of energy that rest does not resolve.
Common Signs and Symptoms
While fatigue is the hallmark symptom, iron deficiency anemia presents in many ways. Patients often experience weakness, shortness of breath with minimal exertion, dizziness, and cold intolerance. Some develop brittle nails, hair loss, or restless legs syndrome. Pale skin, headaches, and difficulty concentrating are also common. In more severe cases, heart palpitations or chest discomfort may occur due to the heart working harder to move oxygen-poor blood.
Causes of Iron Deficiency Anemia
Understanding the underlying cause is crucial for proper treatment. The most common causes include:
Inadequate dietary intake, especially in individuals who consume low amounts of red meat or follow vegetarian/vegan diets.
Chronic blood loss, such as heavy menstrual cycles or gastrointestinal bleeding from ulcers, polyps, or medications like NSAIDs.
Increased needs, especially during pregnancy, growth spurts, or endurance training.
Poor absorption, often due to celiac disease, bariatric surgery, chronic inflammation, or low stomach acid.
Because symptoms of anemia overlap with many other conditions—including thyroid disorders, depression, sleep problems, and chronic fatigue syndrome—accurate diagnosis requires laboratory testing.
The Importance of Lab Testing
A full iron panel is essential to properly diagnose iron deficiency anemia. Useful tests include:
Complete blood count (CBC)
Serum ferritin (the most sensitive marker of iron stores)
Serum iron
Total iron-binding capacity (TIBC)
Transferrin saturation
Identifying declining ferritin levels long before anemia develops allows for early treatment and improved energy levels.
Fatigue should never be dismissed as simply “stress” or “getting older.” When caused by iron deficiency anemia, proper testing and targeted treatment can restore energy, improve cognitive function, and dramatically enhance quality of life.
Sources
World Health Organization. Anaemia. WHO Fact Sheets.
Centers for Disease Control and Prevention (CDC). Iron Deficiency – United States.
National Institutes of Health (NIH), Office of Dietary Supplements. Iron Fact Sheet for Health Professionals.
Short MW, Domagalski JE. Iron Deficiency Anemia: Evaluation and Management. American Family Physician. 2013.
Cappellini MD, Musallam KM, Taher AT. Iron Deficiency Anemia Revisited. Journal of Internal Medicine. 2020.
