Iron Deficiency: Early Signs, Causes, Diagnosis, & Treatment

In today’s fast-paced world, it’s easy to blame tiredness on lack of sleep, stress, or endless to-do lists. But for many Malaysians, fatigue has a deeper cause, iron deficiency.

Iron deficiency happens when your body doesn’t have enough iron to support healthy blood and energy production. In Malaysia, it’s surprisingly common: 1 in 7 premenopausal women has low iron stores, while men rarely experience it unless linked to medical issues. Left unchecked, this condition can silently erode your health and quality of life.

Let’s take a closer look at the signs, causes, and solutions, so you can recognise it early and take control of your well-being.

Early Signs You Might Be Low on Iron

Iron deficiency often hides in plain sight. In the early stages, symptoms may feel like everyday fatigue or stress. But pay attention, your body might be sending signals.

In adults, warning signs include:

• Persistent tiredness and low energy
• Poor concentration and brain fog
• Shortness of breath or reduced stamina
• Heart palpitations
• Restless legs at night
• Brittle nails, hair thinning, or cracks at the corners of the mouth

In children, it can be trickier to spot. Teachers or parents may notice poor exercise tolerance, fainting during activity, or unusual food cravings (like ice, chalk, or clay), a condition called pica.

Because these symptoms are often brushed off as “normal,” many people don’t realise they’re iron deficient until the condition worsens.

Risk Factors and Causes

So who’s most at risk? The answer depends on age, gender, and health conditions.

• Women of reproductive age: Menstrual bleeding is the number one cause of iron deficiency in Malaysia. If blood loss is heavy, it can outweigh dietary intake.
• Men and post-menopausal women: For these groups, iron deficiency is a red flag, usually pointing to blood loss from the gut. In such cases, doctors often recommend endoscopy to check for hidden causes.
• Post-surgery patients: Those who have undergone bariatric (weight loss) surgery may struggle with iron absorption, leading to long-term deficiencies.

In short, for women, heavy periods are the most common culprit. For men, it’s almost always a sign of something more serious.

Long-Term Impact of Iron Deficiency

Untreated iron deficiency doesn’t just sap your energy, it can reshape your life.

Over time, it leads to:

• Constant fatigue and reduced productivity
• Difficulty exercising or focusing
• Anaemia (low haemoglobin levels), which can become severe
• In rare cases, heart failure if Anaemia is left unchecked
• In pregnant mothers, severe Anaemia may affect fetal growth

The good news? These consequences are largely preventable if iron deficiency is recognised and treated early.

How Iron Deficiency is Diagnosed

Think you might be iron deficient? The only way to know for sure is through proper testing.

Early detection:

• Blood tests like Serum Ferritin or Transferrin Saturation (TSAT) measure your iron stores accurately.
• A simple serum iron test isn’t reliable on its own.

When Anaemia develops:

• Haemoglobin levels fall: less than 13 g/dL signals Anaemia. 
• Other clues may show up too, like a low red cell haemoglobin content (MCH < 27 pg) or mildly increased platelet counts.

By catching deficiency before Anaemia sets in, you can start treatment early and avoid complications.

Taking Action: Prevention and Treatment

Here’s the reassuring part: iron deficiency can always be corrected.

• Supplements: Iron tablets or injections replenish stores, but consistency is key.
• Addressing the cause: For women, managing heavy menstrual bleeding helps prevent recurrence. For men and post-menopausal women, doctors investigate and treat hidden sources of blood loss.
• Lifestyle: Recognising the signs early and getting tested regularly if you’re at risk is the best prevention strategy.

Recovery times vary, sometimes weeks, sometimes months, but steady treatment restores energy and prevents relapse.

When Should You See a Doctor?

Seek medical advice if you or your child experience:

• Persistent fatigue, shortness of breath, or frequent dizziness
• Blue lips, pale skin, or fainting spells
• Heavy menstrual bleeding or unexplained blood loss
• Unusual food cravings or restless legs syndrome

Don’t Ignore the Signs

Iron deficiency is common, correctable, and often overlooked. For premenopausal women, it’s one of the most frequent health issues; for men, it signals something that should never be ignored.

The earlier it’s detected, the easier it is to treat. If you suspect iron deficiency, speak to your Doctor and request the right tests. With timely care, you can restore your strength, focus, and quality of life.