Symptoms in women with iron deficiency
A detailed recent count comes from an iron deficiency clinic at a university hospital in Türkiye, published in BMC Women's Health in 2025. It recorded 41 distinct symptoms or symptom groups, from neuropsychiatric to gastrointestinal. These were the ten most common.
Read this for what it is. These were women seen at an iron deficiency clinic, looked back on from their records, and there was no comparison group without iron deficiency. It shows how often each symptom turned up among women who had the deficiency. It does not show that iron caused every one of them.
Symptoms without anaemia
Of the 239 women, 71, or 30 per cent, had iron deficiency without anaemia. Most symptoms appeared at similar rates in both groups; only palpitations, cold intolerance, tiring easily and an unclassified other group differed. Women with anaemia reported slightly more symptoms on average, 17 against 15. The authors concluded that anaemia is not a prerequisite for most iron deficiency symptoms.
That matches the 2021 Lancet review of iron deficiency, which states that clinical and functional impairments can occur in the absence of anaemia. A normal haemoglobin is not the same as normal iron; Iron deficiency without anemia (IDNA) covers this in more depth.
Restless legs
Restless legs syndrome is an urge to move the legs, usually in the evening or at night, that disrupts sleep. A 2013 study of 251 patients referred to a community haematology practice with iron deficiency anaemia, 89 per cent of them women, found clinically significant restless legs in 23.9 per cent, which the authors estimated as nine times the rate in the general population.
Those with restless legs reported poorer sleep quality, shorter sleep, and more tiredness and less energy during the day than those without it. So some of the tiredness in iron deficiency may come through broken sleep, and restless legs is worth naming to a doctor rather than putting up with.
Transferrin saturation and symptom count
In the 2025 clinic study, the blood marker most closely linked to how many different symptoms a woman had was transferrin saturation, the share of iron-carrying protein in the blood that is actually carrying iron. The link was weak, a correlation of -0.23, although the authors describe it as robust, so no single result predicts how someone will feel. It is one reason to ask for transferrin saturation alongside ferritin.
Tests to ask for
- Ferritin and transferrin saturation, not a full blood count alone.
- A search for the cause. The 2021 Lancet review advises that an underlying cause should be sought in everyone with iron deficiency, and that coeliac screening should be considered routinely.
- If sleep is broken by an urge to move your legs, say so, because it changes what treatment is worth discussing.
The Iron Deficiency Body Map shows these signs on a figure, and the Iron Risk Check takes about two minutes and tells you whether a ferritin test is worth raising with your general practitioner (GP).
Related articles
- Ferritin and fatigue
- Iron deficiency without anemia (IDNA)
- A Practical Guide to Iron Deficiency and Anaemia
Sources
The study figures on this page come from these three papers.
- Özbilen M, Kaya Y. Beyond anemia: a comprehensive analysis of iron deficiency symptoms in women and their correlation with biomarkers. BMC Women's Health 2025;25(1):376. doi:10.1186/s12905-025-03906-w
- Allen RP, Auerbach S, Bahrain H, Auerbach M, Earley CJ. The prevalence and impact of restless legs syndrome on patients with iron deficiency anemia. American Journal of Hematology 2013;88(4):261-4. doi:10.1002/ajh.23397
- Pasricha SR, Tye-Din J, Muckenthaler MU, Swinkels DW. Iron deficiency. The Lancet 2021;397(10270):233-248. doi:10.1016/S0140-6736(20)32594-0
This article is educational and not medical advice. Never begin iron supplementation without testing, and always discuss changes to supplementation or testing with a qualified clinician who knows your full history.