Are You Getting Enough Iron?

Are you getting enough iron?

Iron is one of the most quietly important minerals in the body — and iron deficiency is the most common nutritional deficiency worldwide. It often develops slowly enough that people adapt to feeling tired without realising anything is wrong.

What is iron deficiency?

Iron deficiency occurs when your body lacks enough iron to produce haemoglobin, the protein in red blood cells that carries oxygen. Left unaddressed it progresses to iron deficiency anaemia, where oxygen delivery to tissues and organs is measurably reduced.

It is worth knowing there are two stages: iron stores (measured by ferritin) fall first, and haemoglobin drops later. You can have depleted stores and symptoms before anaemia shows on a standard blood count.

Signs to look out for

• Persistent fatigue and weakness — the most common symptom, and the most easily dismissed
• Pale skin, often most noticeable inside the lower eyelid
• Breathlessness or dizziness, particularly on exertion
• Heart palpitations
• Cold hands and feet
• Brittle or spoon-shaped nails, and hair shedding
• Headaches and poor concentration
• Restless legs — a genuinely common and under-recognised sign
• Pica — craving non-food items such as ice, chalk or soil

Why iron matters

• Oxygen transport — haemoglobin and myoglobin both depend on iron
• Energy production — iron is required by the enzymes that generate ATP
• Immune function — supports the development of immune cells
• Brain function — involved in neurotransmitter production and cognitive development

Who is most at risk

• Women with heavy periods — by far the most common cause in the UK
• Pregnant women
• Vegetarians and vegans
• Frequent blood donors and endurance athletes
• People with coeliac disease, Crohn's disease or after gastric surgery
• People taking long-term proton pump inhibitors
• Infants, toddlers and adolescents during growth spurts

Important: deficiency needs a cause

This matters more than any dietary tip in this article. Iron deficiency is a finding, not a diagnosis — something is causing it. In men, and in women past the menopause, unexplained iron deficiency requires investigation for a source of bleeding in the gut, because it can be the first sign of something serious that is highly treatable when caught early.

See your GP rather than simply starting a supplement, particularly if you also have changes in bowel habit, blood in your stool, abdominal pain or unexplained weight loss.

Dietary iron

Iron comes in two forms. Haem iron, from animal foods, is absorbed far more efficiently. Non-haem iron, from plants, is absorbed less readily but can be improved with the right pairings.

Haem sources

• Red meat — beef and lamb
• Poultry
• Shellfish — clams, mussels, oysters
• Oily fish such as sardines

Non-haem sources

• Lentils, chickpeas and beans
• Dark leafy greens — spinach, kale, spring greens
• Fortified breakfast cereals and bread
• Pumpkin seeds, cashews and nuts
• Tofu and tempeh
• Dried apricots

Improving absorption

• Add vitamin C. Pairing plant iron with peppers, tomatoes, citrus or strawberries substantially increases absorption.
• Separate the blockers. Tea, coffee and calcium-rich foods reduce iron absorption — leave an hour either side of iron-rich meals.
• Cast iron cookware can add small amounts of iron, especially with acidic dishes.

Supplements — with care

Where deficiency is confirmed, supplements are effective. Common forms include ferrous sulfate, fumarate and gluconate. Taking them on alternate days is often better tolerated and absorbed as well as daily dosing.

Do not self-prescribe iron. Excess iron is genuinely harmful, and in people with haemochromatosis — an inherited iron-overload condition — it can be dangerous. Iron tablets are also a leading cause of accidental poisoning in young children, so keep them well out of reach.

Testing with Rightangled

Rightangled's home blood tests can assess ferritin, full blood count and related markers, processed by accredited UK laboratories. Results are reviewed by our clinical team, which includes GPhC-registered independent prescribers, with medical oversight from our doctor, Dr Abdullah — so you get an explanation of what your levels mean and whether further investigation is warranted.

Verify us with the General Pharmaceutical Council (registration 9011933), see our LegitScript certification, and read reviews on Trustpilot.

Related reading: vitamin B12 and folate deficiency.

This article is for general information and does not replace personalised medical advice. See your GP before starting iron supplements.