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Haematology · Same-week appointments · Including IV iron
Iron deficiency anaemia.
Iron deficiency is one of the most common nutritional problems worldwide and one of the most common reversible causes of fatigue, breathlessness, and brain fog. It’s also commonly under-treated — many patients are told their "iron levels are normal" when their ferritin is still suboptimal for symptom resolution. Proper assessment and treatment changes lives.
Educational information — not a substitute for clinical assessment
This page describes iron deficiency and iron deficiency anaemia in general terms to help you decide whether assessment may be helpful. It is not a diagnostic tool. If you recognise yourself in what follows, please book a consultation.
Iron is essential for producing haemoglobin (the protein in red blood cells that carries oxygen), myoglobin (in muscles), and various enzymes throughout the body. Iron deficiency progresses through stages:
Iron-depleted state — low ferritin (iron stores), normal haemoglobin. The person may already have symptoms.
Iron deficiency anaemia — low ferritin and low haemoglobin
Importantly, symptoms can develop at the first stage — before anaemia develops. Many patients are told "your haemoglobin is normal" while their ferritin is dramatically low and their symptoms entirely due to depleted iron stores.
~10%
of pre-menopausal UK women are iron deficient. Many more have ferritin below optimal range. Most don’t know it.
Symptoms
Iron deficiency can cause symptoms across many systems:
Common
Tiredness, fatigue (most common; often dismissed)
Breathlessness on exertion (and at lower exertion thresholds as deficiency progresses)
Anxiety or low mood (iron is involved in dopamine and serotonin synthesis)
Reduced libido
Frequent infections
With severe anaemia
Significant breathlessness even at rest
Chest pain (angina, particularly in those with underlying heart disease)
Light-headedness
Tachycardia (rapid heartbeat)
Who’s commonly affected?
Pre-menopausal women
By far the largest group. Menstrual blood loss is the dominant cause. Women with heavy periods are at particular risk — see our HMB page. Even women with "normal" periods often have ferritin below optimal levels.
Pregnancy
Increased requirements; common cause of fatigue in second and third trimesters. Routine antenatal screening usually identifies it.
Vegetarians and vegans
Plant-based iron is less well absorbed than animal-source iron. Most can maintain adequate levels with good planning but some develop deficiency.
Coeliac disease, inflammatory bowel disease, gastric surgery, atrophic gastritis all impair iron absorption.
Older adults
Iron deficiency anaemia in older patients (particularly men or post-menopausal women) warrants careful investigation for gut blood loss, including from cancer.
Causes and investigation
Iron deficiency has three main mechanisms:
Blood loss
Menstrual loss (commonest in pre-menopausal women)
Low dietary iron (vegans, vegetarians, eating disorders)
Highly restrictive diets
Tea/coffee with meals (reduces absorption)
Malabsorption
Coeliac disease
Inflammatory bowel disease
Atrophic gastritis
H. pylori infection
Post-bariatric surgery
Long-term use of acid-suppressing medication
Why finding the cause matters
Iron deficiency anaemia in men, in post-menopausal women, or in anyone over 50 with no obvious cause (e.g. heavy periods) warrants careful investigation for gut blood loss. NICE guidance recommends gastrointestinal investigation (gastroscopy and/or colonoscopy) in these groups to exclude treatable conditions including bowel cancer. We don’t just replace iron and move on.
How we assess at the clinic
1. Detailed history
Symptoms, duration, menstrual history (women), bowel habit, dietary history, family history, medications, previous iron treatment if any, weight changes, other symptoms.
2. Examination
Looking for signs of iron deficiency (pallor, koilonychia, glossitis), checking for sources of blood loss, abdominal examination, rectal examination where indicated.
3. Comprehensive blood tests
Full blood count (haemoglobin, MCV, reticulocyte count)
Ferritin (iron stores) — the most useful single test
Transferrin saturation
Iron, TIBC (total iron-binding capacity)
Vitamin B12, folate (other common causes of anaemia)
CRP (inflammation can falsely elevate ferritin)
Coeliac antibody screen
Liver and kidney function
Thyroid function
HbA1c
FIT test (faecal immunochemical test) where bowel investigation indicated
4. Further investigation if indicated
Endoscopy (gastroscopy/colonoscopy) for unexplained iron deficiency anaemia in higher-risk groups
Pelvic ultrasound in women with gynaecological symptoms
Specialist haematology referral for complex anaemia
5. Treatment plan
Targeting both treatment and investigation of the cause.
Treatment options
Dietary iron
Useful for maintenance, less useful for treating established deficiency. Animal-source (haem) iron is more absorbable than plant (non-haem) iron:
Haem iron sources: red meat, liver, poultry, fish
Non-haem iron sources: lentils, beans, fortified cereals, dark leafy greens, dried fruit, nuts
Boosters: vitamin C with meals (orange juice, peppers, citrus); cooking in cast iron
Inhibitors: tea and coffee with meals (avoid for 1 hour either side); calcium supplements at the same time
Oral iron supplements
First-line treatment for established deficiency. Several preparations exist with varying tolerability. Common approach: starting dose for several weeks, retest at 3 months, continue until ferritin reaches target. UK law prevents naming specific medications; choices are discussed in consultation.
Common challenges with oral iron:
Side effects (nausea, constipation, dark stools, metallic taste) in many patients
Slow response — ferritin takes weeks to months to rise
Absorption issues in some patients
Strategies: take with food (slightly reduces absorption but improves tolerability), alternate-day dosing (newer evidence suggests this may improve absorption and reduce side effects), try different preparations if one isn’t tolerated.
IV iron
For patients in whom oral iron isn’t working or isn’t tolerated, or where rapid replenishment is needed (e.g. pre-surgery, severe symptoms). See dedicated section below.
Treating the underlying cause
Heavy periods, gastrointestinal sources, coeliac disease, etc. — treating these prevents recurrence.
Intravenous (IV) iron
IV iron has become much more accessible in recent years with development of newer preparations that allow rapid, well-tolerated infusion. Indications include:
Severe deficiency requiring rapid replenishment
Oral iron intolerance (significant side effects)
Oral iron not working (poor absorption)
Pre-surgical optimisation
Heavy menstrual bleeding with ongoing losses
Inflammatory bowel disease
Pregnancy with severe deficiency
The infusion typically takes 15–30 minutes. Patient must be observed for a period after. Side effects can include temporary changes in taste, mild flu-like symptoms, and rarely allergic reactions (the reason for observation). We can arrange IV iron through our facility or partner providers.
Maintenance and prevention
Once levels are restored, maintenance includes:
Addressing ongoing losses (heavy periods, GI sources)
Dietary iron intake
Low-dose maintenance oral iron in some patients (e.g. women with heavy periods, vegans)
Periodic ferritin monitoring
Avoiding factors that reduce absorption where possible
When to see us
Consider booking if:
You have symptoms suggesting iron deficiency (fatigue, breathlessness, brain fog)
You’ve been told your iron level is "normal" but your ferritin is low
You’ve been on iron tablets for months without improvement
You can’t tolerate oral iron and want to discuss alternatives
You have heavy periods and want a full assessment
You’re vegan or vegetarian and want to check your iron status
You have hair loss or restless legs and suspect iron may contribute
You’re pregnant or planning pregnancy
You’ve been told you need IV iron but can’t get it easily through the NHS
Frequently asked questions
What ferritin level should I aim for?
Reference ranges allow ferritin as low as 15–20 to be classed as "normal," but many patients have symptoms until ferritin is 50–70 or higher. For hair regrowth, restless legs, and fatigue, levels above 70 are often needed. We discuss target levels individually.
Why does the NHS say my iron is fine?
NHS reference ranges identify clinical deficiency at the population level, but don’t target optimal levels for individual symptom resolution. Many patients with ferritin 20–50 are told they’re "fine" when they actually have symptoms of iron depletion.
How long does treatment take?
Oral iron raises ferritin slowly — typically 3–6 months to fully replenish stores. IV iron acts within days to weeks but takes longer for some clinical benefits (e.g. hair regrowth) to appear.
How much does it cost?
Current consultation, blood test, and treatment prices are on our Fees page. IV iron is the most expensive option (several hundred pounds for the infusion plus consultation) but transformative for many.
Will insurance cover this?
Most UK PMI policies cover iron deficiency assessment and treatment. IV iron coverage varies. We provide procedure codes.
Can I just take supplements without testing?
Low-dose iron supplements (e.g. as part of a multivitamin) are generally safe. Higher doses without confirmed deficiency aren’t recommended — iron overload is a real concern in some genetic conditions and unnecessary supplementation can cause GI side effects.
What about vitamin C with iron?
Yes — vitamin C enhances non-haem iron absorption. Taking iron supplements with orange juice or a vitamin C supplement is reasonable.
Can iron deficiency cause anxiety/depression?
Yes — iron is involved in neurotransmitter synthesis. Some patients with low ferritin notice mood improvement with replenishment. Worth checking iron in anyone with new or persistent mood symptoms.
I have heavy periods and ongoing iron loss — will I just keep getting deficient?
Yes, without addressing the underlying loss. Treatment of heavy periods (see HMB page) plus iron replenishment usually solves the problem. Some women benefit from low-dose maintenance iron long-term.
Book an appointment
Private appointments at our Whitechapel clinic, open 7 days, 9am–7pm. Book online, call or WhatsApp.
Who oversees iron deficiency anaemia care at the clinic
Care at Tower Bridge Hospital London is delivered by a small clinical team, with Dr Haydar Bolat as Clinical Director. The specific clinicians involved in your care depend on the plan agreed with you at consultation.
Clinical Director · GP
Dr Haydar Bolat
UK-registered GP and Clinical Director at the clinic. Conducts comprehensive iron deficiency assessments including history, examination, full iron panel, investigation of underlying cause, oral iron supplementation, and arrangement of IV iron where appropriate.
Languages spoken across the team: English, Turkish, Bulgarian, Bengali, Hindi, Albanian, Azerbaijani, German, Romanian. We can also arrange professional telephone interpreters in most other languages at no extra cost. More on languages and interpreters →
Editorial review
This page was reviewed by Dr Haydar Bolat, Clinical Director at Tower Bridge Hospital London. Content is based on NICE Clinical Knowledge Summaries on anaemia — iron deficiency, British Society of Gastroenterology guidance, and current UK clinical practice. It is updated when guidance changes. Educational information only — not a substitute for clinical assessment.
Specialist medicine · Whitechapel, East London
Treating iron deficiency is often transformative
Book an appointment for proper assessment, identification of cause, and a treatment plan that actually works for you.
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Our clinic at 97–99 Whitechapel Road, E1 cares for patients from across London and the Docklands — including Aldgate, the City, Bethnal Green, Bow, Shoreditch, Canary Wharf, Stratford and Bermondsey — a few minutes’ walk from Aldgate East and Whitechapel stations.
In an emergency, call 999. Tower Bridge Hospital London is not an emergency service. Your nearest A&E is The Royal London Hospital, Whitechapel Road E1 1FR — 5 minutes’ walk from our front door.
Iron Deficiency Anaemia in London & East London — Whitechapel, the City & Canary Wharf
Our Iron Deficiency Anaemia service at Whitechapel, E1 cares for patients from right across London and East London, the City and the Docklands — including Aldgate, Bethnal Green, Bow, Shoreditch, Canary Wharf, Stratford, Bermondsey and the surrounding areas. Same-day and walk-in appointments are available and you do not need a GP referral.
Whitechapel E1
Aldgate E1
Stepney E1
Shadwell E1
Wapping E1W
Bethnal Green E2
Mile End E1
Bow E3
Poplar E14
Limehouse E14
Canary Wharf E14
Isle of Dogs E14
Shoreditch EC2
Hoxton N1
Dalston E8
Hackney E9
Stratford E15
Canning Town E16
City of London EC2
Liverpool Street EC2
Bank EC3
Old Street EC1
Clerkenwell EC1
Angel N1
London Bridge SE1
Bermondsey SE1
Borough SE1
Rotherhithe SE16
Easy to reach — minutes from the Royal London Hospital and Aldgate East, Whitechapel, Aldgate and Liverpool Street stations, and one stop from Canary Wharf on the Elizabeth line.
Looking for iron deficiency anaemia near me?
If you are searching for a private iron deficiency anaemia near me, a doctor, clinic or specialist near me in East London, our Whitechapel practice is on your doorstep — walk-in and same-day appointments, no GP referral, and no long NHS waiting list.
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For City & Canary Wharf professionals and East London families
Book a same-day appointment or call 020 7916 0029. See our transparent fees. Open 7 days a week, 9am–7pm. Private clinic on Whitechapel Road, London E1 — serving Tower Hamlets, Hackney, Newham, Islington, the City of London and Southwark.