Iron-deficiency anaemia is a condition that’s generally caused by reduced iron intake (via diet), but also by blood loss or pregnancy, including heavy periods. Around a quarter of the world’s population are thought to have anaemia , and for girls and women of reproductive age, heavy menstrual bleeding is the most common cause of iron deficiency.  

With it impacting so many people across the world, you may want to find out more about this deficiency or know which signs and symptoms you should look out for. This guide takes you through the three stages of iron deficiency, as well as how you can tell if you have this condition. 

What are the three stages of iron deficiency?

Iron deficiency can develop in three separate stages. These are the pre-latent stage, the latent stage and the marked iron deficiency stage. 

During the pre-latent stage, the iron stores in the body are low, but iron concentration and haemoglobin levels remain normal.  Haemoglobin is a protein that’s present in the blood that allows oxygen to be transported to the tissues in the body.   When the iron stores are low, this can in turn result in a reduced serum ferritin level.  Ferritin is really important when it comes to iron stores and absorption efficiency. It’s a protein shell that is able to store iron molecules, and is generally found in the liver, spleen and bone marrow cells.  

The next stage is known as the latent stage, and this is when transferrin saturation can drop.  Transferrin is a type of blood plasma that enables iron compounds to be transported around the body.  Haemoglobin levels, however, remain the same.  

In the last stage, known as iron-deficiency anaemia, there is a depletion of iron stores, as well as a reduction in transferrin saturation and a drop in haemoglobin.  Anaemia will generally develop during this last stage of iron deficiency, whereas the first two stages may simply be considered a deficiency without being labelled ‘anaemia’.  

How to tell if you have an iron deficiency

Interestingly, despite the fact that iron-deficiency anaemia is responsible for 50% of all anaemias,  you may not have any symptoms at all. This is particularly the case for mild to moderate anaemia.  However, when signs do arise, what sorts of symptoms should you look out for?

What are the symptoms of iron deficiency?

Common symptoms of iron-deficiency anaemia can include:

• Lack of energy or tiredness
• Heart palpitations
• Shortness of breath
• A paler complexion than usual
• Headaches.

Other less common symptoms might include: 

• Tinnitus (a ringing in the ear that no one else can hear)
• Itchiness
• Hair loss
• Cravings for non-food items, like paper, ice or clay
• Ulcers on the corners of your mouth
• Spoon-shaped nails (a hollowed indent in the surface of your nail).

The severity of your symptoms may depend on how quickly the anaemia has developed. If the condition has developed slowly, your symptoms might appear gradually and over a longer period of time. This may also be the case when your iron-deficiency anaemia is caused by another long-term condition, like a stomach ulcer.  

If you think you might have anaemia, your GP can order a full blood count (FBC) test that will look at the number of red blood cells in your blood. Should this number be lower than normal, they may be able to recommend some treatment options.   

Sources

https://www.nhs.uk/conditions/iron-deficiency-anaemia/ 
https://www.nhlbi.nih.gov/health/anemia/iron-deficiency-anemia 
https://www.nhsinform.scot/illnesses-and-conditions/nutritional/iron-deficiency-anaemia/  
https://www.ncbi.nlm.nih.gov/books/NBK448065/ 
https://obgyn.onlinelibrary.wiley.com/doi/10.1002/ijgo.14943  
https://www.southtees.nhs.uk/services/pathology/tests/ferritin/  
https://www.ncbi.nlm.nih.gov/books/NBK532928/  
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4462328/  
https://www.ncbi.nlm.nih.gov/books/NBK259/