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Signs and symptoms[edit]

Iron deficiency anemia may present without symptoms. If symptomatic patients may present with the sign of pallor (reduced oxyhemoglobin in skin or mucous membranes), and the symptoms of fatigue, lightheadedness, and weakness. None of these symptoms (or any of the others below) are sensitive or specific. Pallor of mucous membranes (primarily the conjunctiva) in children suggests anemia with the best correlation to the disease, but in a large study was found to be only 28% sensitive and 87% specific (with high predictive value) in distinguishing children with anemia [hemoglobin (Hb) < 11.0 g/dl] and 49% sensitive and 79% specific in distinguishing severe anemia (Hb < 7.0 g/dl). Thus, this sign is reasonably predictive when present, but not helpful when absent, as only one-third to one-half of children who are anemic (depending on severity) will show pallor.

Because iron-deficiency anemia tends to develop slowly, adaptation occurs to the systemic effects that anemia causes, and the disease often goes unrecognized for some time. In severe cases, dyspnea can occur. Pica may also develop; pagophagia has been suggested to be "the most specific for iron deficiency."

Other possible symptoms and signs of iron-deficiency anemia include:

• Irritability
• Angina
• Palpitations
• Breathlessness
• Tingling, numbness, or burning sensations
• Glossitis (inflammation or infection of the tongue)
• Angular cheilitis (inflammatory lesions at the mouth's corners)
• Koilonychia (spoon-shaped nails) or nails that are brittle
• Poor appetite
• Dysphagia due to formation of esophageal webs (Plummer-Vinson syndrome)
• Restless legs syndrome