Iron Deficiency Anaemia: The Silent Epidemic Affecting Indian Women

Quick answer: Iron deficiency anaemia is confirmed with a CBC (low haemoglobin, small pale red cells — low MCV and MCH) and iron studies, especially serum ferritin, which shows your iron stores. In women, haemoglobin below 12 g/dL (11 g/dL in pregnancy) indicates anaemia, and a ferritin below about 15–30 ng/mL strongly suggests low iron stores. Common causes in Indian women are heavy periods, pregnancy, low dietary iron and poor absorption. Symptoms include tiredness, breathlessness, hair fall, pale skin and cravings for ice or mud.

According to India's National Family Health Survey (NFHS-5), more than half of Indian women aged 15–49 are anaemic, and iron deficiency is the most common cause. Many women accept constant tiredness as normal — "it's just work" or "it's just being a mother". It isn't, and it's very treatable.

Why Are Indian Women So Prone to Iron Deficiency?

• Monthly blood loss, especially with heavy or prolonged periods
• Pregnancy and breastfeeding, which greatly increase iron needs
• Diet: vegetarian diets provide non-haem iron, which is absorbed less well than iron from meat
• Tea and coffee with meals reduce iron absorption
• Short gaps between pregnancies
• Worm infections and gut conditions in some cases
• Skipping meals and crash diets

Symptoms of Iron Deficiency Anaemia

• Persistent tiredness and low energy
• Breathlessness or palpitations on climbing stairs
• Pale skin, inner eyelids or nails
• Hair fall and brittle, spoon-shaped nails
• Headaches and dizziness
• Cold hands and feet
• Restless legs at night
• Cravings for ice, raw rice, chalk or mud (called pica)
• Poor concentration and irritability

Iron stores (ferritin) often drop before haemoglobin falls — so you can feel tired with a "normal" haemoglobin but low ferritin.

Tests That Confirm Iron Deficiency

Complete Blood Count (CBC)

• Haemoglobin: below 12 g/dL in non-pregnant women indicates anaemia
• MCV and MCH: low values mean red cells are small and pale — typical of iron deficiency
• RDW: often raised in iron deficiency
• Platelets: sometimes mildly raised

See understanding CBC.

Iron Studies

• Serum ferritin: the best single test for iron stores; low ferritin confirms iron deficiency. Note that ferritin can be falsely normal during infection or inflammation
• Serum iron and TIBC (Total Iron Binding Capacity): low iron with high TIBC supports iron deficiency
• Transferrin saturation: low in iron deficiency

Other Tests Your Doctor May Order

• Vitamin B12 and folate — deficiencies can coexist
• Hb electrophoresis — if small red cells are present but iron is normal, to check for thalassaemia trait
• Stool for occult blood — especially in older women or with digestive symptoms
• Thyroid profile — hypothyroidism can contribute to anaemia and heavy periods

Treatment and Follow-Up

Treatment usually involves iron tablets, and sometimes intravenous iron when tablets aren't tolerated or the deficiency is severe — as prescribed by your doctor. Treating the cause, such as heavy periods, is equally important.

• Haemoglobin usually starts rising within 2–4 weeks of treatment
• Repeat CBC after about 4–8 weeks
• Continue iron for some months after haemoglobin normalises, to rebuild stores, and recheck ferritin

Improving Iron Through Diet

• Iron-rich foods: green leafy vegetables, legumes, chana, rajma, sprouts, jaggery, dates, seeds, eggs, chicken and fish
• Pair them with vitamin C — lemon, amla, oranges, tomatoes — to boost absorption
• Avoid tea or coffee within an hour of iron-rich meals or iron tablets
• Cooking in iron utensils can help slightly

When to Test

• If you have any of the symptoms above
• Every year if you have heavy periods
• Before and during pregnancy (see pregnancy tests)
• After delivery and while breastfeeding
• Vegetarian teenage girls and women

Frequently Asked Questions

What haemoglobin level is considered anaemia in women?

For non-pregnant adult women, haemoglobin below 12 g/dL is considered anaemia. In pregnancy, the cut-off is 11 g/dL.

Which test is best for iron deficiency?

Serum ferritin is the best single test for iron stores. It is usually done with a CBC to see whether anaemia is present.

Can I have iron deficiency with normal haemoglobin?

Yes. Iron stores can be low before haemoglobin drops. A low ferritin with normal haemoglobin is called iron deficiency without anaemia and can still cause tiredness and hair fall.

Do I need to fast for iron studies?

A morning sample after an overnight fast is usually recommended for serum iron, because levels vary through the day and after meals.

How long does it take to correct iron deficiency?

Haemoglobin often improves within weeks, but rebuilding iron stores can take three months or more of treatment.

Which Aarvak package includes iron studies?

The ₹3,000 ADC Swasthya Panel includes CBC and iron studies along with vitamin B12, vitamin D, thyroid and more.

Book an Anaemia Check in Gurugram

A CBC and iron studies take minutes to collect, at our Sector 67 lab or at home. The ₹3,000 ADC Swasthya Panel covers CBC, iron studies, B12 and vitamin D together. Read more in our guide to essential tests for women. Call +91 92663 33711.

This article is for general information only. Please consult your doctor before starting iron supplements.