Anaemia – everything you need to know

Anaemia is common and a third of women will be affected at some point in their lifetime. The most common cause is iron deficiency. Our bodies need iron to make red blood cells, responsible for transporting oxygen around the body. Iron is also important for all muscle function and the metabolism of energy in the cell.

If we have a shortage of this vital mineral, red blood cells become depleted and it’s more difficult to get oxygen to where it’s so sorely needed. That’s why those with anemia often feel tired and breathless.

If this all sounds familiar, read on to discover the symptoms of anaemia and what you can do to tackle this condition.

What are the symptoms of anaemia?

Iron deficiency can take a long time to develop, and there’s a lot more to this deficiency than looking pale.

“The body normally contains 3000-4000mg of iron, of which you have about 1000mg in reserve,” says Professor Toby Richards of The Iron Clinic. “Daily losses are minimal (1-2mg), so an iron deficiency can take several years to slowly develop.

“It’s often caused by increased losses, such as heavy periods (30-50mg per month) or pregnancy (a baby takes approximately 1200mg of iron from the mother).”

Here are some of the lesser-known but common symptoms of anaemia to look out for:

  • Fatigue and exhaustion
  • Lack of concentration or ‘brain fog’
  • Shortness of breath
  • Headaches or dizziness
  • Fast or irregular heart beat or palpitations
  • Anxiety or depression
  • Poor nails and hair loss
  • Feeling the cold easily and/or having cold hands and feet
  • Restless or achy legs
  • Pica (craving non-food items such as ice or paper)
  • Unexplained or excessive bruising
  • Prone to coughs and colds

How to treat anaemia

Visit a GP for a diagnosis

If the symptoms of iron deficiency ring true, or you’re at a higher risk of iron deficiency (e.g. if you have heavy periods, are a vegetarian/vegan, or a recent mother), your GP is your first port of call.

Explain your concerns and they’ll be able to pick up an iron deficiency with a simple blood test. While a haemoglobin/blood count will identify anaemia, a full screen should test iron levels and iron storage (ferritin) as well as B12 or folate levels.

Tackle the root cause

When visiting your GP, you’ll likely be asked a few questions to determine the cause of your depleted iron levels. For example, your GP may ask if you have heavy periods. It’s estimated that 30% of women experience heavy bleeding, but this may be an underestimate. Research shows that women often don’t seek help or may not even recognise that they have heavy periods.

Increase your iron intake

When it comes to restoring iron levels, a well-balanced diet and iron supplements are the first course of action. We can improve our iron intake by eating meat or fish, or plant-based foods rich in iron, such as soya, lentils, seeds and pulses, as well as fortified cereals. Contrary to popular belief, leafy vegetables are a poor source of iron as it’s very badly absorbed.

The National Institute of Clinical Excellence (NICE) is clear that ‘dietary changes alone are not enough to correct iron deficiency anaemia, and iron supplements are needed’. Multivitamins and ‘liquid iron’ are often very low dose and not effective to treat iron deficiency. Check the dosage – you need to aim for 65mg of elemental iron a day.

Commit to treatment

Persistence is key when it comes to restoring iron levels. Up to half of those taking oral iron supplements experience local gastrointestinal side-effects such as diarrhoea or constipation, so don’t fully adhere to the prescribed course.

In these cases, Professor Richards recommends taking a week-long break from tablets and then resuming with one tablet of 65mg elemental iron on alternate days.

“Recent data suggests this may be just as effective and can minimise the side effects,” he says.

It’s important that iron deficiency is treated because, as well as damaging our current quality of life, in the long run it can hamper our immune system, increases the risk of heart or lung failure and, in pregnancy, cause a greater risk of complications before and after birth.

Read more features like this