Are Low Iron and Hemoglobin of 5 g/dL Dangerous?

If you've recently had a blood test and your level of hemoglobin, the iron-containing protein in your blood that transports oxygen around your body, came back too low, you may have a condition called iron-deficiency anemia, or a low iron level.

Read on to learn more about iron deficiency and ways to supplement this mineral if your levels are too low.

What Iron Levels Are Dangerous?

• Irregular heartbeat (and other heart issues)
• Chronic fatigue
• Pregnancy complications
• Developmental delays in children

Low levels of a protein called ferritin could also indicate that the body has a low level of stored iron. Lower than 25 micrograms per deciliter (mcg/dL) could indicate iron deficiency and less than 15 mcg/dL does indicate iron deficiency.

What Causes Iron-Deficiency Anemia?

Low-Iron Diet

Not eating enough iron-rich foods can cause a deficiency. Some iron-rich foods:

• Meat
• Eggs
• Leafy greens
• Iron-fortified whole grains

Pregnancy

Pregnant women need to share their body's iron stores with their baby, which can deplete their own levels quickly. This is why prenatal vitamins with iron are typically recommended during pregnancy.

Internal Bleeding

When you have any form of blood loss, you lose iron, including when you bleed internally. Conditions like peptic ulcers, hernias, colon polyps, and colorectal cancer can cause chronic blood loss, which leads to iron-deficiency anemia.

Likewise, if your gastrointestinal tract is bleeding (from overuse of over-the-counter pain relievers like aspirin, for example), you can get anemia.

Heavy Menstrual Bleeding

If your blood flow is heavy during your period, you may lose enough blood to cause low iron levels.

Inability to Absorb Iron

Any condition that keeps you from absorbing nutrients from your food can cause anemia. If you have a chronic illness like celiac disease, for example, you’re unable to absorb iron through your small intestine and into your bloodstream.

You may also be unable to absorb iron if you've had gastric bypass surgery to remove or bypass part of your intestines.

Who's at Risk for Iron-Deficiency Anemia?

Some people are at a greater risk of iron-deficiency anemia:

• Women who experience heavy menstrual bleeding or iron loss during pregnancy
• Infants and children
• Vegetarians
• Frequent blood donors

Iron-Deficiency Anemia Symptoms

• Fatigue
• Chills
• Shortness of breath
• Weakness
• Chest pain
• Dizziness
• Bruises
• Difficulty concentrating
• Headaches
• Restless legs syndrome

• Pica (a condition in which people crave nonfood items, like ice, chalk, clay, or starch)
• Cracks at the corners of the mouth
• Pale skin (or paler than usual)
• Sore, painful tongue
• Cold hands
• Brittle nails that often form a spoon shape (a condition called koilonychia)

How Is Iron-Deficiency Anemia Diagnosed?

Complete Blood Count

This is usually the first test that doctors will order if you come to their office with anemia symptoms. Sometimes doctors will even order it as part of your routine physical checkup. A complete blood count (CBC) tests these components of your blood:

• Red blood cell count
• White blood cell count
• Hemoglobin (iron) level
• Hematocrit level
• Platelet level

Your hemoglobin and hematocrit levels and the size of your red blood cells will confirm whether you have anemia. Both hemoglobin and hematocrit are often low in people with anemia, and red blood cells are often smaller than normal in people with iron-deficiency anemia.

Additional Blood Tests

Once you've gotten a CBC test, your doctor may request more blood work to figure out the type of anemia you have. Tests for iron deficiency may include a ferritin level and total iron-binding capacity test.

There are also tests to determine internal bleeding — endoscopy, colonoscopy, ultrasound — if your doctor thinks this is the cause of your low iron levels.

Treatment for Iron-Deficiency Anemia

Iron Supplements

Taking an iron supplement can help increase iron levels in people without malabsorption issues. This method takes several months to restore your levels.

Iron pills typically include these side effects:

• Dark urine
• Constipation
• Upset stomach

While you should try to take iron pills on an empty stomach (for better absorption), you can also take them with meals if they upset your stomach.

Do not take iron pills unless your doctor recommends it. Taking too much can lead to an iron overdose.

It's also recommended that you avoid taking antacids with iron pills. And for better absorption, take iron supplements with a source of vitamin C, like orange juice or a vitamin C supplement.

Iron IV

Sometimes doctors will recommend getting iron intravenously. This option is good for people who have underlying conditions that make it difficult to absorb iron through pills, like celiac disease or ulcerative colitis.

Typically, you'll need only one or two doses over the course of a few weeks to restore your level.

You may experience nausea or headaches after receiving iron intravenously. But both should go away after a day or two.

Certain Medications

Your doctor may prescribe a medication called an erythropoiesis-stimulating agent if your bone marrow doesn't have enough iron to make sufficient hemoglobin. You may have to take this with other iron treatments, especially if you have a chronic health condition.

Blood Transfusions

If your iron-deficiency anemia is severe, your doctor may recommend a blood transfusion. This is a quick way to restore iron levels, but it is only necessary in people with acute cases or other underlying conditions.

Surgery to Treat Internal Bleeding

If internal bleeding is causing your iron-deficiency anemia, you may need surgery to help stop it.

How to Prevent Iron-Deficiency Anemia

• Red meat, poultry, and pork
• Seafood
• Beans
• Dark, leafy greens (like spinach)
• Dried fruit (like raisins and apricots)
• Iron-fortified cereals, breads, and pastas
• Peas

If you're vegan or vegetarian, try to find plant-based foods that are rich in iron. And if you have high cholesterol, talk to your doctor about nutritious meat options that won't increase your levels.

When to See a Doctor

If you feel any symptoms of low iron, talk with your doctor about getting a blood test. They can figure out if you need to take iron pills or get other treatments.

If your iron deficiency is severe, you can develop dangerous long-term health effects if you don't treat it.

The Takeaway

• Hemoglobin levels of 5 g/dL can be dangerous. Lower than normal hemoglobin levels indicate anemia.
• One of the best ways to prevent iron deficiencies is to make sure your diet has enough iron.
• Severe iron deficiency can cause dangerous long-term health effects without treatment.