A most common belief is that anaemia is caused by iron deficiency. But there are several other factors causing anaemia. Dr Rakesh Gupta, senior consultant, Internal Medicine, Indraprastha Apollo Hospitals, says: “While iron deficiency is the most widely known cause of anaemia, it is not the only one. Anaemia can occur due to several other reasons that affect the body’s ability to produce healthy red blood cells or maintain adequate hemoglobin levels. Deficiency of essential nutrients such as vitamin B12 and folate is a common cause, particularly in people with poor dietary intake or absorption problems.
Chronic illnesses like kidney disease, cancer, autoimmune conditions, or long-standing infections can also lead to anaemia. Certain inherited blood disorders such as thalassemia and sickle cell disease are additional causes. Blood loss from heavy menstrual cycles, gastrointestinal bleeding, ulcers, or surgeries can also reduce haemoglobin levels over time. In some cases, bone marrow disorders such as aplastic anaemia affect the body’s capacity to produce blood cells. Treatment differs depending on the reason behind the anaemia.”
Why do otherwise healthy people have negligible ferrous levels and low iron absorption?
Low iron levels can occur even in people who appear otherwise healthy, and this often happens due to a combination of dietary, lifestyle, and physiological factors. One of the most common reasons is insufficient intake of iron-rich foods, especially among people following restrictive diets or consuming limited animal-based foods. Even when iron is present in the diet, the body may not absorb it efficiently.
Conditions affecting the digestive system, such as celiac disease, inflammatory bowel disease, or chronic gastritis, can reduce iron absorption. Frequent consumption of tea or coffee with meals can also interfere with iron uptake because certain compounds block absorption. Women of reproductive age often experience iron deficiency due to menstrual blood loss. Increased iron requirements during pregnancy, adolescence, or periods of rapid growth can also lead to depletion if dietary intake does not keep pace. In some individuals, long-term use of certain medications or antacids may further affect iron absorption.
What are the tests needed to diagnose reasons for low iron content and anaemia?
The first step is usually a complete blood count, which evaluates hemoglobin levels, red blood cell count, and other parameters that help determine whether anaemia is present. To assess iron status, doctors typically recommend tests such as serum ferritin, serum iron, total iron binding capacity, and transferrin saturation. These tests help determine whether iron stores in the body are depleted or if there is an issue with iron transport or utilisation.
If vitamin deficiencies are suspected, vitamin B12 and folate levels may also be checked. In some cases, tests for inflammation, kidney function, or thyroid function may be recommended to rule out chronic disease-related anaemia. When blood loss is suspected, stool tests for hidden blood or endoscopic examinations of the digestive tract may be advised to identify possible internal bleeding.
What are the signs not to ignore?
Anaemia often develops gradually, and many people ignore early symptoms mistaking them for general fatigue. However, there are several warning signs that should not be overlooked. Persistent tiredness, weakness, and reduced stamina are among the most common symptoms. People with anaemia may also experience shortness of breath during routine activities, frequent dizziness, or headaches. Pale or dull skin, brittle nails, and hair thinning can also indicate low hemoglobin levels.
Some individuals develop unusual cravings for non-food substances such as ice, chalk, or clay, a condition known as pica, which is associated with iron deficiency. Rapid heartbeat, chest discomfort, or difficulty concentrating may occur when anaemia becomes more severe. In children and adolescents, anaemia may affect growth, attention, and academic performance.It is important to seek medical evaluation for these symptoms, as untreated anaemia can affect overall health and daily functioning.
What dietary course should be adhered to in case of low iron and anaemia?
Individuals with low iron levels should focus on including iron-rich foods in their daily meals. Good sources of iron include green leafy vegetables such as spinach, legumes, lentils, beans, nuts, seeds, whole grains, and fortified cereals. Animal-based sources like lean meat, poultry, fish, and eggs contain heme iron, which is more easily absorbed by the body. Pairing iron-rich foods with vitamin C-rich foods such as citrus fruits, tomatoes, amla, or bell peppers can significantly improve iron absorption. Cooking in iron utensils may also help increase dietary iron intake slightly. For individuals with moderate to severe deficiency doctors may recommend iron supplements along with dietary modifications to restore normal levels.
Disclaimer: The information in this article is for educational and informational purposes only and is not intended as medical advice. While the author has incorporated expert medical guidance while producing the story and ensured full authentic information is provided to the reader, you should always seek the advice of a qualified healthcare provider regarding a medical condition or treatment. Never disregard professional medical advice or delay in seeking it because of something you have read here.