An iron deficiency quite simply means you don’t have enough iron in your body. Iron is an important mineral that your body needs to grow and develop. Without iron, you can’t produce enough hemoglobin, a protein in red blood cells that helps deliver oxygen to your tissues.
An iron deficiency can lead to anemia, which is a blood disorder that happens when red blood cells shrink and contain less hemoglobin. Most people get enough iron, but some have a higher risk of an iron deficiency, including:
Women who have heavy periods
Pregnant women
People with a poor diet
People who donate blood a lot
Babies
People with cancer, heart failure, or gastrointestinal disorders
While fatigue, paleness, and headaches are common signs of an iron deficiency, there are also some unusual symptoms to watch out for. Here are seven weird signs of an iron deficiency.
1. Tongue Changes
When iron levels are low, the tongue may become swollen, painful, smooth, and red — a condition called glossitis. Low iron levels can affect the health of your muscles, including your tongue. Your doctor or dentist can recommend oral medications or supplements to help treat a swollen tongue.
2. Swelling, Soreness, or Dryness Around the Mouth
Anemia symptoms can manifest in your mouth. You may develop:
Dry mouth
Mouth ulcers
Burning in your mouth
Sores or redness at the corners of your mouth
Inflammation and cracking on the corners of your mouth is called angular cheilitis and can affect people with an iron deficiency. Topical medicines and ointments can help temporarily ease the discomfort, and dietary changes and iron supplements may get rid of your symptoms altogether.
Talk to your doctor if you develop these oral symptoms.
3. Blue in the Whites of Your Eyes
A bluish tint in the whites of your eyes, which doctors call “blue sclera,” may be a sign of iron deficiency. With blue sclera, the white part of your eye may appear blue, gray, or purplish. Experts think the blue hue appears because the fibers in the white part of the eye allow the uvea — the middle layer of the eye — and blood vessels show through.
4. Spoon-Shaped Nails
An iron deficiency can cause your nails to dip in the middle and appear indented. This spoon-shaped appearance is known as koilonychia. Most of the time, this symptom can be reversed with iron supplements.
5. Restless Legs
Low levels of iron in the brain can trigger restless legs syndrome (RLS), which causes involuntary and uncomfortable sensations that make you want to move your legs. Researchers believe low levels of iron can lead to a drop in the brain chemical dopamine, which prompts RLS symptoms. To test for low iron levels in the brain, you may need a special type of blood test that measures ferritin, the main type of stored iron in the brain. It’s possible to have normal blood levels of iron and low brain levels of iron.
6. Memory Problems
Trouble remembering things, difficulty concentrating, or “brain fog” could all signal an iron deficiency. Some research has even suggested that having anemia is linked to a higher risk of mild cognitive impairment, which can be a precursor to Alzheimer’s and other types of dementia. Decreased oxygen to the brain could be to blame for the problems with memory and thinking.
7. Ringing in Your Ears
Ringing in the ears, which is called tinnitus, affects some people with anemia. The ringing happens because your heart has to work harder to pump blood. Your sensitive ears can pick up the sounds as blood flows through nearby arteries. You might also hear other sounds, like a whooshing noise, buzzing, or a pulsing heartbeat.
This symptom could also be a sign of a serious heart condition, so you should report it to your doctor right away.
The Takeaway
Common symptoms of an iron deficiency include fatigue and pale skin. But more unusual signs, such as a bluish tint in the whites of the eyes, can also indicate low iron. It’s important to know the signs of iron deficiency and to seek treatment if you suspect your levels are low. Without adequate iron, the body is unable to produce enough hemoglobin in red blood cells to carry oxygen throughout the body, leaving the body unable to function properly.
Allison Buttarazzi, MD, is board-certified in internal medicine and lifestyle medicine, and is a certified health and well-being coach. In her primary care practice, Dr. Buttarazzi focuses on lifestyle medicine to help her patients improve their health and longevity, and her passion is helping patients prevent and reverse chronic diseases (like heart disease, high blood pressure, and diabetes) by improving their lifestyle habits.
She is a graduate of Tufts University School of Medicine and completed a residency at Maine Medical Center. Diagnosed with celiac disease during medical school, she realized the power of improving one's health through diet and lifestyle habits, which she later incorporated into her practice.
Julie Marks is a freelance writer with more than 20 years of experience covering health, lifestyle, and science topics. In addition to writing for Everyday Health, her work has been featured in WebMD, SELF, Healthline, A&E, Psych Central, Verywell Health, and more. Her goal is to compose helpful articles that readers can easily understand and use to improve their well-being. She is passionate about healthy living and delivering important medical information through her writing.
Prior to her freelance career, Marks was a supervising producer of medical programming for Ivanhoe Broadcast News. She is a Telly award winner and Freddie award finalist. When she’s not writing, she enjoys spending time with her husband and four children, traveling, and cheering on the UCF Knights.
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