8 Things You Should Know if You Have Iron-Deficiency Anemia

Iron deficiency anemia is something (unfortunately) near and dear to my heart.  I’ve struggled with this condition on and off since my early teenage years and it can often fly under the radar until it becomes a serious problem!  There are billions of people around the world with iron-deficiency anemia (1).  The good news is that it’s an easy fix!

(Updated December 8, 2023)

What is anemia?

ANEMIA, in a nutshell, is a condition in which our blood is not carrying enough oxygen to the rest of our body, either because we don’t have enough red blood cells or we don’t have enough hemoglobin (an iron-rich protein that is carried by our red blood cells).

If we don’t have enough iron in our body, we can’t make enough hemoglobin, and without enough of that…well, let’s just say it’s no picnic!

When our hemoglobin levels are low, our cells aren’t getting enough oxygen to do everything they need to do.

What is iron-deficiency anemia?

Iron-deficiency anemia is a condition in which we have low blood levels of iron (for one reason or another) to the point where it has compromised our hemoglobin production, ultimately resulting in a decreased oxygen supply to all of our cells.

Common symptoms of iron-deficiency anemia

3d rendered illustration of many blood cells

  • General weakness/fatigue
  • Pale skin
  • Rapid heart beat
  • Light-headedness
  • Dizziness
  • Shortness of breath
  • Reduced exercise endurance
  • Brittle nails
  • Ridged or spoon-shaped nails
  • Hair loss
  • Cold hands and feet (poor circulation)

Did you know… Pre-menopausal women need more than DOUBLE the amount of iron from food compared to men!  A healthy young adult female on average requires about 18 milligrams daily, while men need only need 8 milligrams of iron per day (2).

8 things you should know if you have iron-deficiency anemia

All iron is NOT created equal!

There are two types of iron: HEME and NON-HEME.

Heme iron comes from animal food sources such as red meat, liver, and eggs

Non-heme iron comes from plant sources such as leafy greens, beets, beans, and even dark chocolate. Supplemental iron is also considered non-heme.

Heme iron is naturally more “bioavailable” (better absorbed by our body) than non-heme iron: we absorb about 15% of heme sources of iron, while we only absorb 3-8% of non-heme iron (2).

Iron and vitamin C make a great team

I recommend using this to your advantage, especially if you’re vegetarian or vegan!

Combining a plant source of iron (non-heme) with vitamin C will significantly increase the amount of iron that gets absorbed by your body.

A few examples are adding berries, peppers or citrus to a spinach salad, or even just taking your iron supplement with a small glass of pineapple juice or orange juice instead of water.

Recommended reading:

Iron and calcium clash.

If you’re trying to increase your iron levels, don’t mix your iron-rich meal or supplement with a glass of milk or calcium-fortified food.  This is because iron and calcium compete for the same absorption sites in the stomach and cancel each other out.

Remember to watch out for other hidden calcium sources like multivitamins, calcium chews, or even antacids such as Tums which are made of calcium carbonate.

Iron can interfere with certain medications. 

If you’re taking iron supplements, make sure to take them at least a few hours apart from antibiotics, Mycophenolate Mofetil (CellCept ®‎) or any meds used for treating any of the following:

    • Osteopenia/osteoporosis
    • Thyroid problems
    • Parkinson’s disease
    • Wilson’s disease

Iron supplements can be known to cause upset stomach.

The most common side effects of iron supplements (even when prescribed by a doctor) are nausea and constipation.

How to take iron pills without getting sick

  1. Never take iron on an empty stomach!  I always recommend taking iron with a meal or snack to reduce and minimize any potential unpleasant side effects.
  2. Try incorporating probiotics (from food or supplements) into your routine.
  3. If you’re into German sauerkraut, you would love my traditional lacto-fermented sauerkraut recipe!
  4. If you’re prone to constipation, you may benefit from adding prunes into your regimen (if you don’t mind the taste!).
    • In my opinion, the best iron supplement for anemia without constipation as a side effect is an herbal iron syrup. 

The lower our iron levels, the higher our iron absorption (2)

Our bodies are smart and they know what they need!

You might also find yourself craving more spinach salads or red meat (or in cases of PICA, you could even crave ice or non-food substances like dirt, clay or chalk).

Iron feeds many types of pathogenic (“bad”) bacteria (3)

Proceed with caution, and make sure to increase your probiotic intake especially if you have any kind of bacterial infection or are prone to “dysbiosis”.

ALWAYS consult a doctor or dietitian before starting iron supplements

It’s surprisingly easy, and very dangerous, to overdose on iron.

“Safe” levels of iron will be completely different depending on your blood levels of hemoglobin, so you need to leave your dosing up to a medical professional.

Overdosing on iron can lead to nausea/vomiting/diarrhea, liver failure, and even death. Use only as directed!

Thanks so much for reading! If you found this article, please let me know in the comments! -Jenna


  1. Miller, Jeffrey L. Iron Deficiency Anemia: A Common and Curable Disease. Cold Spring Harb Perspect Med. 2013 Jul; 3(7): a011866. doi: 10.1101/cshperspect.a011866
  2. Mahan, L. Kathleen., and Sylvia Escott-Stump.Krause’s Food & Nutrition Therapy. 12th ed. St. Louis, MO: Saunders/Elsevier, 2008. 816-1300. Print.
  3. Barclay, R., and A. JM Messenger. “Bacteria, Iron and Pathogenicity.”Wiley Online Library. Biochemical Education, 26 June 2010. Web. 02 Jan. 2017. <http://onlinelibrary.wiley.com/doi/10.1016/0307-4412(83)90043-2/pdf>.

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