Iron Deficiency and Anaemia in Indian Women: Symptoms, Tests, and Treatment

Iron deficiency anaemia is the most common nutritional deficiency in the world, and India carries one of the heaviest burdens. National Family Health Survey data has consistently shown that more than half of Indian women of reproductive age are anaemic.
Here is the short answer on what to do: a CBC plus serum ferritin test identifies both anaemia and iron deficiency before anaemia develops. Both tests together cost under Rs. 1,000 in Bangalore. Treatment is usually oral iron supplementation for 3 to 6 months, with dietary changes alongside.

Why Iron Deficiency Is So Common in Indian Women

Several factors combine:

Menstrual blood loss: Regular monthly iron loss that is not always matched by dietary intake. Heavy menstrual bleeding significantly increases the deficit.

Predominantly vegetarian diets: Plant sources contain non-haem iron, which is absorbed at roughly 2 to 10 percent efficiency compared to 15 to 35 percent for haem iron from animal sources.

Dietary inhibitors: Tea and coffee contain tannins and polyphenols that substantially reduce iron absorption when consumed with meals. Calcium and phytates in whole grains and legumes also inhibit absorption.

Pregnancy and lactation: Iron requirements increase substantially during pregnancy and often deplete stores further.

Undiagnosed causes: Fibroids, endometriosis, coeliac disease, and gastrointestinal bleeding can all cause chronic iron loss.

Iron Deficiency Symptoms in Women

Important point: you can have iron deficiency without anaemia. Ferritin, which reflects iron stores, drops well before haemoglobin does. Symptoms including fatigue, hair fall, and restless legs can appear at this stage, with a completely normal haemoglobin on a CBC.
This is why testing ferritin alongside a CBC matters. A normal haemoglobin alone does not rule out iron deficiency.

Which Tests You Actually Need

Note: ferritin is also an acute phase reactant, meaning it rises during inflammation or infection. A normal ferritin in someone with active inflammation does not fully exclude iron deficiency, and your doctor will interpret it in context.

Iron Deficiency Treatment

Oral iron supplementation is first-line. Commonly prescribed forms include ferrous sulphate, ferrous fumarate, ferrous ascorbate, and iron bisglycinate, which is often better tolerated.

Key points on taking iron effectively:

• Take it on an empty stomach if tolerated, as food reduces absorption
• Take with a source of Vitamin C such as citrus juice, which substantially improves absorption
• Do not take with tea, coffee, milk, calcium supplements, or antacids; separate by at least 2 hours
• Alternate-day dosing may be better absorbed than daily dosing in some cases, as daily dosing raises hepcidin and reduces absorption
• Continue for 3 to 6 months after haemoglobin normalises to rebuild stores
• Dark stools are expected and harmless
• Constipation is common; increase fluid and fibre

Intravenous iron is used when oral iron is not tolerated, absorption is impaired, deficiency is severe, or correction is needed quickly, such as in late pregnancy.

Dietary Iron Sources for Indian Diets

Pair iron-rich foods with Vitamin C sources such as amla, lemon, tomato, guava, or citrus. Cooking in iron cookware adds a measurable amount of dietary iron.

When to Investigate Further

Iron deficiency in a woman with heavy periods usually has an obvious cause. But your doctor should consider further investigation if: anaemia is severe or recurs after treatment, you are postmenopausal, there are gastrointestinal symptoms, or there is unexplained weight loss.
In these situations, causes such as fibroids, coeliac disease, or gastrointestinal bleeding need to be excluded.

Book an Anaemia Test at Stepcare Whitefield

Stepcare offers in-house CBC, ferritin, and full nutritional panels with physician and clinical nutritionist consultation to address both the deficiency and its underlying cause.

Call or WhatsApp: +91 9606910113 Email: appointments@stepcare.co.in Address: G-01, Ground Floor, Brigade IRV Center, Nallurhalli, Whitefield, Bengaluru 560066 Hours: Monday to Saturday, 8 AM to 8 PM | Sunday, 10 AM to 6 PM

Disclaimer: This content is for informational purposes only and should not be considered medical advice. Please consult a qualified healthcare professional before making any medical decisions.