Iron Deficiency in Women: Why 57% of Indian Women Are Anaemic

Understanding Iron Deficiency: What It Means for Your Body

Iron is not just another mineral; it is the foundation of your body’s oxygen delivery system. Every red blood cell in your body contains haemoglobin, a protein that carries oxygen from your lungs to every tissue and organ. Iron is the critical component that allows haemoglobin to bind and transport oxygen. When your body lacks sufficient iron, your red blood cells cannot carry enough oxygen, leading to a cascade of symptoms.

Iron deficiency develops in stages. Initially, your body consumes its iron stores without affecting haemoglobin levels, called iron deficiency without anaemia. Many women experience symptoms at this stage but remain undiagnosed because their blood tests appear “normal”. As the deficiency progresses, haemoglobin levels drop, and iron deficiency anaemia develops. At this point, symptoms become more pronounced and harder to ignore.

Why Indian Women Are Particularly Vulnerable?

The 57% prevalence of anaemia among Indian women is not coincidental. Several interconnected factors create a perfect storm for iron deficiency in this population:

• Heavy menstrual bleeding remains the leading cause of iron loss in reproductive-age women. Many Indian women experience prolonged or excessive periods due to hormonal imbalances or underlying gynaecological conditions.
• Vegetarian and vegan dietary patterns, common in many Indian communities, rely on non-heme iron from plant sources, which is absorbed less efficiently than heme iron from animal products.
• Phytates, oxalates, and tannins found in traditional Indian foods like tea and coffee inhibit iron absorption when consumed with iron-rich meals.
• Socioeconomic disparities mean many women lack access to iron-rich foods, healthcare screening, and timely treatment.
• Pregnancy and breastfeeding dramatically increase iron demands, yet many Indian women enter pregnancy already iron-deficient.

Iron Deficiency Causes: Identifying the Root of Your Problem

Iron deficiency causes fall into three main categories: increased blood loss, inadequate dietary intake, and impaired absorption.

Blood Loss as the Primary Culprit

Heavy menstrual bleeding is the most common cause of iron deficiency in women of reproductive age. If you lose more than 80 millilitres of blood during your menstrual period (roughly equivalent to soaking through more than 16 regular pads or 8 super-absorbent pads), you are losing more iron than your diet can replace [4]. Conditions like fibroids, polyps, hormonal imbalances, and bleeding disorders can cause excessive menstrual bleeding.

Dietary Deficiency: The Role of What You Eat

Your body cannot manufacture iron; it must come from food. Many Indian women fall short of these targets due to:

• Limited access to iron-rich foods like meat, fish, and poultry.
• Reliance on plant-based iron sources without understanding how to optimise their absorption.
• Consuming tea or coffee with meals, which blocks iron absorption.
• Skipping meals or following restrictive diets.

Malabsorption: When Your Gut Cannot Process Iron

Even if you consume adequate iron, your body must absorb it efficiently. Conditions affecting your gastrointestinal tract can impair iron absorption:

• Coeliac disease damages the intestinal lining, reducing nutrient absorption
• Inflammatory bowel disease causes chronic inflammation and blood loss
• Atrophic gastritis reduces stomach acid necessary for iron dissolution
• Proton pump inhibitors and antacids decrease stomach acidity, hindering iron absorption
• Bariatric surgery reduces the absorptive surface area of your intestines

How to Test for Iron Deficiency: Essential Tests for Iron Deficiency Diagnosis

Diagnosing iron deficiency usually requires more than one blood test. Your doctor may use the following results together to assess iron stores and determine whether anaemia is present.

How Can I Check My Iron Level at Home?

Home testing can help you decide whether you need a proper iron assessment, but it cannot replace laboratory testing.

Step 1: Check for possible symptoms: Persistent fatigue, hair thinning, dizziness, breathlessness or poor concentration can indicate iron deficiency, but these symptoms can have other causes.

Step 2: Use a home haemoglobin test, if available: Finger-prick devices can provide a haemoglobin reading. A low result can suggest anaemia, but normal haemoglobin does not rule out depleted iron stores.

Step 3: Get a laboratory iron profile: For a reliable assessment, ask your doctor about haemoglobin, serum ferritin and transferrin saturation. Ferritin is a key marker of stored iron, while inflammation can affect its level.

Step 4: Discuss the results with your doctor: Do not start iron supplements based only on a home result. Your doctor can determine whether you have iron deficiency, anaemia or another condition and identify its underlying cause.

Iron Deficiency Treatment

Iron deficiency treatment depends on the severity of deficiency, the cause of iron loss, and whether anaemia is present. The aim is to restore iron stores and address the reason for the deficiency so it does not recur.

Iron deficiency treatment depends on the severity of deficiency, the cause of iron loss, and whether anaemia is present. The aim is to restore iron stores and address the reason for the deficiency so it does not recur.

Dietary Changes

• Choose iron-rich foods such as leafy greens, lentils, beans, fortified grains, meat, poultry and fish.
• Combine plant-based iron sources with vitamin C-rich foods such as citrus fruits, tomatoes and capsicum to improve absorption.
• Keep tea, coffee and calcium supplements away from iron-rich meals because they can reduce iron absorption.
• Do not rely on diet alone when blood tests show significant anaemia or depleted iron stores.

Oral Iron Supplements

• Take iron as prescribed, preferably away from meals when tolerated.
• Taking it with food reduces nausea or stomach discomfort.
• Alternate-day dosing may improve absorption and reduce gastrointestinal side effects in some patients.
• Constipation, nausea and abdominal discomfort are common side effects.

Intravenous Iron

Intravenous iron is considered when oral iron is ineffective, poorly tolerated, not adequately absorbed, or when iron replacement is needed more rapidly. It can be useful in selected patients with significant iron deficiency, ongoing blood loss, certain gastrointestinal conditions or situations where oral treatment is unsuitable.

Symptoms You Should Never Ignore

Iron deficiency can affect energy, appearance, concentration and appetite. Some symptoms develop gradually and may be overlooked.

Iron Deficiency Test at Eskag Sanjeevani Hospitals

Eskag Sanjeevani Hospitals recognises that iron deficiency is not merely a laboratory abnormality. Our specialised department offers iron deficiency tests via the 24/7 NABL-accredited pathology and haematology investigation services, including serum ferritin, transferrin saturation, and advanced markers like soluble transferrin receptor. For patients requiring intravenous iron therapy, Eskag Sanjeevani Hospitals provides modern IV iron formulations administered by trained healthcare professionals in a safe, monitored environment.