01 February 2018

12 signs you could be anaemic, other than just being tired all the time

Up to 57% of SA women could be iron deficient…


Did you know that iron deficiency anaemia (IDA) is the most common nutritional deficiency globally?

But it’s easy to miss if you don’t know the signs, which can be subtle or incorrectly attributed to other health conditions.

What exactly is anaemia?

You’re anaemic if your level of red blood cells is lower than normal, explains sports medicine specialist Dr Jon Patricios.

“The most common cause is inadequate amounts of the mineral iron, and this is called iron-deficiency anaemia. It occurs because iron is required to make a protein called haemoglobin. Haemoglobin is responsible for oxygen transport around the body. Inefficient oxygen delivery results in the symptoms and signs associated with anaemia,” he says.

Read more: 8 foods your body needs if you think you might be lacking iron

In a recent study of iron status in a healthy South African adult population, the prevalence of iron deficiency (ID) was 39.8% in all participants, and as high as 56.6% in women.

ID occurs when the iron stores in the body are becoming depleted and can lead to anaemia. Yet because the effects of ID and IDA tend to be subtle, it is easy to miss.

Watch for these 12 signs

Often feel exhausted, fatigued and weak? Then you best pay attention to these other signs too:

1. pale skin,

2. brittle nails,

3. chest pain,

4. irregular or fast heartbeat,

5. shortness of breath,

6. headache,

7. light-headedness or dizziness,

8. cold hands and feet,

9. tingling legs,

10. inflammation or soreness of the tongue,

11. poor appetite, or

12. cravings for non-nutritive substances such as dirt or ice.

Read more: 5 signs you might have a scary vitamin B12 deficiency

If you experience these, see your doctor, who can confirm anaemia through a thorough medical history and tests, and identify the underlying cause. Apart from inadequate dietary iron, anaemia can stem from excessive iron loss – “for instance, heavy periods or a gastric bleed,” says Dr Patricios.

Poor iron absorption can be an issue, aggravated by meds such as antacids or foods such as tea, coffee or wine, he says. Dairy products, too, may inhibit absorption.

Anaemia can also be caused by iron loss through internal bleeding from parasites such as hookworms in underdeveloped populations, ulcers or infections, such as TB and malaria.

What can you do about it?

“Addressing the underlying cause may include an oral contraceptive pill to lighten menstrual flow, medications to heal peptic ulcers associated with micro-bleeds, or surgery to remove bleeding polyps, fibroids or tumours,” Dr Patricios says.

You will usually be advised to eat iron-rich foods – red meat such as beef and liver, and to a lesser extent, chicken, pork and shellfish, and vegetable sources including beans, lentils, dark green leafy vegetables and fortified cereals and breads. But with today’s busy lifestyles, meals can be rushed or skipped, and you may benefit from an iron supplement.

Thinking of going the supplement route? The usual recommended dose of oral iron for the treatment of IDA in adults is 100 to 200mg of elemental iron daily.

But before you just grab the first supplement off the shelf, know this: many supplements contain only small amounts of elemental iron.

Chat to your pharmacist about the best one for your needs – preferably one which has fewer and milder side effects (constipation and nausea).

This article was originally published on

Image credit: iStock