Warning signs of iron deficiency in chronic heart failure
There are many possible signs that you could be iron deficient, and some are similar to the symptoms of your heart failure, such as reduced physical function, impaired wellbeing and decreased quality of life.1,2,3
Other symptoms to look out for include:
- Looking pale4
- Shortness of breath5 and a racing heart6
- Sore tongue or dry mouth7,8
- Cracks at the corners of your mouth9
- Mouth ulcers10
- Cold intolerance or cold hands and feet11
- Craving to eat non-food items (pica/ pagophagia)12,13
- Restless leg syndrome (RLS)14,15
- Hair loss16
- Brittle17 or spoon-shaped nails17
- Increased susceptibility to infections19
- Dizziness,20 irritability21 and loss of concentration22
Use our Symptom Browser to understand what each of these symptoms involves.
Fatigue is also one of the main symptoms of iron deficiency. Fatigue is a more extreme version of tiredness, that some people may call exhaustion. If you are experiencing fatigue, you may feel physically and mentally exhausted and lack energy for a number of days each week, even if you have not been doing any particularly tiring physical activities.23 You may be too exhausted to complete normal daily tasks such as getting dressed or going shopping, and you may often feel too tired to spend time with friends or family.
To check if you are suffering from fatigue you can use our Fatigue Survey.3 are symptoms of both chronic heart failure and iron deficiency. It is therefore important that you discuss all of your symptoms with your doctor to find out what is causing your symptoms and what the best way to treat them might be. Tips on how to get the most out of your time with your doctor can be found at Talk to your Doctor.
Treating any iron deficiency you may have could improve your day-to-day quality of life and give you the energy you need to get out and about – you don’t need to feel tired all the time. For more information on how iron deficiency is treated click on Treatment Options.
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- 2. Okonko DO, Mandal AKJ, Missouris CG, Poole-Wilson P a. Disordered iron homeostasis in chronic heart failure: prevalence, predictors, and relation to anemia, exercise capacity, and survival. J Am Coll Cardiol. 2011;58(12):1241-51. doi:10.1016/j.jacc.2011.04.040.
- 3. a. b. Chronic heart failure. NICE Clin Guidel. 2010;108:1-119.
- 4. Stoltzfus R, Edward-Raj A. Clinical pallor is useful to detect severe anemia in populations where anemia is prevalent and severe. J Nutr. 1999;129(May):1675-1681.
- 5. Milman N. Postpartum anemia I: definition, prevalence, causes, and consequences. Ann Hematol. 2011;90(11):1247-53. doi:10.1007/s00277-011-1279-z.
- 6. Anand IS Anemia and chronic heart failure implications and treatment options. J Am Coll Cardiol. 2008 Aug 12;52(7):501-11. doi: 10.1016/j.jacc.2008.04.044.
- 7. Baird IM, Dodge OG, Palmer FJ, Wawman RJ. The tongue and oesophagus in iron-deficiency anaemia and the effect of iron therapy. J Clin Pathol. 1961;14:603-9.
- 8. Osaki T, Ueta E, Arisawa K, Kitamura Y, Matsugi N. The pathophysiology of glossal pain in patients with iron deficiency and anemia. Am J Med Sci. 1999;318(5):324-9.
- 9. Stein J, Hartmann F, Dignass AU. Diagnosis and management of iron deficiency anemia in patients with IBD. Nat Rev Gastroenterol Hepatol. 2010;7(11):599-610. doi:10.1038/nrgastro.2010.151.
- 10. Scully C. ABC of oral health: Mouth ulcers and other causes of orofacial soreness and pain. Bmj. 2000;321(7254):162-165. doi:10.1136/bmj.321.7254.162.
- 11. World Health Organization. Iron deficiency anaemia. Assessment, prevention and control: A guide for programme managers.; 2001.
- 12. Simpson E, Mull JD, Longley E, East J. Pica during pregnancy in low-income women born in Mexico. West J Med. 2000;173(1):20-25.
- 13. Lacey EP. Broadening the perspective of pica: literature review. Public Health Rep. 1990;105(1):29-35.
- 14. Sun ER, Chen CA, Ho G, Earley CJ, Allen RP. Iron and the restless legs syndrome. Sleep. 1998;21(4):371-7.
- 15. Wang J, O’Reilly B, Venkataraman R, Mysliwiec V, Mysliwiec A. Efficacy of oral iron in patients with restless legs syndrome and a low-normal ferritin: A randomized, double-blind, placebo-controlled study. Sleep Med. 2009;10(9):973-5.
- 16. Stein J, Dignass A. Management of iron deficiency anemia in inflammatory bowel disease–a practical approach. Ann Gastroenterol. 2012;26:1-10.
- 17. a. b. Cashman MW, Sloan SB. Nutrition and nail disease. Clin Dermatol. 2010;28(4):420-5. doi:10.1016/j.clindermatol.2010.03.037.
- 18. Pamuk GE, Mehmet Serif Top, Mehmet Sevki Uyanık, et al. Is iron-deficiency anemia associated with migraine? Is there a role for anxiety and depression? Wien Klin Wochenschr. 2015:1-5. doi:10.1007/s00508-015-0740-8.
- 19. Dhur A, Galan P, Hercberg S. Iron status, immune capacity and resistance to infections. Comp Biochem Physiol A Comp Physiol. 1989;94(1):11-9.
- 20. Paterson JA, Davis J, Gregory M, et al. A study on the effects of low haemoglobin on postnatal women. Midwifery. 1994;10(2):77-86.
- 21. Radlowski EC, Johnson RW. Perinatal iron deficiency and neurocognitive development. Front Hum Neurosci. 2013;7:1-11.
- 22. Albacar G, Sans T, Martín-Santos R, et al. An association between plasma ferritin concentrations measured 48 h after delivery and postpartum depression. J Affect Disord. 2011;131:136-42. doi:10.1016/j.jad.2010.11.006.
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