Symptoms and Diagnosis of Iron Deficiency

By | June 10, 2022

Iron is one of the most abundant metals on earth. The human organism also needs it. Nevertheless, it happens again and again that there is too little iron in the body. About 500 million people worldwide suffer from iron deficiency. But how does iron deficiency manifest itself and how can it be determined?

Iron deficiency – widespread, often underestimated

As an essential trace element, iron is involved in a large number of vital processes in the human body. It is extremely important, especially for blood formation.

In order to be able to maintain the function of all these processes, a certain amount of iron must always be present in the body. If this is not the case, sooner or later symptoms of iron deficiency will appear. For what is diabetes mellitus type 2, please visit

How does an iron deficiency come about?

There are different reasons for an iron deficiency.

First of all, a low or disturbed iron intake can be the cause of the deficiency. Since the body cannot produce iron itself, it must be ingested daily with food. This is not always easy, especially with vegetarian and vegan food. Under certain circumstances, this can lead to an undersupply. Animal iron is considered to be readily available, while plant foods in particular inhibit the absorption of iron. In addition, there are unhealthy eating habits and eating disorders (e.g. bulimia, anorexia), which interfere with iron absorption.

Another cause of iron deficiency is an increased need, such as that found during pregnancy and breastfeeding, in growing children and adolescents, and in athletes.

Ultimately, increased iron loss also contributes to iron deficiency. Excessive blood loss is associated with a loss of iron. This is the case, for example, after operations or in the case of chronic blood loss (e.g. bleeding inflammation of the gastric mucosa), with regular blood donations or with very heavy menstrual bleeding ( hypermenorrhea ).

Iron deficiency is associated with a variety of symptoms

The body not only needs iron for blood formation, but also for the transport of oxygen and electrons and numerous other metabolic processes.

Typical symptoms of iron deficiency are therefore metabolic disorders, which are increasingly aggravated by the deficiency. Symptoms include:

fatigue and exhaustion

Tiredness and sluggishness during the day is not unknown to many people. But if getting enough sleep doesn’t help either, this may be a sign of iron deficiency.

Poor concentration and forgetfulness

Iron is necessary for the brain and brain maturation. It also provides oxygen for growth, life and work. If the brain receives too little iron, the result is poor concentration and forgetfulness.

Shortness of breath and reduced physical performance

If the hemoglobin level falls due to iron deficiency, the muscles are no longer sufficiently supplied with oxygen. Studies have shown that the less hemoglobin in the blood, the higher the heart rate and the stronger the formation of lactic acid.


Due to iron deficiency, the red blood pigment and thus red blood cells in the blood decrease. The tissue to be treated is no longer stained with blood. This is best seen on the oral mucosa, where the skin is very thin and translucent.

Hair loss, brittle nails and cracked corners of the mouth

Hair loss and hair breakage are not always a case for the hairdresser. The organism often lacks micronutrients. An iron deficiency is therefore sometimes noticeable through brittle and falling hair.

Other signs are dry skin, itching, painful cracks at the corners of the mouth, brittle nails and grooves in the nails or canker sores.

susceptibility to infections

Iron is important for the immune system and many cell biological processes. How exactly it affects the immune system has not yet been clearly clarified. However, if colds and other infections occur noticeably often, then the ferritin value should also be determined.

anxiety and depression

Irritability in everyday life is not uncommon. In some cases, an iron deficiency is the cause. Some scientific research is currently being carried out into the connection between iron deficiency and mental illnesses such as depression.

Other symptoms of iron deficiency

In addition to the above signs, there are other symptoms such as

  • restless legs syndrome,
  • Plummer-Vinson Syndrome,
  • Pica disease and
  • an increased tendency to store heavy metals,

that can be associated with iron deficiency.

diagnosis of iron deficiency

In the case of iron deficiency, the clinical picture varies greatly. It can be clearly diagnosed in the laboratory using a combination of different biomarkers. The most important thing is the ferritin level in the blood. For the diagnosis, the doctor will take blood. In quite a few cases, iron deficiency is only diagnosed in the most severe stage.

In order to be able to assess the iron status of a patient individually, several parameters are determined. In addition, there is a classification into different stages of iron deficiency.

  1. Storage iron deficiency

If there is a storage iron deficiency (prelatent iron deficiency), the iron stores and thus the ferritin value in the serum decrease. However, there is still enough iron available for the formation of red blood cells. Functional disadvantages such as tiredness or impairment of the ability to think are already possible at this point.

  1. Functional iron deficiency

In the case of a functional iron deficiency (iron-deficient erythropoiesis), the supply of the precursors to the formation of red blood cells in the bone marrow is no longer adequately guaranteed. As a result, the cells in the body can no longer be supplied with iron and the iron deficiency becomes a disease. At this stage, however, the hemoglobin level is still normal.

  1. Manifest iron deficiency

In the case of a manifest iron deficiency (iron deficiency anemia), the supply of iron to the body’s cells is so low that the hemoglobin value also falls below the normal range. At this point at the latest, other symptoms become noticeable.

Treatment and prevention of iron deficiency

In the long term, treatment consists of changing the diet in the case of dietary iron deficiency. Patients then receive detailed nutritional advice on foods containing iron. Depending on the age, iron supplements can also be prescribed, which are taken with vitamin C if possible.

Vitamin C contributes to better absorption of iron. If a disease is the cause of the iron deficiency, an iron infusion can also help. This is mostly the case with cancer patients. Patients who eat a vegetarian or vegan diet can compensate for an iron deficiency with appropriate iron-rich vegetables.

Diet is also important in preventing iron deficiency. In women who are pregnant, the gynecologist also checks the blood for iron deficiency at regular intervals in order to be able to treat it at an early stage.

Iron deficiency prognosis

The prognosis for iron deficiency depends on whether it is detected early. It is also important to determine the cause of the defect. If this is known, therapy usually leads to success.

If the iron deficiency is normal (e.g. due to an unbalanced diet, after bleeding, during pregnancy, in competitive athletes), then iron supplements help to replenish the iron stores. Chronic gastrointestinal diseases or tumors are more problematic.

In most cases, an iron deficiency can be remedied with appropriate preparations within three to six weeks, but the iron preparations should continue to be taken for about six months afterwards. This replenishes the iron stores sufficiently. During this time, it is important to regularly check your iron levels.

If there is a significant increase in red blood cells about a week after taking the iron supplement, the prognosis is good. However, if symptoms persist after several weeks of use, further investigations must be carried out to clarify other diseases.

Symptoms and Diagnosis of Iron Deficiency