If your body’s not absorbing enough iron—or you’re not consuming enough—you’re not alone. Iron deficiency is the most common nutritional deficiency in the world. (Note to self: Add spinach to the grocery list.) What’s more, you may not notice the signs of a deficiency in this mineral that helps red blood cells transport oxygen throughout your body. “It happens slowly over time,” explains Margaret Long, MD, a Mayo Clinic OB-GYN. “Sometimes people adapt or get used to the symptoms.” Ask yourself the following questions to see if you might be overdue for testing and a chat with your MD.
1. You’re really tired.
There are tons of reasons you might feel exhausted today. Think: last night’s Hulu binge, your recent streak of gym visits, noisy neighbors that wake you in the middle of the night. “If you get enough sleep and you’re still fatigued, that’s a reason to talk to your doctor,” says Long. They can rule out other medical concerns (everything from thyroid issues to depression) and help you adjust your diet or add a supplement to improve your iron count.
2. Your periods are pretty heavy.
Women are more at risk for iron deficiency and excessive blood loss from menstrual cycles is just one of the reasons why. “If you’re soaking through large tampons or pads every two hours, that’s a cause for concern,” says Long. Your doctor can help you identify (and resolve) the source of the problem which could be anything from a hormone imbalance to fibroids to an infection.
3. You’re looking a little pale.
A glance in the mirror or down at your hands can tip you off to a low iron count. If you have pale lips or fingernail beds (without the latest nail art, of course), that’s cause for concern. “You can look at your fingernail bed next to someone else’s for contrast,” says Long. If theirs is pink and yours is white, that’s worth checking out.
4. You’re low on stamina.
Used to be able to run three miles but now it’s harder? Weakness or exercise intolerance are symptoms of being low in this mineral. “When you could do something without shortness of breath but then that changes, it’s a red flag,” says Long. It’s important to note that recommended intake of iron varies by gender and age. Most teenage girls, for example, need 15 mg daily, while women 19-50 require 11mg daily and pregnant women need 29 mg daily.
5. You’re a vegetarian.
We’re not saying that being a vegetarian automatically means you’ll be iron deficient. But lean meat and seafood are top sources of iron. Vegetarian-friendly sources include beans, spinach, tofu, and iron-fortified foods like cereal. “You can be a vegetarian and have an adequate iron intake,” says Long. “You have to have a good diet to do that, though, and teenagers, for example, are terrible about this.”
6. You have a health condition.
Dealing with a health concern is tough enough—making things only harder when you find out that it comes with side effects. Having celiac disease, for example, increases your likelihood of having iron-poor blood with studies showing about 19% of women with celiac are iron deficient and about 20% have anemia. Irritable Bowel Syndrome, ulcerative colitis, or even having had bariatric surgery are also tied to poor absorption of or a deficiency in iron. Ask your MD if you fall into this category so you can create a plan to up your numbers.