Iron-Deficiency Anemia

Iron-Deficiency Anemia

(Reduced Iron in Blood)


Anemia is a low level of red blood cells (RBC). RBCs carry oxygen from the lungs to the rest of the body. Lower RBC counts mean the body is not getting enough oxygen.

Red Blood Cells

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Iron makes a critical component of red blood cells.
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There are different types of anemia. This type is caused by low levels of iron in the body. Iron is needed to build healthy RBCs. Low iron levels may be caused by one or more of the following:

  • Iron that is poorly absorbed in the digestive tract—may occur due to intestinal diseases or surgery
  • Chronic bleeding , such as heavy menstrual bleeding or bleeding in the gastrointestinal (GI) tract
  • Not enough iron in the diet—common cause in infants, children, and pregnant women

Risk Factors

These factors may increase your chance of developing this condition:

  • Rapid growth cycles—may occur with infancy or adolescence
  • Heavy menstrual bleeding or chronic blood loss from the GI tract
  • Pregnancy
  • Breastfed infants who have not started on solid food after 6 months of age
  • Babies who are given cow’s milk prior to age 12 months
  • Alcohol use disorder
  • Diets that contain insufficient iron—rare in the US


There may be no symptoms with mild anemia. In those who do have them, anemia may cause:

  • Fatigue
  • Pale skin
  • Fingernail changes
  • Weakness
  • Headache
  • Decreased work capacity
  • Heart palpitations
  • Infection
  • Craving to eat things that are not food (called pica) such as ice or clay
  • Hair loss
  • Shortness of breath during or after physical activity
  • Restless legs at night


You will be asked about your symptoms and health history. A physical exam will be done.

Tests to diagnose iron-deficiency anemia may include:

  • Blood test—to look at RBC and iron levels
  • Urine tests—to look for abnormal bleeding
  • Stool tests—to look for abnormal bleeding


Iron levels will need to be brought back to normal. The body will be able to increase RBCs as iron levels improves. This will relieve the anemia.

Iron Supplements

Iron can be taken as a supplement:

  • Iron comes in many "salt" forms, examples include:
    • Ferrous salts—better absorbed than ferric salts
    • Ferrous sulfate—cheapest and most commonly used iron salt
  • Slow-release or coated products may be easier on the stomach. However, the iron may not be absorbed as well.
  • Some include vitamin C. It can help to improve absorption. It could make iron level too high.

Iron can also be given through an injection. Iron stores may be fully restored over 1 to 2 injections.

Iron-Fortified Cereal

Your doctor may recommend that you feed your baby iron-fortified cereal.


To help reduce your chance of having anemia:

  • Eat a diet rich in iron. Include iron-rich foods such as oysters, meat, poultry, or fish.
  • Avoid foods that interfere with iron absorption. Black tea is one common iron blocker.

Talk to your doctor about your baby’s diet. General guidelines include:

  • Starting at 4 months, breastfed infants need an iron supplement. Once they are older they can get iron from other sources, like cereal or fortified formula.
  • Bottle-fed infants should get a formula that is fortified with iron.
  • Premature infants may need extra iron by 1 month of age.


Healthy Children—American Academy of Pediatrics
The American Congress of Obstetricians and Gynecologists


Dietitians of Canada


Iron. EBSCO Natural and Alternative Treatments website. Available at: EBSCO Natural and Alternative Treatments website. Available at:
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Updated December 15, 2015. Accessed September 29, 2017.
Iron deficiency anemia in adults. EBSCO DynaMed Plus website. Available at: http://www.dynamed... . Updated July 12, 2016. Accessed September 29, 2017.
Iron deficiency in children (infancy through adolescence). EBSCO DynaMed Plus website. Available at: http://www.dynamed... . Updated November 21, 2016. Accessed September 29, 2017.
US Preventive Services Task Force. The Guide to Clinical Preventive Services: Report of the United States Preventive Services Task Force. 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2002.
US Preventive Services Task Force. The Guide to Clinical Preventive Services: Report of the United States Preventive Services Task Force. AHRQ Publication No. 06-0588; Rockville, MD: 2006.
10/12/2010 DynaMed Plus Systematic Literature Surveillance http://www.dynamed... : Baker R, Greer F, Committee on Nutrition American Academy of Pediatrics. Diagnosis and prevention of iron deficiency and iron-deficiency anemia in infants and young children (0-3 years of age). Pediatrics. 2010;126(5):1040-1050.
Last reviewed September 2018 by EBSCO Medical Review Board Marcin Chwistek, MD
Last Updated: 7/19/2018

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