Iron deficiency: the most common cause of unexplained fatigue
Tiredness, breathlessness, pale skin
Dr. Camille Roux
Internist

In simple terms
Why treating low iron means finding out why it is low.
Two different things
You can be short of iron without being anaemic. Iron stores, measured by ferritin, fall first; only later does haemoglobin drop and true anaemia appear. Low stores alone can already cause fatigue, hair shedding and restless legs.
Symptoms
- Fatigue out of proportion to activity
- Breathlessness climbing stairs
- Pale skin, brittle nails, hair loss
- Headaches, poor concentration
- Craving ice or unusual non-food items
Finding the cause matters more than the tablet
In menstruating women, heavy periods are the usual explanation. In men and in women after menopause, iron loss from the digestive tract must be investigated, since it can reveal an ulcer, coeliac disease or a bowel tumour. This is why doctors ask about stools and often recommend an endoscopy.
Taking iron properly
Take it with vitamin C, away from tea, coffee, calcium and dairy. Every other day dosing is absorbed better than daily dosing and causes less constipation. Stores take three to six months to refill, so continue after the blood count normalises.
The words explained
Medical terms used above, in everyday language.
- Symptom
- A sign you can feel or see that something is wrong, like pain, tiredness or a rash.
When should you see a doctor?
- Your symptoms last more than a few weeks or keep coming back.
- They get worse quickly, or stop you doing everyday things.
- You notice sudden pain, breathing trouble, fainting or bleeding — seek urgent care.
- You already take medication and want to change anything about it.
This article explains general health information. It does not replace advice from your own doctor.
Frequently asked questions
- What is Iron deficiency: the most common cause of unexplained fatigue?
- Why treating low iron means finding out why it is low.
- What are the main symptoms or signs of Iron deficiency: the most common cause of unexplained fatigue?
- Common signs vary from person to person. The article above lists the symptoms to watch for, how they progress, and when they need medical attention.
- When should you see a doctor for Iron deficiency: the most common cause of unexplained fatigue?
- See a doctor if symptoms last more than a few weeks, get worse quickly, stop you doing everyday things, or if you notice sudden pain, breathing trouble, fainting or bleeding.
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