Swollen tongue and cold hands? This is the vital nutrient that's missing from your diet
Iron – a metallic element long associated with strength and power – is a mineral we now know is essential to the inner workings of a fit and healthy body and mind. Its key function in our circulatory systems, which transport blood around our bodies, is making hemoglobin, the protein in red blood cells that carries oxygen. So, a deficiency in iron, or an issue with your body’s absorption of it, can lead to anemia, characterised by fatigue and shortness of breath and a host of other symptoms.
You might be more prone to anemia if you suffer from certain stomach and intestinal diseases such as peptic ulcers or inflammatory bowel disease because they can restrict the uptake of iron in your system. During pregnancy too, a woman’s body is under extra strain to meet the iron demands of both her own body and the developing baby. In fact, you may also be susceptible to low iron levels if you’re a child-bearing-age woman, due to blood loss during periods, a child, due to rapid growth and picky eating, a vegetarian (meat is a great source of iron) or a frequent blood donor.
It's not only our circulatory system that needs iron – our metabolism, immune system, brain function, hormone and DNA synthesis all need iron to function normally. Let’s look at the main signs that some of these processes might be struggling and what we can do to remedy it.
1. Mental and physical fatigue
One of the first signs a doctor will look for in diagnosing anemia is exhaustion. As iron is crucial for carrying oxygen in the blood around your body, a lack of it will lead to weakness in your muscles, tiredness and a foggy head. This is different to sleeplessness – your energy levels will be consistently low – low enough to find movement an effort. Dizziness and light-headedness may accompany this.
2. Cold hands and feet
You might be prone to cold extremities and body temperature varies from person to person. However, it can be a sign of anemia if your circulation is poor and not able to effectively reach the furthest parts of your body to warm them up. If you suddenly experience cold hand and feet out of nowhere, or you’re finding it harder to regulate your temperature, it could be down to a lack of iron.
3. Pale skin
If iron deficiency is causing your circulation to struggle, you’ll have less colour in your cheeks while your body prioritises getting oxygen further inside your body towards your organs. Rather than being anything to do with your skin colour, as that’s controlled by melanin, this is to do with pallor. It’s more noticeable on your face, your palms and your nail bed – check to see whether you have a paler appearance than usual.
4. Loss of appetite
Less oxygen in your stomach can mean less hunger – it’s another symptom of severe tiredness that comes with anemia. Studies have shown that iron deficiency anemia may be related to changes in the hormone ghrelin, which regulates hunger. If you suddenly find you’re skipping meals or not interested in food, it may be a good idea to chat it over with your doctor.
5. Brittle, discoloured or concave nails
As well as weak nails that break easily, the shape of your nails (and the colour, as discussed above) can show whether you’re getting enough iron or not. A lack of iron can trigger a condition called koilonychia that gives nails a spoon-shaped dent where the edges are raised rather than following the convex curve of your fingers.
6. Shortness of breath
If you have anemia, your blood isn’t carrying enough oxygen around your body, including to your lungs. To make up for the reduced oxygen levels, you may start breathing quicker and your heart will pump faster. Everything will be working harder to take in more oxygen, which will leave you feeling like you’re struggling for breath.
7. Restless legs
As well as lower blood oxygen levels, restless leg syndrome (RLS) is exacerbated by iron deficiency causing a decrease in dopamine. This neurotransmitter is involved in movement, so it’s thought to be a factor in RLS, which in many cases is difficult to explain on its own. If you have RLS with any other of these symptoms it’s worth checking for anemia.
8. Swollen or sore tongue
A swollen tongue may not be an allergic reaction, but a common sign of iron deficiency known as glossitis. It can make your tongue look more red, enlarged and smooth rather than textured.
9. Hair loss
In some cases, an iron deficiency can also cause weak, brittle hair and hair loss. When your body doesn't absorb enough iron, it cannot produce enough hemoglobin to regenerate hair follicle stem cells. Hemoglobin is a protein found in your red blood cells that carries oxygen through the blood to grow and repair the cells in your body.
10. Weird cravings
Maybe this explains bonkers pregnancy cravings such as ice and coal! Low iron can make you crave things that have no nutritional value – a compulsion called ‘pica’. This might include being drawn to chew things like chalk, soil or paper. Though anemia can present this way, pica isn’t limited to nutritional deficiencies. It can be caused by mental health conditions, and young children often have a form of pica up to the age of six.
Fact: Non-heme iron, is mainly found in plant sources such as beans, nuts, dark chocolate, legumes, spinach, and fortified grains. Heme iron, present in meats, poultry, and seafood, is more easily absorbed than non-heme iron.
Will supplements help?
BANT registered nutritional therapist, Laura Southern, works for London Gynaecology supporting women's health. ‘I have been in practice for 15 years so supported lots of women with low iron, and had 3 pregnancies where my iron also needed supporting,’ she explains.
‘The iron supps generally prescribed by NHS are ferrous sulphate - these often give side effects - usually constipation, but there can be other digestive disturbances too. They don't always get absorbed that easily either.
‘There are some things I look out for when recommending iron supps’:
- Bioavailability - this means how easily the body can absorb and utilise the iron. Forms like 'bisglycinate' and 'heme' iron have more bioavailability than sulphate but their total iron content is often lower. Food state iron supplements are also good - these have a much lower dose of iron than standard iron tablets, but the form is in a state your body can recognise so you can absorb more of it.
- Ensuring that the iron supp is either taken with, or contains, nutrients to support absorption - most common is vitamin C but also molybdenum is helpful.
- Timing of iron supplement - iron absorption can be blocked by certain foods such as tannins (in tea) and phytates (in grains). Laura often recommends taking it on an empty stomach (last thing before bed), but if it causes digestive issues then take with some fruit.
Below are supplements that Laura has recommend the most and has used herself. She advises to always remember to check your iron levels (via blood test) before taking iron supplements and they shouldn't be continued long term as too much iron is dangerous.
You should be cautious and always seek advice from your GP or pharmacist if you are already taking medications as some supplements can interact with certain meds such as blood thinners.
- Cytoplan - Iron (with molybdenum and vitamin C)
- Terranova - Easy Iron, 20mg, non-constipating
- Wild nutrition - Iron Plus for All, blended with vitamin C
Changes to your diet
Superintendent pharmacist, Abbas Kanani, from Chemist Click explains that while supplements can be beneficial to some, you should be able to get all the iron you need from your daily diet. Abbas says, ‘The NHS recommends an iron intake of 8.7mg a day for men aged 19 and over. 14.8mg a day for women aged 19 to 49 and 8.7mg a day for women aged 50 and over. Women having periods after the age of 50 may need the same amount of iron as women aged 19 to 49.’
Abbas explains how to get more iron into your diet naturally:
- Dark-green leafy vegetables like broccoli, spinach and curly kale are an excellent source of iron and can help give your body the necessary iron intake. They are packed full of nutrients which help to reduce the risk of iron-deficiency anemia.
- Liver and red meat like beef and lamb are rich in heme iron, a form of iron that is better absorbed by your body.
- You can also bump up your iron intake by eating legumes such as beans, peas and lentils.
- Dry fruits, such as raisins and dates have a high iron content and offer antioxidant benefits too.
Good to know
- It’s beneficial to eat iron-rich foods (from plant sources) alongside foods that are high in vitamin C, since this essential vitamin aids our bodies in the absorption of iron.
- You may want to avoid consuming dairy, coffee, tea, chocolate, or high-fibre foods when taking iron supplements, as components of these foods may bind to the iron and reduce its absorption.
- A surprising source of non-heme iron is dark chocolate with a high cocoa content (ideally over 70%). It’s not as easily absorbed into the body but does has other benefits such a magnesium (plus, it’s a delicious treat!).
- Recent studies have linked anemia with tinnitus – a condition that causes ringing or buzzing in your ears. It can be caused by your arteries working harder to pump blood around the body. It’s a less common symptom but worth checking with your GP.
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