Overview
Tiredness that will not lift, feeling cold when others are comfortable, or noticing your skin looks a little pale, these are easy to write off as a busy week or simply not sleeping enough. For many people, especially women and young children, the real explanation is iron-deficiency anaemia, one of the most common and most treatable conditions in the world.
Disease Summary
- Category
- Non-Communicable Disease
- Cause
- Insufficient iron in the body to produce enough haemoglobin, most often from inadequate dietary intake, poor absorption, or blood loss
- Transmission
- Not applicable; iron-deficiency anaemia is not an infectious condition, though some underlying causes, such as hookworm or schistosomiasis, can be
- Body System
- Blood
- Preventable
- Yes
- Curable
- Yes
Symptoms
Common Symptoms
Symptoms often develop gradually and can be easy to attribute to other causes at first.
Fatigue and Weakness
Persistent tiredness, even after rest, is one of the most common signs.
Pale Skin
Reduced haemoglobin can make the skin, and the inside of the lower eyelids, look noticeably paler than usual.
Shortness of Breath
Can occur with everyday activity as the body struggles to carry enough oxygen.
Dizziness or Headache
Can occur as the brain receives less oxygen than usual.
Unusual Cravings
Craving non-food items like ice, dirt, or starch, known as pica, can be a sign of significant iron deficiency.
Danger Signs
Seek prompt medical attention if any of the following develop.
Severe Shortness of Breath
Can indicate the anaemia is severe enough to strain the heart and lungs.
Chest Pain or Rapid Heartbeat
Can indicate the heart is working harder than normal to compensate for low oxygen-carrying capacity.
Fainting
Can indicate significant anaemia or blood loss and needs prompt evaluation.
Visible Bleeding or Black, Tarry Stools
Can indicate an underlying source of blood loss that needs urgent attention.
Diagnosis
Complete Blood Count (CBC)
Measures haemoglobin and red blood cell size, the first step in identifying anaemia and suggesting iron deficiency as the cause.
Serum Ferritin
Reflects the body’s stored iron and is the most specific test for confirming iron deficiency.
Investigating the Underlying Cause
Depending on the situation, this might include checking for blood loss, reviewing dietary intake, or testing for an infection such as hookworm.
Laboratory Tests
Complete Blood Count (CBC)
Measures haemoglobin levels and red blood cell size, which is typically smaller than normal in iron-deficiency anaemia.
Serum Ferritin
The most reliable marker of the body’s iron stores. Low ferritin confirms iron deficiency.
Serum Iron and Total Iron-Binding Capacity (TIBC)
Provides additional detail on how iron is being carried and used in the blood.
Stool Test for Occult Blood or Parasites
Checks for hidden blood loss or parasitic infections, such as hookworm, that can cause or worsen iron deficiency.
Treatment
Oral Iron Supplementation
The standard treatment, taken well beyond when haemoglobin returns to normal, since iron stores take longer to rebuild than blood counts take to recover.
Treating the Underlying Cause
Addressing the source, such as heavy menstrual bleeding, an ulcer, or a parasitic infection, is essential for the anaemia not to return.
Prevention
Eat iron-rich foods
Foods such as beans, leafy green vegetables, meat, and fortified cereals help maintain healthy iron levels.
Pair iron-rich foods with vitamin C
Foods like citrus fruits, tomatoes, and peppers improve how much iron the body absorbs from a meal.
Take iron supplements during pregnancy
Routine iron supplementation during pregnancy is recommended in most settings, given the significantly increased iron needs of pregnancy.
Treat parasitic infections promptly
Deworming and treating infections such as hookworm or schistosomiasis reduces a significant, preventable cause of iron loss.
Risk Factors
Higher Risk
These groups are most commonly affected by iron-deficiency anaemia.
- Children under 5, particularly during periods of rapid growth
- Pregnant and postpartum women
- Menstruating adolescent girls and women
Related Causes
These factors and conditions increase the risk of iron deficiency.
- A diet low in iron-rich foods
- Chronic blood loss, including heavy menstrual periods or gastrointestinal bleeding
- Parasitic infections such as hookworm or schistosomiasis
Additional Considerations
Other contributing factors.
- Frequent malaria infections
- Conditions that reduce iron absorption, such as certain digestive diseases
Complications
Developmental Delays in Children
Untreated iron-deficiency anaemia in early childhood can affect cognitive and motor development.
Pregnancy Complications
Increases the risk of preterm birth, low birth weight, and complications during delivery.
Heart Strain
Severe, longstanding anaemia forces the heart to work harder, which can lead to heart problems over time.
When to Seek Medical Care
Persistent Fatigue or Pale Skin
Should be evaluated, particularly if it is new or worsening.
Severe Shortness of Breath or Chest Pain
Needs prompt medical attention.
Unusual Cravings for Non-Food Items
Worth mentioning to a healthcare provider, since this can be a sign of significant iron deficiency.
Heavy Menstrual Bleeding or Visible Blood Loss
Should be assessed, since ongoing blood loss is a common and treatable cause of anaemia.
Prognosis
Highly Treatable
Iron-deficiency anaemia responds well to treatment once identified, and most people see improvement within weeks.
Full Recovery Is Common
With adequate iron replacement and by addressing the underlying cause, iron stores and haemoglobin can return to normal.
Recurrence Is Possible Without Addressing the Cause
Anaemia can return if the original cause, such as ongoing blood loss or diet, is not also addressed.
Differential Diagnosis
Anaemia of Chronic Disease
Caused by long-term inflammation or illness rather than iron deficiency itself, and does not always improve with iron supplementation alone.
Malaria
Can cause anaemia directly by destroying red blood cells, and often coexists with iron deficiency in the same regions.
Vitamin B12 or Folate Deficiency
Causes a different type of anaemia, usually with larger, rather than smaller, red blood cells.
References
World Health Organization (WHO)
World Health Organization fact sheet on anaemia prevalence, causes, and populations most affected.
WHO Global Anaemia Estimates, 2025 Edition
WHO’s current global and regional estimates of anaemia prevalence among women and children.
Iron Deficiency Anaemia in Sub-Saharan Africa (ScienceDirect)
A review of the causes, burden, and primary care recommendations for iron-deficiency anaemia specific to sub-Saharan Africa.
Frequently Asked Questions
Can iron-deficiency anaemia be cured?
Yes, in most cases. With iron supplementation and by addressing the underlying cause, whether that is diet, blood loss, or an infection, iron levels and symptoms typically improve within weeks to months.
Why do I need to keep taking iron after I feel better?
Feeling better usually means your haemoglobin has improved, but your body’s iron stores take longer to rebuild. Stopping too early is one of the most common reasons anaemia returns.
Is craving ice or dirt a real symptom of anaemia?
Yes. This craving, known as pica, is a recognised sign of significant iron deficiency and is worth mentioning to a healthcare provider.
Can malaria cause anaemia?
Yes. Malaria can destroy red blood cells directly, and in many regions, malaria and iron deficiency are the two leading causes of anaemia, often occurring in the same person at the same time.