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5 Sneaky Signs You Might Have Iron Deficiency Anemia

Have constant cravings for ice? Keep reading…

Headshot of Lambeth HochwaldBy Lambeth Hochwald
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Lots of us use the word ‘anemic’ loosely whenever we feel lethargic or tired. But if you’re diagnosed with iron deficiency anemia (IDA), which occurs when iron levels are insufficient, it can actually be a very serious issue—one that is under-diagnosed and may lead to heart problems, infections, and depression, according to the National Heart, Lung, and Blood Institute (NHLBI). Unfortunately, it takes an average of almost four years for women with IDA to get a proper diagnosis, according to the recent Get Iron Informed survey conducted online by The Harris Poll on behalf of the pharmaceutical company, Daiichi Sankyo, Inc.

There may be a number of reasons for this. For one, according to the survey, 42 percent of women can’t identify any of the common IDA risk factors despite the fact that one in five women of childbearing age has the condition. Also, too often, women dismiss symptoms as no big deal.

So how do know if you might have IDA? We asked Dr. Stephanie Martin, an OB/GYN, to walk us through some subtle signs and symptoms of this condition, which is estimated to affect up to five million U.S. adults.


It’s important to note that you’re at a higher risk for IDA if you are a woman of childbearing age, if you experienced blood loss during childbirth, have long or abnormally heavy periods, or have bleeding fibroids, according to the NHLBI. In addition, cancer, chronic kidney disease, heart failure, or gastrointestinal conditions like inflammatory bowel diseases may put you at increased risk for IDA, according to the Mayo Clinic.

Visit GetIronInformed.com for easy-to-understand information and resources about IDA, including a discussion guide with questions that will help you start a conversation with your doctor.


1. Your nails look different.

woman hands on blue background
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If you’ve noticed that your nails are unusually brittle, you may have IDA, Dr. Martin says. “Your skin may also look yellow or pale, but we don’t clearly understand why this is the case.”

2. You’re perpetually exhausted.

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Fatigue is the most common symptom of all types of anemias. “I think many women have come to accept feeling fatigue and mental fog as a part of normal life,” Dr. Martin says. “We don’t consider that there may be an underlying health problem.”

Bottom line: If you’re chronically zonked don't assume it’s par for the course. Definitely let your doctor know.

3. You’re experiencing shortness of breath.

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Depending on the severity of your IDA, you may experience difficulty breathing, chest pain, or an irregular heartbeat, Dr. Martin says. “We think this is likely related to the body’s decreased ability to deliver oxygen as blood counts decrease which happens when the body doesn’t get enough oxygen to produce the red blood cells it needs.”

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4. You may have unusual cravings.

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One of the most unique cravings: a desire for ice. “This is very common with iron deficiency and goes away quickly once iron levels are restored,” Dr. Martin says. “We don’t understand much about why this craving develops, but one theory is that it improves mental alertness in patients with anemia. We know that mental fog is a well-described symptom of iron deficiency and anemia, so this would make sense.”

5. You just don’t feel well.

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IDA can contribute to a wide range of symptoms, including headaches, dizziness, and cold hands or feet. “We need iron to produce red blood cells and transport oxygen,” Dr. Martin says. “When we can’t deliver oxygen these signs and symptoms may occur.”

Getting a diagnosis.

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Ultimately, if you think you may have symptoms of IDA or have an underlying condition that puts you at an increased risk for IDA, be sure to speak to your doctor. (BTW, it’s also possible that you may not experience any symptoms at all.) Reviewing this handy discussion guide is a great way to prep for that appointment.

During your appointment, ask about getting a blood test to check your iron levels. A blood test is the only way to know for sure if you have IDA, Dr. Martin says.

If it turns out you have IDA, your healthcare provider may recommend diet changes and/or supplemental oral or intravenous iron as a treatment.

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