Iron Deficiency Signs Your Skin, Hair & Nails Are Trying To Warn You About

Added: 2026-05-09

[00:00:00]Well, hey guys. Welcome back. If you're new here, I'm Dr. Dre. I'm a board-certified dermatologist. And in today's video, we're going to be talking about iron deficiency, why it's so common, and how it shows up in your skin, your hair, your nails, and even inside your mouth. Not only are we going to go over the warning signs of iron deficiency, but I'm going to be talking about some of the most common causes, at risk groups, and importantly, we're going to address how to correct iron deficiency and prevent it moving forward. We'll talk about diet and the best foods for getting quality iron.

[00:00:30]Then I'll touch on the best blood tests that should be evaluated for iron deficiency. Iron is an essential mineral. It's vital for hemoglobin, a protein inside of your red blood cells.

[00:00:41]It carries oxygen around throughout your body. It's vital for cellular energy and metabolism as well as your brain function. When your iron levels are low, your body really can't deliver oxygen efficiently. Over time, this can lead to something known as iron deficiency anemia. But even before a frank anemia develops, symptoms of iron deficiency can begin to manifest. Common symptoms include fatigue, brain fog, decreased concentration, memory problems, and intolerance to exercise. And you guessed it, it 100% can impact your skin, your hair, your nails. One of the most searched topics with regards to iron deficiency is hair loss. Low iron levels can be associated with diffuse non-scarring hair shedding. Meaning the hair loss is occurring all over the scalp, not just in discrete patches.

[00:01:28]Growing hair is a very energydemanding task. So when iron levels are low, your body shifts things around so as to ignore hair growth and prioritize more vital bodily functions. Hair growth takes a backseat and eventually you develop massive hair shedding known as tiloggen aluvium. Iron deficiency also can show up on your skin in a variety of ways. First of all, you may notice that your skin looks paler, just overall more dull. It's lost some of that vitality.

[00:01:55]This is due to reduced hemoglobin and a decrease in oxygen delivery. One of the more common skin findings is kind of non-specific because, well, it can happen in a variety of circumstances, but that is dryness. With that dryness comes an increased tendency towards skin irritation. Low iron can impair the integrity of your skin barrier, making your skin more vulnerable to transepidermal water loss, subsequent penetration of irritants, as well as the symptoms of itch. In fact, diffuse itch is often associated with low iron. Itch that happens without any rash. Sometimes you may even see these red purplish spots. If you press on those spots, they do not blanch. These are called petiki.

[00:02:37]Iron deficiency can also affect skin hydration and nerve signaling. Together, these two factors contribute to symptoms of itch in people with iron deficiency.

[00:02:46]Nails can provide important clues as well. A classic finding is something known as coil nicia or spoon nails where the nails become thin and curved up at the sides. They have a little depression in the center and you could put a drop of water there and it would stay in place. Looks like a little cup. Iron deficiency can even affect your taste buds and lead to the appearance of a smooth, pale, shiny tongue. Many people with iron deficiency will develop cracks at the corners of the mouth. This is known as keeliosis. These are all important clues that for the unsuspecting eye will easily go overlooked. Now, some other less obvious signs that you definitely should not ignore are this insatiable appetite for ice. Like you're always craving ice chips. This is a very common symptom of iron deficiency known as pagophasia.

[00:03:33]Also, restless leg syndrome. This is where you feel an uncontrollable urge to move your legs around at night. Can be very disruptive to your sleep quality.

[00:03:41]These symptoms may all seem unrelated, but they're important clues that iron deficiency could be lurking below the surface. Now, before you get freaked out, it's important to take a look at who exactly is at risk for iron deficiency. Certain groups, without a doubt, are at much greater risk. Women, especially those who menrate, are at a much greater risk because, well, they lose blood every single month. Pregnancy is a time where iron demands increase quite a bit because, well, you're building another human being. It requires you to make more of your own blood to well, grow that baby. So, if that's not taken into account, it's pretty easy for a pregnant woman to become iron deficient. Then when she delivers and loses even more blood, well, yeah, you can really run into quite a severe situation with iron deficiency. That becomes life-threatening. Most people get more than enough iron in their diet, though certain patterns of eating are more predisposed to inadequate iron intake if not properly planned, such as vegetarian and vegan diets that maybe forget to include and eat their legumes and pulses. Athletes have an increase in iron needs. And if that's not accounted for, they can run into iron deficiency.

[00:04:53]People with gastrointestinal disorders like ulcerative colitis, Crohn's disease, celiac disease, helicoacttor pylori, and people who have undergone weight loss surgery and had parts of their digestive tract removed. These groups might have impaired absorption.

[00:05:07]Also, chronic users of a class of medications known as proton pump inhibitors. For example, omerazol, GLP-1 medications, which are increasingly being prescribed for weight loss, are associated with an increased risk of iron deficiency due to combination of a reduction in food intake coupled with a slowing down of transit through the digestive tract, meaning less dietary iron is consumed and absorbed. Of note, for this group in particular, obesity on its own by itself is associated with decreased iron absorption. This is because atapost tissue produces something called hepaceetin. Hepetin is a hormone that our body naturally makes as a way to put the brakes on iron absorption. In normal circumstances, it does this when we've had the right amount of iron and we don't want to take up too much. So, it's a good thing that our body makes this hormone. However, excess atapost tissue can be producing it abnormally, limiting absorption of iron. in patients who have excess body fat and having excess atapost tissue also increases inflammation. Anything that increases inflammation in the body will also increase hepeetum production.

[00:06:13]Then there are individuals who have chronic blood loss. Of course, regularly menrating women make up the bulk of this group but also people who are losing blood through their gastrointestinal tract may be related to an underlying inflammatory bowel disorder or a gastrointestinal cancer. Excess atapost tissue is not the only thing that increases inflammation throughout the body and subsequently increases hepocetin putting you at risk for low iron. There are variety of underlying medical conditions where you have chronic inflammation. Cancer is a big one. Rheumatological disorders like rheumatoid arthritis and systemic lupus aithmitosis. Inflammatory bowel disease, chronic kidney disease, heart failure, and endocrine disorders like low thyroid. So, it kind of sounds like everybody's at risk. Iron deficiency is super rare in men who are otherwise healthy. So if you suspect or concerned about iron deficiency, what kind of testing can help get the bottom of this as to whether or not that's something that you have? The most important test is something called ferotin, which reflects your total body iron stores. A ferotin level below 30 nanogs per milliliter is typically considered diagnostic of iron deficiency. Another important test is something called the transparent saturation or T-at. This gives us an idea of how much circulating iron is available. It's also important to remember that if you get your hemoglobin checked, a normal hemoglobin doesn't necessarily mean that you don't have iron deficiency because many people can have low iron without yet having anemia. In other words, if you're having symptoms, it's definitely worth talking to your doctor about having proper testing done. How do you go about correcting iron deficiency? Well, treatment is going to depend on the root cause. You can imagine that if the root cause is you losing iron through heavy periods, well, it's going to be very difficult to catch up with that because every month you have a very heavy period flow. Well, that's going to be another deficit. So, if there's something driving the heavy periods, addressing that will be just as important as trying to chase a lab value and correcting the existing iron deficiency. But for most people, oral iron supplementation is firstline treatment. A common approach is taking iron once a day or every other day to improve tolerance. Side effects like nausea and constipation unfortunately are common with oral iron supplementation. So the every other day approach can help with these symptoms.

[00:08:31]Vitamin C can also help to improve absorption of iron. Things like coffee, tea, calcium, and high-fiber foods can reduce iron absorption. So being mindful of what you consume iron supplements with can be pivotal in getting proper responses. But in some cases, such as with poor absorption from the digestive tract, IV iron replacement may be needed. What about diet? Don't get it twisted. Diet plays an important role in providing iron to our bodies. However, diet is not going to be enough to correct existing iron deficiency. Once iron deficiency actually happens, the typical iron deficit is about 1,000 mg of iron. 1,00 mg of iron plus the 1 to 5 millig needed daily. That 1,000 mg on top of our daily needs is not something we can realistically get from diet alone. That said, incorporating iron rich foods into the diet is very important. Foods highest in iron include animal meats, fortified cereals, lentils, beans. The recommended daily iron intake for women is 18 milligs a day, of which about 10% is actually absorbed, which equates to 1.8 milligrams a day absorbed from her diet.

[00:09:41]To put it into perspective, the average daily intake in the United States is 13 milligrams per day. Though certain poorly planned diets may be lacking in iron. So if you're planning to go on some juice fast for a prolonged period of time, you could put yourself at risk for iron deficiency. Or if you're new on a GLP-1 medication, your dose too high, you're not eating anything. Yeah, you can run into iron deficiency there as well. Menration increases iron requirements to an additional 2 millig per day. The recommended daily allowance of iron for men and post-menopausal women is much lower than for menrating women, it's 8 milligrams per day.

[00:10:19]Adolescent males, 14 to 18, on the other hand, they're growing. They have higher iron needs. They um need 11 milligs per day. Hem iron found in animal foods is more easily absorbed. The non-heem iron in fortified cereals, leafy greens, legumes, and beans in vegetarian and vegan diets can be absorbed, however, and more than adequate, especially if you pair these foods with vitamin C rich foods. Have an orange or a kiwi with your dark leafy greens, your legumes, and you will just be absorbing that iron just fine. Key takeaway here is that iron deficiency can easily be overlooked, especially if you don't recognize warning signs. It is the most common nutritional deficiency worldwide.

[00:11:00]If you're experiencing symptoms like dry skin, shedding hair, brittle nails that take on the appearance of a spoon, your tongue is smooth and shiny, you have fatigue, poor memory, brain fog, restless leg syndrome, you feel really itchy, then it's definitely worth getting evaluated. Treating the underlying cause, though, is just as important as replacing the iron. So, if you feel like you might have iron deficiency, don't just take iron supplementation without first seeing your health care provider for a proper evaluation. Because here's the thing, some people with iron deficiency are not going to be able to absorb iron from an oral supplement. And taking it can lead to, of course, unnecessary nausea and constipation, but also taking iron supplementation unnecessarily can cause harm as well. I hope this video was helpful to you guys in explaining the most common nutritional deficiency worldwide, the warning signs on our skin, hair, nails, and inside of our mouth, the best tests, how it's treated, and who's at risk. If you guys enjoyed this video, give it a thumbs up, share it with your friends, and as always, don't forget sunscreen and subscribe.

[00:12:09]I'll talk to you guys tomorrow. Bye.

[00:12:27]Heat. Heat.