Understanding Iron Deficiency

Iron deficiency is a common health concern in Australia, affecting people of all ages and often going unnoticed until significant health issues arise. Understanding the causes, symptoms and treatment options is crucial for maintaining overall well-being.

Prevalence of Iron Deficiency in Australia

Iron deficiency is the most common micronutrient deficiency worldwide and the leading cause of anaemia (a condition where the body lacks enough healthy red blood cells to carry oxygen). Globally, anaemia affects one-quarter of the population. In Australia:

• 22.3% of women¹ and 12% of pregnant women² are iron deficient.
• 8% of children under 5³ have anaemia.
• Up to 90% of Aboriginal children between 6 and 24 months of age have iron deficiency anaemia².
• 20% of people over 85 years have anaemia⁴

These statistics highlight the widespread impact of iron deficiency and the importance of early detection and treatment.

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Causes of Iron Deficiency

Iron deficiency is not just a lack of iron—it often signals an underlying issue that needs to be addressed. Common causes include:

1. Blood Loss

• Heavy periods (menorrhagia)
• Gastrointestinal bleeding (ulcers, polyps, cancers, inflammatory bowel disease)
• Frequent blood donation

2. Inadequate Dietary Intake

• Low consumption of iron-rich foods (e.g., red meat, leafy greens, fortified cereals)
• Vegetarian and vegan diets without proper iron sources

3. Increased Iron Requirements

• Pregnancy and breastfeeding
• Athletes undergoing intense training
• Rapid growth phases (infants, children and teenagers)

4. Poor Iron Absorption

• Certain medical conditions impair the body’s ability to absorb iron, including:

  • Coeliac disease and inflammatory bowel disease (IBD)
  • Previous bariatric surgery
  • Certain foods that inhibit iron absorption, such as:
    • Phytates (found in whole grains, legumes, seeds)
    • Polyphenols & tannins (in tea, coffee, some fruits and vegetables)
    • Soy and dairy proteins

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Symptoms of Iron Deficiency

Iron deficiency can affect many aspects of health before anaemia develops. Symptoms may include:

• Fatigue, weakness and low energy
• Difficulty focusing or “brain fog”
• Shortness of breath and dizziness
• Restless legs syndrome
• Brittle nails and hair loss
• Unusual cravings (pica), such as chewing ice

It’s important to note that other conditions can cause similar symptoms. If you experience any of these, consult your GP for a blood test to confirm a diagnosis.

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Treatment and Prevention of Iron Deficiency

Once iron deficiency is diagnosed, treatment involves a combination of dietary changes, supplementation and medical intervention.

1. Dietary Sources of Iron

• The Recommended Dietary Intake (RDI) varies by age, gender and life stage.
• Iron can be obtained from animal-based sources (e.g., red meat, fish, poultry) and plant-based sources (e.g., fortified cereals, legumes, spinach).
• Pairing vitamin C-rich foods (e.g., citrus, strawberries, tomatoes) with plant-based iron sources enhances absorption.
• Avoid consuming iron-blocking foods (tea, coffee, dairy, and calcium supplements) with iron-rich meals.
• For a detailed breakdown of iron-rich foods, including their iron content per serving, refer to this Iron content food chart from Nutrition Australia.

2. Iron Supplements

• Iron supplements are often needed to replenish iron stores quickly and relieve symptoms.
• They can be taken orally (tablets, liquid) or parenterally via an intravenous iron infusion.
• There are many formulations of oral iron supplements available in Australia⁵:
  Oral iron supplements in Australia
• Multivitamins with low iron concentrations are generally insufficient to correct iron deficiency.
• Studies show that a single 200 mg dose taken on alternate days doubles iron absorption compared to a daily 100 mg dose.
• Alternate-day dosing may also reduce side effects like nausea and constipation, making it more tolerable.

3. Iron Infusions & Medical Review

• Iron infusions are recommended for:
  • Severe iron deficiency
  • Poor absorption of oral iron
  • Intolerance to oral iron supplements
• This treatment delivers iron directly into the bloodstream, restoring iron levels more rapidly.
• Modern iron infusions in Australia are safe, well-tolerated, and can be administered in a GP clinic.
• Side effects are rare but may include:
  • Mild dizziness, nausea, headache, metallic taste or minor discomfort at the infusion site.
  • Severe reactions are extremely rare and are carefully monitored.

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Conclusion

Addressing iron deficiency goes beyond simply replenishing iron levels—it’s about identifying and treating the underlying cause for long-term health. Whether through dietary improvements, iron supplementation or medical treatment, a personalised approach ensures lasting results rather than temporary relief.

At The Practice at Clem Jones Centre, our experienced doctors provide comprehensive assessments, tailored treatment plans and iron infusions when necessary. If you’re experiencing symptoms or need advice about iron deficiency, book an appointment today to take control of your health.

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References:

1. Pasricha, S.-R., Anderson, D., Boyling, A., Leahy, M. F., & Olynyk, J. K. (2024). Updating the diagnosis and management of iron deficiency in the era of routine ferritin testing. Medical Journal of Australia, 221(7). 
2. QIMR Berghofer – Iron Deficiency
3. RACGP – Check CPD activity Unit 601 Feb 2023
4. Walter and Eliza Hall Institute of Medical Research – Research / Disease / Anaemia 
5. Stoffel NU, Zeder C, Brittenham GM, et al. Iron absorption from supplements is greater with alternate day than with consecutive day dosing in iron‐deficient anemic women. 2020; 105: 1232‐1239.