Prevalence of Iron Deficiency in the UK
Iron deficiency is a widespread issue globally, and the UK is no exception. Recent research confirms a significant portion of the population is affected, often unknowingly. A large 2025 UK study of over 33,000 adults found that 6% had anaemia, with iron deficiency identified as the primary cause, suggesting many may have silent, undiagnosed deficiencies.
The National Diet and Nutrition Survey (NDNS) and other studies have highlighted disparities between demographic groups. Iron deficiency is significantly more common in women than men, especially those of menstruating age. An NDNS study found iron-deficiency anaemia in 8% of women versus 3% of men, with low iron stores affecting 11% of women versus 2% of men. This higher risk for women is mainly due to menstrual blood loss and increased iron demand during pregnancy.
Other at-risk groups include:
- The elderly: Studies in England show non-anaemic iron deficiency is common in older adults and linked to increased mortality.
- Vegetarians and vegans: Those on meat-free diets are at higher risk as non-haem iron from plants is less absorbed than haem iron from animal sources.
- Individuals with gastrointestinal issues: Conditions like coeliac disease or IBD can impair iron absorption.
- Frequent blood donors: Regular donation can deplete iron stores.
Symptoms and Diagnosis
Recognising symptoms is crucial. The most common sign is unexplained fatigue, often mistaken for tiredness. As deficiency worsens, other symptoms may include:
- Pale skin
- Shortness of breath
- Headaches
- Heart palpitations
Less common signs can be:
- A sore tongue or mouth ulcers
- Hair loss
- Strange food cravings (pica), such as for ice
- Spoon-shaped nails
- Restless legs syndrome
Diagnosis typically starts with a GP visit to discuss symptoms, diet, and history. A full blood count (FBC) checks for low haemoglobin. A ferritin test measures iron stores, confirming deficiency. Ferritin levels can be affected by inflammation, requiring doctors to consider other factors.
Comparison of Oral Iron Supplementation Regimens
Oral iron supplements are standard treatment, but dosing affects efficacy and side effects. Recent research suggests high-dose regimens may be less effective due to the body's hepcidin response inhibiting absorption. The table below compares approaches:
| Feature | Traditional Dosing (e.g., 200mg ferrous sulfate 3x daily) | Alternate-Day Dosing (e.g., 200mg ferrous sulfate once daily, every other day) |
|---|---|---|
| Absorption | Lower fractional absorption due to increased hepcidin response. | Significantly higher fractional absorption, maximizing iron uptake. |
| Side Effects | Often associated with higher rates of gastrointestinal side effects. | Potentially fewer and less severe gastrointestinal side effects. |
| Effectiveness | Can be effective, but high rates of side effects may lead to poor compliance. | Long-term studies show comparable or better effectiveness. |
| Target Patient | Historically common; less suitable for sensitive individuals. | Recommended for patients with side effects or to optimise absorption. |
Treatment and Prevention
Treatment involves supplements and addressing the cause. For women with heavy periods, a GP may discuss reducing blood loss. For dietary deficiencies, a dietitian referral may help. Oral supplements are common, but intravenous infusions may be needed for malabsorption or intolerance.
Prevention focuses on a balanced diet rich in haem (animal) and non-haem (plant) iron.
- Eat haem iron: Red meat, poultry, and fish are good, easily absorbed sources.
- Boost non-haem absorption: Combine plant sources like lentils and spinach with vitamin C-rich foods (e.g., orange juice).
- Avoid inhibitors: Limit tea, coffee, and large amounts of dairy around meals.
Conclusion
Is iron deficiency common in the UK? Yes, evidence shows a notable prevalence of anaemia and subclinical iron insufficiency, particularly among women, the elderly, and those with specific conditions. The condition often goes undiagnosed due to subtle symptoms, highlighting the need for checks for at-risk groups. Understanding causes, recognising symptoms, and adopting an iron-rich diet with appropriate supplementation are key to management and prevention. Proactive steps can combat fatigue and other related health issues. For more information, see NHS guidelines on iron deficiency anaemia.
