The symptoms of iron deficiency


Iron is an important trace element in the body and plays an essential role in the formation of red blood cells and the transport of oxygen. In addition, iron strengthens our immune system and keeps us performing.

Manifest iron deficiency can cause various symptoms such as fatigue, brittle nails and hair loss. The individual symptoms are described in more detail in the following text.

The typical symptoms

While the latent iron deficiency can often only be recognized in the blood by means of a reduced ferritin concentration and is often asymptomatic, a wide variety of symptoms can be found with manifest iron deficiency:

  • Skin and mucous membrane
    • dry skin
    • recurrent aphthae of the oral mucosa
    • diffuse hair loss
    • Brittleness of the nails
    • Shrinkage of the lining of the tongue, esophagus and throat (Plummer-Vinson syndrome)
  • Nervous system
    • a headache
    • Difficulty concentrating
    • fatigue
    • Dizziness and easy excitability.
    • Abnormal appetite e.g. on lime or earth (Picacism).
  • Symptoms of anemia due to iron deficiency
    • Pale skin and mucous membranes
    • Difficult breathing under exertion
    • increased heart rate
    • dizziness

Here learn how to treat anemia

In the case of latent iron deficiency, the clinical symptoms appear before the occurrence of anemia (anemia). This disorder is then called sideropenia designated. The symptoms affect the skin and mucous membranes as well as psychological and neurological symptoms. In detail, the various skin appendages are affected: fingernails and toenails form grooves or are referred to as hollow nails. The hair of the scalp can also fall out and the oral mucosa tears.

The Plummer-Vinson syndrome describes a defined combination of symptoms in an iron deficiency. This includes mucosal atrophy of the tongue, upper throat, and esophagus. This creates a painful burning sensation in the tongue and pain in the mouth and esophagus during the swallowing process.

In addition to these skin and mucous membrane symptoms, unspecific psychological and neurological symptoms can also occur. These can be headaches, easy excitability, poor concentration and the symptom of picacism. This describes an unusual hunger for, for example, lime or earth.

All of these symptoms can occur both in the context of iron deficiency, but also together with the symptoms of iron deficiency anemia. These include paleness of the skin and mucous membranes due to the insufficient number of red blood cells. However, pale skin is physiological in many people and therefore cannot be used as the only diagnostic criterion. A form of shortness of breath may occur due to the low number of red blood cells and thus too few oxygen carriers in the blood.

Find out more about the topic here: The consequences of iron deficiency.

The individual symptoms

The change on the nails

The fingernails and toenails are among the first parts of the body to change when there is an iron deficiency. This can be explained by the fact that the body has priorities which cells need to be supplied more urgently and in the case of an oxygen deficiency due to an iron deficiency anemia, the nails are not necessary for survival.

The cells that make up the nail are poorly supplied and the nails that grow back become brittle and thinner. Grooves and cavities in the nails are also possible. Even after the iron deficiency has been remedied, it will still take a few months for the slowly growing nails to fully recover.

Also read the article: The lack of iron on the fingernail.

The pale skin

Iron is an important component of hemoglobin, the red blood pigment that transports oxygen. If there is an iron deficiency, not enough blood can be produced and the proportion of hemoglobin in the blood decreases. This is called anemia or anemia. Anemia can often be seen in those affected because they have a very pale face.

However, iron deficiency is not the only cause of anemia, so if you are paleness you should look more closely for the cause. The pallor goes back quickly after the deficiency has been remedied.

Causes of Anemia? Find out more about this here.

The hair loss

Since iron is an important part of blood formation, an iron deficiency leads to an insufficient supply of oxygen to all cells in the body. Cells that are growing or multiplying need a lot of oxygen. The first cells that are no longer adequately supplied are not vital cells. This also includes the hair follicles from which new hairs form. If there is a lack of oxygen, the hair-forming cells do not remain in the active growth phase, but switch to the resting phase. If this happens too early, the affected hair will fall out. Hair loss is often one of the early symptoms of iron deficiency anemia.

If the cause is eliminated, the hair loss is completely reversible. However, this can take a few months. Complete recovery of the hair follicles can only be expected six months after the hemoglobin level has normalized. Hair loss can also have many causes and is not only possible with iron deficiency. Genetically, some people lose more hair than others and other deficiency symptoms and diseases can promote hair loss.

more on the subject Hair loss can be read here: Hair loss due to iron deficiency

The headache

Headaches are one of the most common illnesses in Germany and have many different causes. With iron deficiency, headaches are mostly secondary and cannot be directly explained by the deficiency. Iron deficiency leads to difficulty concentrating and sleeping, which can lead to headaches.

In addition to these secondary disorders, those affected can also suffer from headaches such as migraines, regardless of their iron deficiency. After successful treatment of the iron deficiency, those affected can sleep better again and are able to concentrate during the day, which often also reverses the headache. In the case of a known migraine, attacks of iron deficiency can occur more frequently, but this is more likely to be attributed to the lack of sleep than to the iron deficiency itself.

In the event of sudden, unusually severe headache or in combination with a fever, a doctor should be consulted, as the cause is not iron deficiency anemia but can be an emergency.

For more information, also read: The iron deficiency headache.


Fatigue is a very common symptom of iron deficiency. Since iron is required for blood formation and thus for the oxygen supply to the body, an iron deficiency can lead to an overall weakness of the body. Those affected report fatigue and sleep disorders more quickly, which also lead to daytime sleepiness.

Fatigue is also the symptom that restricts those affected the most in everyday life and therefore often leads to a doctor's visit. After starting therapy, many sufferers report a very rapid improvement in fatigue and feel more productive overall.

The Depression

With many chronic illnesses that lead to a restriction in everyday life, depression occurs in the course of the illness. Chronic iron deficiency anemia is associated with impaired concentration and decreased performance.

Affected people often cannot keep up with their circle of friends and cannot always go about their work. This leads to social isolation and can thus trigger depression. If the iron deficiency is corrected, the depression can also be reduced. However, those affected should contact a specialist, especially if symptoms persist.

For more information, see: Iron deficiency and depression.

The racing heart

If there is an iron deficiency, there is an insufficient supply of oxygen throughout the body, as the body cannot produce enough blood to carry the oxygen. Since the target cells cannot distinguish why not enough oxygen is arriving, it always reacts to the body with the same information.
Too little oxygen is compensated for by pumping the blood faster through the body and thus more oxygen charges reach the cells. This means that the heartbeat needs to get faster as this is crucial for blood flow. Those affected feel this as a racing heart.

Change in the mucous membranes

Changes in the mucous membranes are a specific symptom of iron deficiency, but they only appear in the late course of the disease and are not among the early symptoms. Inflammations at the corners of the mouth, so-called rhagades, and increased canker sores of the oral mucosa are possible. There may also be a breakdown of the oral mucosa with difficulty swallowing, which is summarized as Plummer-Vinson syndrome.

Other mucous membranes can also be affected. Those affected can also express stomach problems. The symptoms are completely reversible if the iron deficiency treatment is successful.

The weight gain

Iron deficiency is usually not associated with weight gain. In some cases, however, this can be a domino effect. Those affected are more often tired and exhausted and therefore isolate themselves from their circle of friends and their hobbies. Less everyday exercise and a lack of exercise with the same diet can lead to secondary weight gain.

In many cases, the relationship between weight and iron stores tends to be the other way around. Weight loss diets can lead to iron deficiency.

The muscle pain

Iron deficiency leads to an energy-saving mode of the cells in the whole body, as these cannot be adequately supplied with oxygen. Muscle cells require a comparatively large amount of oxygen to maintain their function and to build new cells. If there is a lack of oxygen, muscle cells then break down.
This is where the body saves energy, especially when those affected no longer carry out their sporting activities due to fatigue and the muscles are less needed. Muscle weakness is also reduced when the iron deficiency is corrected.

How do you fix an iron deficiency? Find out more here.

The pimple

Pimples are not a typical symptom of iron deficiency. Some sufferers, who are already prone to blemished skin, can develop more pimples as the skin is damaged and bacteria can penetrate more easily. However, this is a rather unusual reaction to iron deficiency anemia.

The random but independent occurrence of pimples and iron deficiency in girls during puberty is far more common. Since the first menstrual period occurs during puberty, girls can develop an iron deficiency and at the same time develop blemished skin due to the normal skin changes during puberty.

The visual disturbances

Visual disturbances are also not a direct consequence of iron deficiency, but can occur secondary. This is usually not direct damage to the eye or retina.

Because of the iron deficiency, those affected can have fluctuations in blood pressure and dizziness, which can also lead to a blurred field of vision. In addition, some sufferers interpret their concentration disorders as a visual disorder, since the letters in front of the eyes are subjectively blurred.

The backpain

Both back pain and migraine attacks are more of a secondary symptom than a direct consequence of iron deficiency.

Back pain can be caused by weak muscles. Migraine attacks affect people who already have a migraine, more so when they lack sleep. Since iron deficiency can lead to insomnia, the frequency of attacks can increase. Both diseases can also occur coincidentally, but independently of the iron deficiency.

Find out more about the topic here: The backpain.

The cramps

Iron deficiency leads to a breakdown of the muscles due to the lack of oxygen in the muscle cells. Muscle cramps can therefore increase during exercise. Even after physical activity that results in micro-injuries to the muscles, regeneration is poorer and cramps occur more quickly.

However, more often than the iron deficiency, the magnesium deficiency or calcium deficiency can be observed as the cause of muscle cramps. Many other diseases or medications also lead to muscle cramps, so that this can occur regardless of an existing iron deficiency.

You can find more information on this topic at: The cramps.

The tinnitus

Tinnitus, also known as tinnitus, is a very common disease. In most cases it cannot be explained with certainty how the tinnitus develops. Iron deficiency is discussed as the cause, but has not yet been confirmed.

Changes in the cardiovascular system can cause tinnitus and therefore racing heart, in the context of iron deficiency, is also a possibility. There is no known direct connection between ringing in the ears and iron deficiency.

The cracked corners of the mouth

A classic late symptom in severe iron deficiency are the so-called rhagades. These are cracks in the corners of the mouth caused by damage to the mucous membrane. In addition, areas of inflammation develop around the cracks, which distinguish the rhagades from simple cracks caused by cold weather.

The rhagades are completely reversible if the cause and the associated iron deficiency anemia are eliminated. Those affected suffer from both the pain and the cosmetic consequences of the fissures.

Symptoms in men

Iron deficiency is generally less common in men than in women, but it is still possible. If the body has too little iron available over a longer period of time, there is a reduction in the oxygen-carrying red blood cells (erythrocytes). The resulting anemia leads to an insufficient supply of oxygen to the various body tissues and produces typical symptoms.

If there is only a slight iron deficiency, the body usually manages to compensate for this, as it initially uses the iron reserve from the iron stores (Ferritin) can use. In this case, the deficiency often remains asymptomatic or just creates a small performance drop with fatigue and susceptibility to infections.

In the case of a severe iron deficiency that persists over a long period of time, the symptoms already described, such as tiredness, poor concentration, brittle hair and nails, palpitations and shortness of breath occur (for further symptoms see above).

Symptoms in women

Iron deficiency is a common problem in women. Due to the monthly blood loss during menstruation, a woman's iron requirement of 15 milligrams per day is around 50% higher than that of a man (10 milligrams per day). When a woman loses a certain amount of blood due to her menstruation, new blood must be produced to compensate. For this, a sufficient iron concentration in the blood as well as filled iron stores are important, because iron is built into the hemoglobin, which is the most important component of the red blood cells and is responsible for the transport of oxygen.

The symptoms of iron deficiency in a woman are fundamentally little different from those of a man. At the beginning they express themselves in the form of everyday complaints such as persistent tiredness, poor performance and susceptibility to colds. If the iron deficiency lasts for a long time, other symptoms such as paleness, dry mucous membranes and headaches can also arise (other symptoms have already been described above).

Symptoms in the child

It is not uncommon for an iron deficiency to occur in children. Especially in the growth phase, when the amount of blood and muscle mass increases, children have an increased need for iron, which must be covered by a balanced diet (meat, beans, peas, spinach, apricots, etc. are particularly rich in iron).

In most cases, a child's symptoms are little different from an adult's. It is particularly common for children with iron deficiency to be more susceptible to infections, as well as to be more tired and pale.

An iron deficiency is also noticeable in children during meals: many children suffer from a loss of appetite, which means that even their favorite dishes no longer taste good. A lack of learning and concentration is often noticeable at school. Just like adults, children with severe iron deficiency can have cracked corners of the mouth and brittle hair and nails.

In particularly severe iron deficiency situations, mental and physical growth and development disorders can even occur, with a severe reduction in performance.

Find out more about the topic here: The diet for iron deficiency and Iron deficiency in the child