Iron deficiency affects millions of Americans, consistently ranking as the number one mineral deficiency worldwide and one of the top nutritional deficiencies, alongside vitamin D.
The reason low iron is more common than other mineral and nutrient deficiencies varies, but it is most often because many people have difficulty absorbing iron from their diet and even supplements. Dietary factors (especially if you are vegetarian or vegan) also contribute, as does blood loss from menstruation or pregnancy.
While there are some tell-tale signs of low iron, most people don’t know their iron is low until the deficiency has progressed to a more advanced stage. Even then, most assume an over-the-counter iron supplement is the solution.
In some cases, an iron pill might be enough. But for many, iron IV therapy may be the better, more effective option.
In this article, we’ll cover why iron is essential to your body, the problems low iron can cause, who is most at risk for iron deficiency, what to do if you suspect your iron levels are low, and why self-treating isn’t typically recommended.
We’ll also give you the best options to prevent iron deficiency, get your iron levels in an ideal range, and explain why iron IV therapy might be the best solution to do that.
Why Iron is Important in the Body
Iron is a vital mineral in every cell of the body. It isn’t optional; iron is an essential mineral, meaning your body requires it to function, but cannot produce it on its own. Iron must be obtained from food, supplements, or other advanced solutions such as IV iron therapy.
Two of the most important reasons you need to maintain optimal iron levels are that iron is needed to make hemoglobin, the protein in your red blood cells that transports oxygen from your lungs to all your tissues and organs, and myoglobin, the protein found in muscles.
But that only scratches the surface of why iron is such an important mineral. Optimal iron levels are essential for your body for many reasons, including:
Oxygen Transport
Every cell in your body needs oxygen to function. Oxygen transport is the process of moving oxygen from your lungs to all tissues and organs throughout your body. Iron is essential for this process because it forms the central component of hemoglobin molecules that bind to oxygen in your lungs and deliver it where needed.
When iron levels are insufficient, your body produces less hemoglobin, reducing oxygen delivery to tissues and organs. The result is fatigue, weakness, and reduced physical capacity that can affect even the smallest everyday activities.
Poor oxygen delivery due to low iron also explains why you may feel constantly cold, especially in your hands and feet, even when it’s warm outside or others around you are comfortable.
Energy Production
Your body needs energy to do everything—from being able to focus at work, power through a workout, or just make it through the day without feeling wiped out.
That energy comes from the food you eat, but your body has to convert it into a form your cells can actually use. Iron plays a key role in that process. It helps certain enzymes inside your cells do their job, turning nutrients into usable energy.
When your iron levels are low, these energy-producing systems don’t work as efficiently. That means your body has to work harder to function, often leaving you feeling tired, sluggish, and drained, even if you’re getting plenty of sleep.
Cell Health & Repair
Your body is constantly working behind the scenes to clean out damaged or unhealthy cells so it can stay healthy and function at its best.
Iron plays a role in one of those natural cleanup processes, called ferroptosis—a way your body breaks down and removes cells that are no longer working properly.
When iron levels are too low, this process can slow down or stop, making it harder for your body to repair and maintain healthy tissues over time.
Immune Function
Your immune system relies on iron to do its job. It helps your body make the cells that fight off infections and supports the signals those cells use to communicate.
Without enough iron, your immune response can be weaker, making it harder for your body to defend against and recover from illness and infection.
Brain Development and Function
Your brain relies on iron to produce neurotransmitters (the chemicals that help your brain cells talk to each other), support nerve function, and fuel mental energy. When iron levels are low, it can cause brain fog, trouble focusing, and forgetfulness.
In developing children, the impact can be even more serious since iron is essential for brain development. A deficiency early in life can potentially affect cognitive function in the long term.
Muscle Function
Iron plays a key role in how your muscles use and store oxygen. It’s a main component of myoglobin, a protein that helps deliver oxygen to your muscles so they can work properly—especially during movement or exercise.
When iron is low, your muscles don’t get the oxygen they need, which can lead to early fatigue, decreased endurance, and even weakness during everyday tasks—not just workouts.
Problems That Can Occur with Iron Deficiency
Most people associate iron deficiency with anemia—and that’s true. If your body doesn’t get or absorb enough iron, your stores begin to deplete, and iron-deficiency anemia will eventually develop if left untreated.
However, what many people don’t realize is that iron deficiency can cause other symptoms and health issues long before it progresses to full-blown anemia. Even moderately low iron levels can cause issues such as:
- Extreme fatigue
- Muscle weakness
- Anxiety
- Pale skin
- Brittle nails
- Hair loss
- Shortness of breath during everyday activities
- Headaches and dizziness
- Poor concentration and memory problems
- Cold hands and feet
- Increased heart rate
- Weakened immune system, making you more prone to infections
- Restless leg syndrome and cravings for non-food items (pica)
Iron deficiency can also worsen existing health conditions. For those with heart disease, low iron levels may exacerbate symptoms, and it can complicate pregnancy, leading to preterm birth or low birth weight.
Iron deficiency doesn’t just leave you feeling tired—it affects your ability to function, perform, and even stay healthy in ways you might not realize.
Risk Factors for Iron Deficiency
Iron deficiency doesn’t affect everyone equally. Certain groups face significantly higher risks due to biological factors, medical conditions, or lifestyle circumstances.
If you fall into any of the below categories, it might increase your risk of developing an iron deficiency or be a reason for you to increase your iron intake:
- Women with heavy menstrual bleeding
- When pregnant or breastfeeding
- Infants and children under the age of 5
- Teenagers, due to rapid growth and increased iron needs during puberty
- Adults over age 65, especially those who may have reduced iron intake, chronic inflammation, or undiagnosed blood loss
- Frequent blood donors
- Endurance athletes, especially long-distance runners and female athletes
- People with gastrointestinal disorders (such as celiac disease, Crohn’s disease, or ulcerative colitis)
- Those who have had gastrointestinal surgery, including bariatric or bowel surgery
- People following vegetarian or vegan diets
- Individuals with chronic kidney disease or heart failure
- People undergoing cancer treatment
- Those taking certain medications that interfere with absorption, like proton pump inhibitors or antacids
- People with a history of eating disorders or severely restrictive diets
- Individuals with alcohol use disorder
- Those living with food insecurity or limited access to nutrient-rich foods
Falling into one of these categories doesn’t automatically mean you’re anemic or low in iron or that you should take an iron supplement; it just means you may need more iron than the average person or be more likely to develop a deficiency, especially if symptoms are present.
Never self-diagnose and self-treat a nutrient deficiency, especially iron. Always work with a healthcare provider before starting any type of iron supplement or treatment.
How Much Iron Do You Really Need
The exact amount of iron your body needs varies based on age, sex, life stage, and sometimes even how active you are.
For example, if you are a female, you are more likely to need more iron, especially in childbearing years or when pregnant. Additionally, sweating can lead to a small amount of iron being lost. If you sweat a lot during exercise or work in hot or humid temperatures, you might need more iron than the average person.
It’s important to consult with a healthcare professional or registered dietitian to determine the most appropriate iron intake for your individual needs.
However, in general, the National Institutes of Health (NIH) recommends a daily intake of iron to be 8 mg for men and post-menopausal women and 18 mg for pre-menopausal women. During pregnancy, that requirement jumps to 27 milligrams per day to support fetal development and increased blood volume.
How to Know if You’re Iron Deficient
Determining if your iron levels are low without bloodwork can be tricky. That’s because many of the most common symptoms of low iron mimic typical signs of a busy lifestyle without balanced rest and recovery, or even just being a naturally cold-natured person.
However, they could also be your body signaling an iron deficiency. Early and common signs of low iron to watch for include:
- Persistent fatigue, no matter how much you rest
- Feeling cold all the time
- Shortness of breath during normal activities
- Pale skin and brittle nails
- Frequent headaches
- Difficulty concentrating
As iron deficiency progresses, you might also experience some of these lesser-known symptoms of low iron:
- Hair loss
- Dizziness when standing up
- Increased heart rate or heart palpitations
- Restless leg syndrome, especially at night
- Cracked corners of the mouth
- Spoon-shaped nails (koilonychia)
- Frequent illness or infections (due to a weakened immune system)
- Unusual cravings for non-food items like ice, dirt, or clay (a condition called pica)
Additionally, it’s rare that any of these symptoms come about hard and fast. Symptoms of low iron are usually slow and progressive and occur in three stages:
- Stage 1: Depleted Iron Stores – At this early stage, your body’s iron reserves (measured by ferritin levels) begin to drop, but your red blood cell production remains normal. You might not notice any symptoms yet. This is why it’s important that you also have ferritin levels checked, not only serum iron.
- Stage 2: Iron-Deficient Erythropoiesis – In this intermediate stage, your body struggles to produce new red blood cells properly. You may begin experiencing subtle symptoms like fatigue and reduced exercise tolerance.
- Stage 3: Iron Deficiency Anemia – By this advanced stage, your body cannot produce enough healthy red blood cells. Symptoms become more pronounced and impact your daily activities and quality of life.
It isn’t uncommon for people to be deep into stage three iron deficiency before they recognize that their symptoms might be more than simply being tired from a busy lifestyle, stress, or aging.
Even then, most people don’t see a healthcare provider to confirm that low iron is the issue. Instead, they Google their symptoms, see that they match anemia, and blindly start taking a random iron supplement.
Self-diagnosing and treating iron deficiency isn’t recommended. Next, we’ll go over why it’s important to confirm low iron levels with lab testing, get to the root issue of why you have low iron, and why treating iron deficiency should be tailored and supervised by a qualified healthcare provider.
What To Do If You Suspect Your Iron is Low
The above symptoms are very telling of low iron, but the only safe and definitive way to diagnose iron deficiency and determine the next best steps for your situation is to work with a healthcare professional educated and trained in nutritional deficiencies.
This ensures you’ll get a proper diagnosis, uncover any underlying causes, and receive the most effective treatment plan—whether that involves dietary changes, oral supplements, or more advanced options like IV vitamin therapy for faster, more effective iron repletion.
Speaking of treatment options, it’s not a good idea to self-treat suspected low iron with iron supplements. While iron supplements are available over the counter and are often the safe first step in treating low iron, if you’re experiencing symptoms of iron deficiency, you should leave it to a healthcare provider to determine whether supplementation is truly necessary, what dosage is appropriate, and which form of iron your body can best absorb.
Taking iron when you don’t really need it can cause problems. Even if you are low on iron, improper dosing or the wrong form of iron can lead to complications or make the issue worse. Not to mention, iron deficiency can sometimes signal other health conditions that need attention. Self-treating with iron supplements without proper diagnosis can mask symptoms of serious conditions and delay necessary medical care.
It is best to get a proper diagnosis from a healthcare provider and let them tailor a treatment plan based on your lab results, symptoms, risk factors, and overall health history.
During your appointment, your provider will get a detailed medical history, including a discussion of symptoms. Next, they will order a comprehensive blood test to check iron levels, including hemoglobin, ferritin (iron storage), serum iron levels, and other markers.
Pending your lab results, additional tests might need to be performed to determine the underlying cause of why your iron levels are low.
How to Prevent and Treat Iron Deficiency
If you suspect your iron levels are low, always consult with a healthcare provider who can order the appropriate tests to confirm your levels are low and check for any possible underlying causes that may also need treatment.
From there, they will recommend the right iron deficiency treatment based on your individual needs. That said, here are some of the steps typically recommended for preventing and treating iron deficiency:
Eat Foods Rich in Iron
Consuming iron-rich foods is essential for maintaining healthy iron levels. The most absorbable form of iron, called heme iron, is found mainly in animal products.
Some examples of heme iron sources include:
- Lean red meat (especially beef)
- Liver and organ meats
- Poultry (especially dark meat)
- Eggs (especially egg yolks)
- Seafood, particularly oysters, salmon, tuna, and sardines
You can also get iron from plant-based (non-heme) sources. However, like iron supplements, this type of iron is often harder for the body to absorb.
Examples of non-heme iron sources include:
- Legumes (lentils, beans, chickpeas)
- Dark leafy greens (spinach, kale)
- Fortified cereals and grains
- Dried fruits, especially apricots
- Tofu and tempeh
- Quinoa and amaranth
- Whole grains
Including a variety of these foods in your diet is a great way to help prevent iron deficiency, especially when paired with nutrients that boost absorption. For instance, vitamin C significantly enhances iron uptake, so pairing iron-rich meals with foods like citrus fruits, bell peppers, or tomatoes can make a big difference.
On the flip side, there are nutrients that do the opposite and limit how much iron your body actually absorbs. For example, calcium and the tannins in tea and coffee can interfere with iron absorption when consumed at the same time as iron-rich foods.
There are also certain medications and medical conditions (like celiac disease, low stomach acid, or inflammatory bowel disease) that reduce the body’s ability to absorb iron effectively from food.
While food should be your foundation, it’s important to be mindful of the supplements, medications, and other foods you consume alongside iron-rich meals. And know that if you have absorption issues, food alone might not be enough to prevent a deficiency.
Additionally, while dietary changes are excellent for prevention and long-term support, they’re often not sufficient to restore iron levels once they’ve dropped too low. In many cases, targeted supplementation or iron IV therapy is needed to rebuild iron stores effectively.
Iron Supplementation
In addition to dietary changes, oral iron supplements are often the first-line treatment for mild to moderate iron deficiency.
Iron supplements are available in various forms, including ferrous sulfate, ferrous gluconate, and ferrous fumarate. They also come in different types, such as tablets, capsules, liquids, and slow-release formulas.
Each form contains a different amount of elemental iron, which affects both absorption and the likelihood of side effects. Dosing also varies depending on the severity of the deficiency, the type used, and individual tolerance, which is why it’s important to work with a healthcare provider to determine the best option and dose for your specific needs.
A quality iron supplement suggested by a healthcare provider can provide a concentrated dose of iron to help replenish depleted stores. However, oral supplementation comes with limitations.
The biggest issue most people face with iron supplements is gastrointestinal side effects. Constipation, nausea, abdominal pain, and diarrhea are common and affect most people taking oral iron supplements.
While these side effects usually diminish with time, not being able to tolerate the stomach issues that often come with taking iron pills can lead to poor compliance. So can the length of time needed to fully restore iron back into a healthy range.
With the right iron supplement and consistent use, hemoglobin levels should begin to improve after about four weeks. However, it’s not uncommon for it to take 3–6 months or longer to replenish iron stores from oral supplementation alone.
One reason is that absorption rates from iron supplements are typically low, ranging from only 2% to 13% in most people and 5% to 28% in those with low iron stores.
Additionally, certain medications and medical conditions—such as antacids, proton pump inhibitors, or inflammatory bowel disease—can further impair absorption. Even common foods and beverages, such as coffee and dairy products can negatively interact with iron supplements.
If your provider suggests iron supplements, it’s generally advised to start with a lower dose and follow an every-other-day dosing schedule. This may improve both absorption and tolerability compared to daily supplementation.
However, in many cases, replenishing iron via IV vitamin therapy is a better solution.
Iron IV Therapy
Intravenous (IV) iron therapy is a modern solution for treating moderate to severe iron deficiency that delivers iron directly into the bloodstream, bypassing the digestive system entirely.
Modern IV iron formulations have excellent safety profiles when administered by qualified healthcare professionals. The treatment is administered in a medical setting where patients can be monitored. Sessions generally take between 30-60 minutes, depending on the specific iron formulation used.
Key Benefits of Iron IV Therapy
IV iron therapy potentially offers several significant advantages over oral supplements:
- Near 100% bioavailability, as the iron enters the bloodstream directly
- Rapid correction of deficiency, often within days or weeks rather than months
- No to low risk of gastrointestinal side effects that commonly occur with oral supplements
- Effective even in patients with absorption issues from gastrointestinal conditions
- No need to remember to take a daily supplement or attempt to calculate and track iron content from food
IV vitamin therapy isn’t just for those who struggle to absorb iron or other key nutrients properly—it can offer a range of wellness benefits for many people. Thanks to its versatility and fast-acting results, IV therapy is a powerful tool for supporting both short-term recovery and long-term health.
Delivering essential vitamins and minerals directly into the bloodstream supports the production of healthy red blood cells and promotes better overall hydration, which is especially valuable for those with active lifestyles or recovering from illness.
Another popular reason people seek IV vitamin therapy is to ease hangover symptoms, as it rapidly replenishes fluids and key nutrients lost through alcohol consumption. People also find intravenous vitamin formulas the most effective for giving their immune system a boost when trying to fight or prevent an everyday illness like a cold and the flu. And athletes swear by IV vitamin therapy solutions containing amino acids.
There are IV infusion formulas for just about anything these days. Whether you go with a custom solution, the popular Myer’s Cocktail, or a newer modern IV vitamin therapy treatment such as NAD+ and Methylene Blue— there are many instances in which IV hydration formulas at Relive Health can save your health.
Is IV Iron Therapy Right For Me?
While not everyone with iron deficiency requires IV therapy, for those who do, it can dramatically improve quality of life and health outcomes by efficiently restoring iron levels when other methods have proven inadequate.
IV iron therapy is particularly beneficial for patients with:
- Severe iron deficiency anemia requiring rapid correction
- Chronic conditions that cause ongoing iron loss or increased requirements
- Inflammatory bowel diseases, celiac disease, or other absorption disorders
- Intolerance or poor response to oral iron therapy
- Need for rapid iron repletion when time is limited
While intravenous vitamin therapy is often the best solution, it’s difficult to say if IV therapy is the best choice for you without a consultation with a healthcare provider who specializes in nutritional deficiencies.
Only after reviewing comprehensive blood work and discussing your symptoms and health history can you know which treatment approach is most appropriate for your specific situation and health needs.
Important Considerations Before Increasing Iron Intake
Before starting any iron supplement or undergoing IV iron therapy, it’s essential to confirm that you actually need more iron. Taking unnecessary iron can be harmful because, unlike many nutrients, iron is not easily excreted by the body.
Additionally, not all anemia is caused by iron deficiency. For instance, anemia due to vitamin B12 or folate deficiency requires different treatment. Taking iron in these cases won’t help and can delay proper diagnosis and care.
It’s also critical to understand the root cause of your iron deficiency. For example, unexplained low iron in men and post-menopausal women could be a sign of internal blood loss, often from gastrointestinal ulcers, polyps, or even colorectal cancer.
Simply taking iron without investigating the cause can mask symptoms and delay the discovery of a serious underlying issue.
These basic guidelines apply to anyone considering iron supplements or IV iron therapy. However, there are situations where extra caution is vital.
Always talk to your healthcare provider before increasing your iron intake if you:
- Have a genetic condition like hemochromatosis, which causes the body to absorb and store too much iron.
- Have a medical condition that increases your risk of iron overload, such as chronic liver disease, certain types of cancer, or a history of repeated blood transfusions.
- Are taking medications that interfere with iron absorption or effectiveness. This includes some antibiotics (like tetracycline or ciprofloxacin), thyroid medications (such as levothyroxine), antacids, proton pump inhibitors, and some blood pressure medications.
- Live with a chronic condition like kidney disease, rheumatoid arthritis, or inflammatory bowel disease, which can affect how your body absorbs or uses iron.
- Are pregnant or planning to become pregnant. While iron needs are higher during pregnancy, supplementing should still be done under medical supervision.
- Have recently undergone or are preparing for surgery, especially gastrointestinal procedures that may affect iron absorption or blood loss.
Conclusion
Iron plays a vital role in your energy levels, immune function, brain health, and overall well-being—but it’s not something to supplement blindly.
While fatigue, brain fog, and being cold are often associated with low iron, those same symptoms can stem from a wide range of other causes. Taking iron without confirming a deficiency can do more harm than good, especially if the true root of the issue goes untreated.
At Relive Health, we take the guesswork out of your health. We offer comprehensive blood testing that checks not only your iron levels but also other key nutrients and markers that affect how you feel and function.
If an iron deficiency is detected, our medical team will create a custom treatment plan tailored to your specific lab results, medical history, and symptoms. That plan might include dietary changes and oral supplements—or, if appropriate, IV iron therapy, which delivers iron directly into the bloodstream for faster replenishment and absorption.
We provide all of these solutions in one place, so you won’t need to visit multiple clinics or specialists. And because we look at the whole picture, if your bloodwork reveals other concerns—like additional nutrient deficiencies, hormone imbalances, or inflammation—our team is here to address those too.
Check out our clinic locator to book a consultation and comprehensive blood panel at a Relive Health clinic near you.
