People often think they are tired due to stress. Some think they just need more sleep. Another reason may be iron-deficiency anemia.

"I'm always tired, but I've gotten used to it," says Kathy, 49. "I come home from work, cook dinner, then clean or do laundry. And I'm wiped out. Maybe I should get to sleep earlier, but it never seems to work out that way."

"I thought I was just run down and stressed out," says Julie, 28, a graduate student who stays up late working. "I had no idea there was a medical cause."

Kathy and Julie both have iron-deficiency anemia. It happens when the body does not have enough iron.

Why Is Iron Important?

Iron is needed to make healthy red blood cells that carry oxygen to the rest of the body. Oxygen is used by your body to help make energy. It also helps with the immune system, wound healing, and other functions.

Should You Be Concerned?

Anemia comes on slowly, so many people do not know they have it. Even a small lack of iron can cause a person to feel tired. Low levels of iron can lead to problems like:

• Pale skin
• Weak nails
• Headache
• Weakness
• Fast heartbeat
• Hair loss
• Shortness of breath during or after physical activity
• Cravings for strange things like ice, dirt, or starch
• Restless leg syndrome

Women who menstruate are at risk because of blood loss. Some women do not get enough iron in their diets to make up for these losses. Iron deficiency is also common among:

• Pregnant women
• People who have certain health problems, such as celiac disease, peptic ulcer, H. pylori infection, inflammatory bowel disease, or colon cancer
• People who take certain medicines, like antacids, H-2 blockers, proton pump inhibitors, chronic use of over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), or zinc or magnesium supplements
• Teens, especially girls

How Much Iron Do You Need?

Here is the Office of Dietary Supplements' Recommended Dietary Allowance (RDA) for iron:

A supplement may be needed for anemia that is severe. Talk to your doctor before you take one. Too much can cause harm.

Iron and Your Diet

People who do not have enough iron should look for ways to add more to their diet. Knowing which foods are rich in iron is the first step. Here are some good sources of iron:

• Meats—lean beef, lean pork, lamb, veal, liver, organ meats
• Fish—clams, oysters, shellfish, tuna
• Poultry—chicken and turkey
• Eggs
• Beans and legumes—black-eyed peas, black beans, kidney beans, lima beans, navy beans, lentils, soybeans
• Vegetables—dark, leafy greens; asparagus; bok choy; broccoli
• Dried fruits
• Grains—iron-fortified cereal, whole-grain or iron-enriched foods
• Other types of food—blackstrap molasses, Brewer's yeast, tofu