Fatigue , pale skin , hair loss – these are symptoms that many women accept as normal. However, these complaints can be caused by iron deficiency anemia, which often goes unnoticed. Women of childbearing age are particularly affected, often with significant impacts on everyday life [1]. In this article, you'll learn how to recognize the symptoms, understand the causes, and find solutions.
The most important things in brief
Iron deficiency anemia particularly affects women of childbearing age. Symptoms include fatigue, paleness, and hair loss.
Common causes : Heavy menstrual bleeding, pregnancy or poor iron absorption.
A blood test will determine whether there is an iron deficiency.
Gentle alternatives such as iron bisglycinate and lactoferrin often work better and are more tolerable than conventional preparations.
Adequate vitamin C intake improves iron absorption.
What is iron deficiency anemia?
Anemia occurs when the body produces too few red blood cells or too little hemoglobin. Hemoglobin is the protein that transports oxygen in the blood. If the body lacks iron, which is needed to form hemoglobin, it cannot produce new red blood cells.
The result: organs and tissues receive too little oxygen , leading to symptoms such as chronic fatigue, weakness, or concentration problems. These symptoms are often not immediately recognized because they are nonspecific [2,3].
Why are women particularly affected?
Women are particularly susceptible to iron deficiency due to various biological factors:
- Heavy menstrual bleeding: Every period means a loss of iron, which is not always replenished quickly enough.
- Pregnancy: During pregnancy, iron requirements increase significantly. The body needs more iron to ensure adequate nutrition for both mother and baby.
- Breastfeeding: Even after birth, the need for iron remains high.
These factors can cause iron stores to gradually deplete without being immediately noticed [4,5].
The symptoms: What you should pay attention to
Iron deficiency anemia often presents with non-specific symptoms:
- Tiredness or exhaustion
- Pale skin
- Brittle nails and hair loss
- Concentration problems
- Freezing , even at moderate temperatures
- Shortness of breath , even with light exertion
In severe cases, symptoms such as rapid heartbeat or chest pain may occur. These symptoms are sometimes mistakenly associated with heart or lung disease [3,6].
Did you know?
The brown color of dried blood occurs because the iron it contains oxidizes in the air—a process similar to the rusting of metal.
How is iron deficiency anemia diagnosed?
If you suspect iron deficiency, you should see a doctor . A blood test will provide clarity.
The most important values:
- Ferritin: The iron storage protein. Low levels indicate depleted iron stores.
- Hemoglobin: Shows the amount of oxygen transport protein in the blood.
- Transferrin: This transport protein increases when the body tries to mobilize more iron.
In addition, a microscope finding can be helpful: In cases of iron deficiency, the red blood cells are often smaller and lighter than normal [6,7].
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How can iron stores be replenished?
Iron-rich foods help replenish stores [3,6,7]:
- Red meat (e.g. beef)
- Legumes (e.g. lentils, beans)
- Nuts and seeds
- Green leafy vegetables (e.g. spinach)
Tip : Combine iron-rich foods with vitamin C-rich foods like peppers, citrus fruits, or berries. This improves iron absorption.
If your diet is insufficient, iron supplements can help. These are available in various forms:
- Tablets or capsules
- Juices
- Iron infusions (in severe cases or poor iron absorption in the intestine)
Challenges in treatment
Conventional preparations, such as ferrous sulfate , can cause side effects such as stomach upset , bloating, or constipation . These symptoms often lead to patients discontinuing use before the deficiency is corrected [8,9].
Modern alternatives:
- Ferrous bisglycinate: Shows high bioavailability and fewer side effects. A significant improvement in hemoglobin concentration has been demonstrated, particularly in pregnant women [10].
- Lactoferrin: This iron-binding protein is well-tolerated and helps improve iron absorption. It also has anti-inflammatory properties [11].
How can you prevent iron deficiency?
There are several ways to prevent iron deficiency:
- Balanced diet: Women at increased risk should regularly include iron-rich foods in their diet.
- Vitamin C combinations: Vitamin C increases iron availability in the body. A glass of orange juice with a meal containing iron can promote absorption [12,13].
- Use supplements in a targeted manner: Products such as iron bisglycinate or lactoferrin are suitable not only for treatment but also for prevention in cases of high iron requirements, for example during pregnancy [14,15].
Conclusion
Iron deficiency is a common but treatable problem that primarily affects women. With early diagnosis, appropriate treatment, and preventative measures, you can optimally support your body. If you notice symptoms such as fatigue or hair loss, don't hesitate to consult a doctor. A healthy diet and well-tolerated supplements will help stabilize your iron levels in the long term.
Our expert
Sharleen Omara, MD
doctor
Focus:
Gynecology | Nutritional Medicine | Public Health
FAQs - The most frequently asked questions
What is iron deficiency anemia?
Iron deficiency anemia is a form of anemia in which the body lacks enough iron to produce sufficient red blood cells. These cells are crucial for transporting oxygen throughout the body. A deficiency leads to symptoms such as fatigue, weakness, and pale skin.
Who is most frequently affected by iron deficiency?
Women of childbearing age, pregnant women, breastfeeding women, and people with heavy menstrual bleeding or poor intestinal iron absorption are at higher risk. Vegetarians and vegans can also be affected, as plant-based iron is less readily absorbed by the body.
How is iron deficiency diagnosed?
A simple blood test performed by a doctor will determine whether you have an iron deficiency. Levels of ferritin (iron storage), hemoglobin, and transferrin are particularly important.
Can iron supplements have side effects?
Conventional iron supplements such as ferrous sulfate can cause side effects such as constipation, nausea, or stomach pain. Gentler alternatives such as ferrous bisglycinate or lactoferrin are better tolerated.
How can I improve iron absorption?
Combining iron-rich foods with vitamin C-rich foods or drinks (e.g., orange juice) significantly improves iron absorption. Avoid drinking coffee or tea directly after a meal, as they inhibit iron absorption.
What is the difference between ferrous bisglycinate and ferrous sulfate?
Ferrous bisglycinate is a modern, well-tolerated form of iron that causes fewer side effects. It has high bioavailability, meaning it is absorbed more efficiently by the body. Ferrous(II) sulfate is an older variant that more frequently causes gastrointestinal discomfort.
How can I prevent iron deficiency?
A balanced diet with iron-rich foods, combined with vitamin C, helps prevent iron deficiency. Women with heavy menstrual blood loss or during pregnancy can also take well-tolerated iron supplements such as lactoferrin.
Which foods are rich in iron?
Red meat, offal, legumes, green leafy vegetables, nuts and seeds are rich in iron.
References for further reading:
- Federal Ministry of Health: Anemia https://gesund.bund.de/blutarmut-anaemie (accessed on August 6, 2023)
- DocCheck Flexikon: Anemia https://flexikon.doccheck.com/de/An%C3%A4mie (accessed on August 6, 2023)
- Professional Association of German Internists: Iron deficiency https://www.internisten-im-netz.de/krankheiten/eisenmangel/was-ist-eisenmangel.html (accessed on August 6, 2023)
- Hahn J. Anemias – Overview . In: Hahn J. , ed. Checklist for Internal Medicine . 9th, completely revised edition. Stuttgart: Thieme; 2023.
- Matzdorff A , Duckert M , Fritze D. Common forms of anemia . In: Arastéh K , Baenkler H , Bieber C , Brandt R , Chatterjee T , Dill T , Ditting T , Duckert M , Eich W et al., eds. Duale Reihe Innere Medizin . 4th, revised edition. Stuttgart: Thieme; 2018.
- Tichelli A , Herrmann R. Iron deficiency anemia . In: Greten H , Rinninger F , Greten T , eds. Internal Medicine . 13th edition. Stuttgart: Thieme; 2010.
- Hahn J. Iron deficiency anemia . In: Hahn J. , ed. Checklist for Internal Medicine . 9th, completely revised edition. Stuttgart: Thieme; 2023.
- Nguyen M, Tadi P. Iron supplementation. [Updated 2022 Jul 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557376/
- Moe S, Grill AK, Allan GM. Newer iron supplements for anemia. Can Fam Physician. 2019 Aug;65(8):556. PMID: 31413026; PMCID: PMC6693619.
- Fischer JAJ, Cherian AM, Bone JN, Karakochuk CD. The effects of oral ferrous bisglycinate supplementation on hemoglobin and ferritin concentrations in adults and children: a systematic review and meta-analysis of randomized controlled trials. Nutr Rev. 2023 Jul 10;81(8):904-920. doi: 10.1093/nutrit/nuac106. PMID: 36728680; PMCID: PMC10331582.
- Bumrungpert A, Pavadhgul P, Piromsawasdi T, Mozafari MR. Efficacy and Safety of Ferrous Bisglycinate and Folinic Acid in the Control of Iron Deficiency in Pregnant Women: A Randomized, Controlled Trial. Nutrients. 2022 Jan 20;14(3):452. doi: 10.3390/nu14030452. PMID: 35276810; PMCID: PMC8839493.
- Lynch SR, Cook JD. Interaction of vitamin C and iron. Ann NY Acad Sci. 1980;355:32-44. doi: 10.1111/j.1749-6632.1980.tb21325.x. PMID: 6940487.
- Hallberg L, Brune M, Rossander L. The role of vitamin C in iron absorption. Int J Vitam Nutr Res Suppl 1989;30:103-8. PMID: 2507689.
- Zhao X, Zhang Nutrients. 2022 Jan 27;14(3):543. doi: 10.3390/nu14030543. PMID: 35276902; PMCID: PMC8838920.
- Abu Hashim H, Foda O, Ghayaty E. Lactoferrin or ferrous salts for iron deficiency anemia in pregnancy: A meta-analysis of randomized trials. Eur J Obstet Gynecol Reprod Biol. 2017 Dec;219:45-52. doi: 10.1016/j.ejogrb.2017.10.003. Epub 2017 Oct 4. PMID: 29059584.