Low iron levels, or iron deficiency, occur when your body doesn’t have enough iron. This leads to a condition called anemia. Common symptoms include fatigue, pallor, and breathlessness.

Iron deficiency anemia is a common type of anemia.

Your body needs iron to make hemoglobin, a protein in red blood cells that enables them to carry oxygen through your blood vessels.

If your body doesn’t have enough hemoglobin, your tissues and muscles won’t get enough oxygen to be able to work effectively.

Here are 14 signs and symptoms of iron deficiency, starting with the most common. Also, find out how to recognize anemia in children and older adults, and when to see a doctor.

Feeling tired is a common sign of iron deficiency anemia. It can also affect people who don’t have enough iron, even if they haven’t received a diagnosis of deficiency.

This fatigue happens because your body lacks the iron it needs to make a protein called hemoglobin, which helps carry oxygen around your body.

Without enough hemoglobin, less oxygen reaches your tissues and muscles, depriving them of energy. Your heart also has to work harder to move more oxygen-rich blood around your body, which can make you tired.

Since tiredness is often considered a part of a busy, modern life, it’s difficult to diagnose an iron deficiency based on this symptom alone.

However, tiredness that occurs with pallor, shortness of breath, and other symptoms may be a sign of anemia.

What are some other reasons for fatigue?


Fatigue is one of the most common symptoms of iron deficiency. This is due to less oxygen reaching your tissues, depriving them of energy.

woman yawning while stretching insideShare on Pinterest
Irina Efremova/Stocksy

Skin that’s paler than usual, as well as pale coloring of the inside of the lower eyelids, can also indicate iron deficiency.

The hemoglobin in red blood cells gives blood its red color, so low levels caused by iron deficiency make the blood less red. That’s why skin can lose some of its color or warmth in people with iron deficiency.

A 2016 study notes that pallor in the skin or inside the eyelids is a reliable indicator of anemia. A person with severe anemia may also have pallor in the creases of the palms of the hands.

If you pull your lower eyelid down while looking in a mirror, the inside layer should be a vibrant red color. If it’s a very pale pink or yellow, you may have iron deficiency.

In people with darker skin tones, the eyelid may be the only area where this condition is noticeable.

However, pallor can happen for many reasons. Only a blood test can confirm if a person has anemia.

Does your skin look pale, gray, or blue? Find out why.


Skin that’s paler than usual in areas like the face, lower inner eyelids, or nails may be a sign of iron deficiency. This paleness is due to low levels of hemoglobin, which gives blood its redness.

Hemoglobin enables your red blood cells to carry oxygen around your body.

When hemoglobin levels are low with iron deficiency, oxygen levels are also low. This means that your muscles won’t receive enough oxygen to do everyday activities, such as walking.

As a result, your breathing rate will increase as your body tries to get more oxygen, resulting in shortness of breath.

If you find yourself out of breath when doing daily tasks that you used to find easy, such as walking, climbing stairs, or working out, it may be due to iron deficiency.

What are some home treatments for shortness of breath?


Shortness of breath is a symptom of iron deficiency, since low hemoglobin levels stop your body from effectively transporting oxygen to your muscles and tissues.

Iron deficiency can occur during menstruation, and headaches can also occur with both.

The link between iron deficiency and headaches is unclear. Several factors may contribute, including the relationship between altered dopamine function and estrogen levels.

Although there are many causes of headaches, frequent, recurrent headaches may be a sign of iron deficiency.

What are 14 types of headache?


Headaches may be a symptom of iron deficiency, although more research is needed on the connection between dopamine dysfunction, estrogen levels, and iron deficiency.

Noticeable heartbeats, or heart palpitations, are another sign of iron deficiency anemia.

Experts are still studying the link between iron deficiency, anemia, and heart problems, but they believe oxygen supply may play a role

Hemoglobin is the protein in red blood cells that helps transport oxygen around your body. In iron deficiency, low hemoglobin levels mean the heart has to work extra hard to carry oxygen.

This may lead to irregular heartbeats or the feeling that your heart is beating abnormally fast.

Consequently, iron deficiency may worsen conditions that affect your heart, such as heart failure and coronary heart disease.

Why do I have palpitations at night?


In cases of iron deficiency, your heart has to work especially hard to transport oxygen. This can worsen conditions that affect heart health.

Dry or damaged skin and hair may be signs of iron deficiency.

Iron deficiency lowers the level of hemoglobin in your blood, which may reduce the amount of oxygen available to cells that cause hair growth.

Skin and hair that lack oxygen may become dry and weak.

Iron deficiency is also associated with hair loss, and some research suggests it may be a cause.

Hair often falls out during everyday washing and brushing. But, significant hair loss may be a sign of iron deficiency.

Get some tips on preventing hair loss.


Skin and hair may receive less oxygen if you have iron deficiency, leading to dryness or damage. In more severe cases, this may lead to hair loss.

Sometimes, changes inside or outside of your mouth can indicate iron deficiency anemia. Signs include a swollen, inflamed, pale, or strangely smooth tongue.

Other possible symptoms around your mouth include:

  • dry mouth
  • a burning feeling in your mouth
  • sore, red cracks at the corners of your mouth
  • mouth ulcers

What else can cause tongue swelling and soreness?


A sore, swollen, or strangely smooth tongue may be a sign of iron deficiency anemia, as are cracks on the corners of your mouth.

There may be a link between iron deficiency and restless leg syndrome.

This condition involves a strong urge to move your legs while they’re at rest. It may also cause unpleasant crawling or itching sensations in your feet and legs.

It’s usually worse at night and can make it difficult to sleep.

The causes of primary restless leg syndrome are not fully understood. However, it can stem from various medical conditions, including iron deficiency anemia.

Indeed, people with iron deficiency anemia are six times more likely to have restless leg syndrome than the general population.

What are the best treatments for restless leg syndrome?


People with iron deficiency anemia may have restless legs syndrome, which is a strong urge to move your legs while at rest.

Spoon-shaped fingernails, also called koilonychia, are another symptom of iron deficiency anemia.

Usually, the first sign is brittle nails that chip and crack easily.

In the later stages of iron deficiency, the nails can become spoon-shaped, meaning that the middle of your nail dips and the edges raise to give a rounded appearance like a spoon.

This is a rare side effect and is usually reversible with treatment to boost the body’s iron levels.

What do brittle, discolored, and weak nails say about your health?


Brittle or spoon-shaped nails may indicate more severe iron deficiency anemia.

Several other indicators signal that your iron levels may be low. These tend to be less common and may be linked to many conditions other than iron deficiency.

Other signs of iron deficiency anemia include:

  1. Strange cravings. A hankering for strange foods or non-food items is called pica. A person may crave ice, clay, dirt, chalk, or paper. It can occur during pregnancy and may be a sign of iron deficiency.
  2. Feelings of depression. There may be a link between iron deficiency anemia and depression in adults, including during pregnancy.
  3. Cold hands and feet. Iron deficiency means less oxygen delivery to your hands and feet. Some people may feel the cold more easily in general or experience cold hands and feet.
  4. More frequent infections. Iron is needed for a healthy immune system, and a lack of iron may increase your risk of infections.
  5. Poor appetite. Iron deficiency is linked to low appetite due to changes in the hunger hormone ghrelin.

Children with iron deficiency anemia may:

  • have pale skin
  • appear irritable or fussy
  • lack energy
  • tire quickly
  • have a rapid heart rate
  • have a sore or swollen tongue
  • have an enlarged spleen, just below the ribs
  • show signs of pica, such as wanting to eat ice

How does anemia affect children?

Anemia is common in older adults, but it can be hard to identify, as some of the symptoms are common as people get older.

Symptoms include:

  • fatigue
  • difficulty thinking and focusing
  • depression
  • muscle weakness
  • frailty

Compared with younger people, older adults are more likely to have conditions associated with iron deficiency anemia, such as chronic kidney disease, inflammation, and nutritional deficiencies.

Older adults are also more likely to use certain medications, like non-steroidal anti-inflammatory drugs (NSAIDs), anticoagulants, and proton pump inhibitors over a long period, which may cause blood loss in the stomach or reduce iron absorption.

Learn more about how anemia affects older adults.


Other signs of iron deficiency include strange cravings, depression, frequent infections, and cold hands and feet. Children and older adults share symptoms, but neurological symptoms, like ADHD, are more common in children.

Talk with a doctor if you have symptoms of iron deficiency. Without treatment, you may develop iron deficiency anemia.

This can increase the risk of complications, such as:

  • heart problems
  • depression
  • a higher chance of infections
  • pregnancy issues

People who are pregnant or have heavy menstrual periods have the highest risk and should talk with a doctor about being tested for iron deficiency anemia.

If your doctor confirms that you have iron deficiency — typically via a blood test — they will develop a treatment plan that best meets your healthcare needs.

They may recommend increasing your intake of iron via your diet or taking supplements.

However, if the doctor suspects anemia stems from gastrointestinal problems, they may recommend further tests and procedures, including upper and lower endoscopies.

If you think you have iron deficiency anemia, speak with a doctor before changing your diet or deciding on any supplements.

If you need help finding a primary care doctor, then check out our FindCare tool here.


Long-term complications of iron deficiency anemia include depression, pregnancy issues, and heart problems. So talk with your doctor if you’re experiencing any symptoms.

How will I feel if my iron is low?

Some people experience no symptoms with iron deficiency anemia. In time, however, you may notice that the insides of your eyes are paler than usual, and you may feel tired and short of breath.

How can I increase my iron level quickly?

Eating an iron-rich diet can help boost iron levels. If your levels are very low, a doctor may recommend iron supplements. In some cases, you may need treatment for an underlying condition.

What causes iron levels to drop?

Nutritional choices, underlying conditions, bleeding, and the use of certain medications are common causes of low iron levels.

Here, learn more about the causes and treatments of anemia.

Symptoms of iron deficiency anemia can depend on the severity of the anemia. In the early stages, there may be no symptoms.

Common symptoms include fatigue, paleness, shortness of breath, and dry or damaged hair and skin.

If you think you have symptoms of iron deficiency, talk with a doctor. They may recommend dietary changes or medication. They may also do tests to see if an underlying condition needs addressing.

Just one thing

Try this today: If you’re vegetarian but still interested in upping your dietary intake of iron, check out our article on iron-rich plant foods.

Was this helpful?

Read this article in Spanish.