Iron Deficiency Anaemia in Women: Why You Are Always Tired

Iron deficiency is the leading cause of anaemia in Pakistani women, and I test for it almost daily. The symptoms — constant tiredness, breathlessness on stairs, pale skin, hair fall, craving ice or clay — are so common that many women assume they are just 'normal'.

The most frequent causes are heavy periods, closely spaced pregnancies, and poor dietary iron intake. Vegetarian or tea-heavy diets reduce absorption further. A simple blood test measuring haemoglobin, serum ferritin and iron studies confirms the diagnosis and its severity.

Oral iron supplements are first-line treatment. Take them on an empty stomach with orange juice or vitamin C to maximise absorption. Avoid taking iron with tea, milk, calcium or antacids — these block absorption by up to seventy percent. Side effects like nausea and constipation can be managed by taking iron every other day, which recent research shows is almost as effective as daily dosing.

Diet alone cannot treat established anaemia, but it prevents recurrence. Red meat, liver, spinach, lentils (daal), chickpeas and fortified cereals are the richest sources. Cooking in cast-iron pots increases the iron content of food — a simple, traditional trick that actually works.

Severe anaemia (haemoglobin below 7 g/dL) or anaemia that does not respond to oral iron may need intravenous iron infusion. This is safe, fast, and avoids the gut side effects of tablets. If your haemoglobin has not improved after six weeks of oral iron, come back for review rather than just continuing the same dose.