Why iron is so important for the body
Iron is an essential trace element that the body needs for numerous vital functions. It is best known for its role in the formation of haemoglobin, the red blood pigment responsible for transporting oxygen from the lungs to all body cells. Iron also plays a central part in energy metabolism, the immune system and a range of enzymatic processes.
Because the body cannot produce iron itself, it relies on a regular intake through food. If the body's needs are not met over a longer period, or if iron reserves are lost in increased amounts, an iron deficiency may develop — one of the most common nutritional deficiencies worldwide.
Who is most often affected?
Iron deficiency can affect anyone, but some groups are at higher risk:
- Women of childbearing age due to regular menstrual bleeding
- Pregnant and breastfeeding women because of increased requirements
- Children and adolescents during growth phases
- Athletes, particularly in endurance sports
- People following a vegetarian or vegan diet, as plant-based iron is less well absorbed
- Older adults with reduced food intake or chronic conditions
- People with chronic inflammatory bowel disease or after gastrointestinal surgery
Causes of iron deficiency
The causes are varied and range from insufficient intake and impaired absorption to increased losses.
Reduced intake
A one-sided diet low in iron-rich foods can lead to deficiency over time. Very restrictive diets or a purely plant-based diet without careful food selection also increase the risk.
Impaired absorption
Conditions of the gastrointestinal tract such as coeliac disease, chronic gastritis or Crohn's disease can impair iron absorption in the small intestine. Certain medicines, such as acid blockers, can also reduce iron uptake.
Increased loss or requirement
Common causes are blood losses — visible in heavy menstrual bleeding or hidden in gastrointestinal bleeding. During pregnancy, breastfeeding and growth phases, the body's requirements rise considerably.
Recognising iron deficiency symptoms
Iron deficiency usually develops gradually. Typical symptoms include:
- persistent fatigue and exhaustion
- reduced concentration and performance
- pale skin and pale mucous membranes
- headaches and dizziness
- brittle nails and increased hair loss
- cracked corners of the mouth (angular cheilitis)
- shortness of breath on exertion
- palpitations or a rapid pulse
- restless legs symptoms, especially in the evening
As many of these complaints are non-specific and also occur with other conditions, a medical assessment is important to reliably identify the cause.
Ferritin: a key laboratory parameter
The ferritin level in the blood is considered the most important marker of the body's iron stores. Ferritin is a protein that stores iron in the liver, spleen and bone marrow. When ferritin falls, the stores are depleted — often before haemoglobin drops and iron-deficiency anaemia develops.
In medical practice, additional values are also assessed:
- Haemoglobin (Hb) to evaluate anaemia
- Transferrin and transferrin saturation as indicators of iron transport
- MCV and MCH to describe the red blood cells
- CRP to put the ferritin value into context, as inflammation can distort the result
Important: ferritin reference ranges are not equally meaningful in all life situations. Interpretation should therefore always be carried out by a doctor.
Diet for iron deficiency: what supports iron stores
A balanced diet can help to prevent iron deficiency and — in milder cases — improve iron status. Iron occurs in two forms:
- Haem iron from animal foods, which is particularly well absorbed by the body
- Non-haem iron from plant-based foods, which is less readily available
Iron-rich foods
- lean red meat, poultry, offal
- fish and seafood
- pulses such as lentils, chickpeas and beans
- wholegrain products and oats
- pumpkin seeds, sesame, nuts
- green leafy vegetables such as spinach, chard and rocket
- dried fruit such as apricots or dates
Tips for better iron absorption
- Vitamin C (e.g. peppers, citrus fruit, berries) consumed with iron-rich meals significantly improves absorption.
- Coffee, black and green tea and dairy products should not be consumed directly with iron-rich meals, as they can inhibit absorption.
- A combination of plant-based and animal sources can improve the utilisation of plant iron.
- For vegetarian or vegan diets, it is worth focusing specifically on iron-rich foods and suitable combinations.
When is a medical assessment advisable?
A medical assessment is particularly advisable when:
- symptoms such as fatigue, hair loss or reduced performance persist for more than a few weeks,
- there is a known increased risk (e.g. heavy menstrual bleeding, chronic conditions),
- there is a pregnancy or wish to conceive,
- a known iron deficiency does not improve despite dietary changes.
A nutritional medical assessment considers the medical history, lifestyle, possible coexisting conditions and laboratory values together. The aim is to identify the cause of the deficiency and to develop an individual plan — this may range from targeted nutritional counselling to medically supervised iron supplementation in tablet or infusion form. Which form is suitable depends on the severity, accompanying circumstances and individual tolerability.
Prevention and keeping iron stores stable
Those who maintain a balanced diet over the long term, attend regular check-ups and seek medical advice early when symptoms persist can in many cases effectively prevent iron deficiency. Self-diagnosis or independently taking high-dose iron supplements is not advisable, as too much iron can also place a strain on the body.
Iron deficiency is well treatable when recognised in time. A careful assessment provides the basis for a sensible and individually appropriate therapy.
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This article does not replace medical advice.