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Iron-Deficiency Anaemia

Learn about iron-deficiency anaemia, including its symptoms, diagnosis, laboratory tests, treatment and prevention.

Last Reviewed 30 Jul 2026
Reading Time 8 min read

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.

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Key Fact

Anaemia affects an estimated half a billion women of reproductive age and 269 million young children worldwide, most commonly because of a lack of iron. It is also one of the most straightforward conditions to treat once the underlying cause is identified.

Warning

Severe shortness of breath, chest pain, a rapid heartbeat, or fainting can indicate severe anaemia and need prompt medical attention. If you feel constantly exhausted, look unusually pale, or crave non-food items like ice or dirt, ask your doctor about testing.

AT A GLANCE

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.
Important
Finding low iron is only half the picture. Identifying why the iron is low, whether from diet, blood loss, or another cause, matters just as much for effective, lasting treatment.

Laboratory Tests

Complete Blood Count (CBC)

Measures haemoglobin levels and red blood cell size, which is typically smaller than normal in iron-deficiency anaemia.

Sample Venous blood
Time Same day

Serum Ferritin

The most reliable marker of the body’s iron stores. Low ferritin confirms iron deficiency.

Sample Venous blood
Time 24–48 hours

Serum Iron and Total Iron-Binding Capacity (TIBC)

Provides additional detail on how iron is being carried and used in the blood.

Sample Venous blood
Time 24–48 hours

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.

Sample Stool
Time 24–72 hours

Laboratory Note

Ferritin can be temporarily raised by inflammation or infection, which can make iron deficiency harder to detect during some illnesses. Doctors sometimes use additional tests to get a clearer picture in these situations.

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.

Route Oral
Duration Several months, to fully replenish iron stores

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.

Route Varies
Duration Depends on the cause

Treatment Note

Taking iron with vitamin C can improve absorption, while tea, coffee, and calcium taken at the same time can reduce it. Stopping iron treatment too early, as soon as symptoms improve, is one of the most common reasons anaemia returns.

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.

Prevention Note

In many low- and middle-income countries, iron deficiency and malaria are the two leading causes of anaemia, often affecting the same people at the same time, which is why anaemia prevention efforts often need to address both together.

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

Risk Note

Iron-deficiency anaemia disproportionately affects women and children in low- and middle-income countries, largely due to a combination of diets lower in easily absorbed iron, higher rates of infection, and the significant iron demands of pregnancy and growth.

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.

Complication Note

Most of these complications are preventable with early detection and treatment, which is why anaemia screening during pregnancy and childhood is such a high public health priority.

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.

Emergency Advice

Because the symptoms of anaemia can be gradual and easy to dismiss, a simple blood test is often the quickest way to know for certain, particularly for anyone in a higher-risk group.

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.

Prognosis Note

Anaemia is estimated to affect half a billion women of reproductive age worldwide, yet it remains one of the most preventable and treatable conditions in global health when the underlying cause is identified and 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.

Clinical Note

Because several types of anaemia look similar on a basic blood count, further testing is often needed to confirm iron deficiency as the specific cause, particularly in regions where malaria and other infections are common.

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.