Iron deficiency anaemia

Iron deficiency anaemia is caused by lack of iron, often because of blood loss or pregnancy. It's treated with iron tablets prescribed by a GP and by eating iron-rich foods.

Symptoms can include:

• tiredness and lack of energy
• shortness of breath
• noticeable heartbeats (heart palpitations)
• pale skin

What happens at your appointment

Your GP will ask you about your lifestyle and medical history.

If the reason for the anaemia is not clear (like pregnancy), your GP might order some tests to find out what might be causing the symptoms.

They might also refer you to a specialist for further checks.

Blood tests for iron deficiency anaemia

Your GP will usually order a full blood count (FBC) test. This will find out if the number of red blood cells you have (your red blood cell count) is normal.

You do not need to do anything to prepare for this test.

Iron deficiency anaemia is the most common type of anaemia. There are other types, like vitamin B12 and folate anaemia, that the blood test will also check for.

Once the reason you have anaemia has been found (for example, an ulcer or heavy periods) your GP will recommend treatment.

If your blood test shows your red blood cell count is low (deficient), you'll be prescribed iron tablets to replace the iron that's missing from your body.

The prescribed tablets are stronger than the supplements you can buy in pharmacies and supermarkets.

You'll have to take them for about 6 months. Drinking orange juice after you have taken them may help your body absorb the iron.

Some people get side effects like:

• constipation or diarrhoea
• tummy pain
• heartburn
• feeling sick
• black poo

Try taking the tablets with or soon after food to reduce the chance of side effects.

It's important to keep taking the tablets, even if you get side effects.

Your GP may carry out repeat blood tests over the next few months to check that your iron levels are back to normal.

If your diet is partly causing your iron deficiency anaemia, your GP will tell you what foods are rich in iron so you can eat more of them.

Eat and drink more:

• dark-green leafy vegetables like watercress and curly kale
• cereals and bread with extra iron in them (fortified)
• meat
• pulses (beans, peas and lentils)

Eat and drink less:

• tea
• coffee
• milk and dairy
• foods with high levels of phytic acid, such as wholegrain cereals, which can stop your body absorbing iron from other foods and pills

Large amounts of these foods and drinks make it harder for your body to absorb iron.

You might be referred to a specialist dietitian if you're finding it hard to include iron in your diet.

If you're pregnant, iron deficiency anaemia is most often caused by a lack of iron in your diet.

Heavy periods and pregnancy are very common causes of iron deficiency anaemia. Heavy periods can be treated with medication.

For men and for women whose periods have stopped, iron deficiency anaemia can be a sign of bleeding in the stomach and intestines caused by:

• taking non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and aspirin
• stomach ulcers
• swelling of the large intestine (colitis) or food pipe (oesophagus)
• piles
• cancers of the bowel or stomach – but this is less common

Any other conditions or actions that cause blood loss could lead to iron deficiency anaemia.

If you leave your iron deficiency anaemia untreated

Untreated iron deficiency anaemia:

• can make you more at risk of illness and infection – a lack of iron affects the immune system
• may increase your risk of developing complications that affect the heart or lungs – such as an abnormally fast heartbeat (tachycardia) or heart failure
• in pregnancy, can cause a greater risk of complications before and after birth