You might be iron deficient and not even realize it.

A recent study, published in JAMA Network Open, revealed that 29% of US adults are affected by absolute or functional iron deficiencies — and nearly one in three Americans may have an undiagnosed iron deficiency.

An absolute iron deficiency affects women, children, vegetarians and vegans and occurs because of a severe reduction or absence of iron “stores,” according to the American Society of Hematology. Meanwhile, functional iron deficiency, which affects women and men, occurs when there are sufficient iron stores but insufficient iron availability.

The study observed “participants that were noninstitutionalized, civilian women and men age 18 years or older who had available serum ferritin, iron and unsaturated iron binding capacity measurements,” the study said.

Iron deficiency anemia can develop because the body struggles to absorb iron, you don’t eat enough food with iron, your body craves more iron than the usual person, or you lose more blood than your body can replace.

Other elements, such as biological sex, lifestyles, underlying health conditions and age can make people more prone to iron deficiency. 

There are several ways to indicate if you have iron deficiency, and symptoms such as headaches or the urge to eat ice or even non-food clay could be a sign. However,

those aren’t the only side effects related to low iron.

Extreme fatigue or weakness

If you constantly feel extreme fatigue or weakness, this could be a sign that you’re deficient in iron.

That feeling develops when there is insufficient iron, so your body does not produce red blood cells, making your bloodstream less capable of carrying oxygen. The lack of oxygen being transported to where it needs to go causes you to feel fatigued.

“Tens of millions of people in the U.S. are basically running on fumes either because there isn’t enough fuel in the tank or because the tank isn’t connecting to the engine well,” Dr. Andrew Eisenberger, a hematologist and associate professor of medicine at Columbia University, who was not involved with the new research, told NBC News. “In our society we are hardwired to be at peak performance. With this tremendous prevalence of iron deficiency, so many people can’t do their best.”

Chest issues 

People with low iron can experience chest pain, fast heartbeat and shortness of breath, explained Healthline. The discomfort they endure can also be related to the minimal oxygen being carried throughout the bloodstream.

Headache, dizziness and lightheadedness 

Dreaded headaches can occur when your body is running low of iron, since your brain receives less oxygen. Other cognitive impairments such as dizziness, lightheadness and migraines, can develop, added the health site.

Cold hands and feet 

Iron deficiency impacts the bloodstream, which transfers oxygen around your body. However, due to the lack of circulation, it also makes your hands and feet cold.

Cravings for non-nutritional objects 

Strange cravings that have no nutritional value or should even be considered for consumption. An extreme level of iron deficiency can cause people to develop a condition known as pica, an eating disorder in which a person eats things not usually considered food, according to KidsHealth.

People diagnosed with pica crave ice, soil, paper and even clay.

Poor appetite 

If you have a minimal appetite or don’t feel hungry at all, that could also be an indicator of low iron.

Pale skin 

When your iron is low, you might notice your skin appearing pale. The lack of melanin comes from iron deficiency which leads to fewer red blood cells.

Medical experts suggest incorporating more iron into your diet to prevent low iron.

One of the ways people can increase their iron is by adding red meat, poultry, pork, beans, peas, seafood, dark leafy vegetables, raisins, apricots, dried fruit, nuts and iron-fortified starches like pasta and cereal, advised the Mayo Clinic.

If adding iron-rich foods to your diet is a challenge, the Cleveland Clinic suggests taking an oral iron supplement or multivitamins. Those substitutes can help increase or maintain your iron levels.

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