Low energy, pale skin, hair fall? Doctors say this common nutrient deficiency could be the real reason behind your everyday problems

A large number of women live with constant fatigue and assume it is simply part of modern life. Work pressure, family responsibilities, irregular meals and lack of sleep are often blamed. However, doctors say there is a quieter and far more common reason behind persistent exhaustion: low iron levels.

Speaking to TOI Health, Dr Manjula Anagani, Padmashree awardee and Clinical Director at CARE Hospitals, says this pattern is increasingly common among young women.

“A surprising number of women come to hospital complaining of constant tiredness. Not dramatic illness, not severe pain, just a lingering lack of energy that does not improve despite rest. Many assume it is stress or poor sleep. Often, the real cause is much simpler and far more common: low iron levels,” she explains.

Iron Deficiency in Women: A Silent and Gradual Decline

Iron deficiency rarely causes alarm because it develops slowly. Unlike sudden illnesses, it creeps in over months or even years.

Dr Anagani notes that iron deficiency remains one of the most widespread nutritional concerns among women, particularly during their reproductive years. The body adapts gradually as iron stores decline, meaning symptoms rarely appear all at once.

This slow progression makes it easy to overlook. Mild fatigue becomes part of routine life. Reduced stamina is blamed on ageing. Difficulty concentrating is attributed to stress. By the time haemoglobin levels drop significantly, the body has already been compensating for a long period.

Why Women Are More Vulnerable to Low Iron Levels

One of the primary biological reasons women are more prone to iron deficiency than men is menstruation. Monthly blood loss steadily reduces iron reserves, particularly in women with heavy cycles.

“Even a balanced diet may struggle to compensate if iron intake does not match the ongoing loss,” says Dr Anagani.

Pregnancy increases iron requirements further, as the body must produce additional blood to support the growing baby. Without adequate intake, iron stores can deplete rapidly.

The scale of the issue is concerning. A study published in BMC Public Health found that over 67 per cent of women aged 15–49 years are anaemic. These figures represent millions of women functioning below their optimal physical capacity.

Diet Patterns That Appear Healthy but Lack Iron

Many women consume sufficient calories but still fail to meet their iron requirements.

Irregular eating habits, skipping breakfast, rushed lunches and reliance on packaged snacks, gradually reduce nutrient intake. In vegetarian diets, which are common in India, iron is primarily sourced from plant foods. However, non-haem iron from plant sources is absorbed less efficiently than iron from animal products.

Dr Anagani explains that unless meals are thoughtfully planned, such as combining iron-rich foods with vitamin C to improve absorption, iron stores can slowly decline even when overall food intake appears adequate.

Tea or coffee consumed immediately after meals can further reduce iron absorption. Crash dieting and intense fitness routines without nutritional planning may add to the risk.

Iron deficiency is therefore not always linked to poverty or food scarcity. Often, it is a matter of absorption, timing and dietary balance.

Subtle Symptoms of Iron Deficiency Women Should Not Ignore

Iron plays a vital role in producing haemoglobin, the protein in red blood cells responsible for carrying oxygen throughout the body. When iron levels fall, oxygen delivery to tissues decreases.

The early signs can be subtle, including:

• Persistent fatigue
• Frequent headaches
• Pale skin
• Hair thinning
• Brittle nails
• Breathlessness during mild activity
• Reduced exercise tolerance

Because these symptoms develop gradually, many women dismiss them as routine stress or overwork.

When Iron Deficiency Progresses to Anaemia

If untreated, iron deficiency can develop into iron-deficiency anaemia. At this stage, the consequences extend beyond tiredness.

Dr Anagani warns that immunity may weaken, mood changes may occur and productivity can decline. During pregnancy, untreated anaemia increases health risks for both mother and baby.

Research from the Indian Council of Medical Research (ICMR) has consistently highlighted the link between maternal anaemia and adverse pregnancy outcomes.

Anaemia does not only affect physical wellbeing; it also impacts emotional health, cognitive function and overall quality of life.

Why Many Women Delay Testing

Cultural attitudes also play a role. Many women prioritise the health of their families over their own and accept fatigue as a normal part of responsibility.

Routine blood tests are often postponed unless symptoms become severe. However, early screening can make a significant difference.

Dr Anagani recommends checking haemoglobin levels and conducting iron studies when necessary, particularly for adolescents, women with heavy menstrual cycles and those planning pregnancy.

Restoring Iron Levels: Small Changes, Significant Benefits

Correcting iron deficiency usually begins with practical dietary adjustments rather than extreme measures.

Iron-rich foods include:

• Lentils
• Green leafy vegetables
• Dates
• Jaggery
• Nuts and seeds
• Fortified cereals

Pairing these with vitamin C sources such as lemon juice, citrus fruits or tomatoes can improve absorption. Spacing tea or coffee away from meals may also help.

In moderate to severe cases, doctors may prescribe iron supplements following proper testing. Self-medication is not recommended, as excessive iron intake can cause complications.

Many women report feeling clearer, more energetic and mentally sharper once their iron levels are restored.

Persistent Fatigue Is Not Normal

Iron deficiency is common, but it should not be ignored. Persistent tiredness is not simply a part of modern life, it may be a sign that the body needs attention.

Fatigue should not feel permanent. When it does, it deserves investigation.


Disclaimer: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.