5 Surprising Signs Of Iron Deficiency In Pregnancy

You didn’t expect to feel like yourself during pregnancy, but you didn’t expect to feel like this: tired, like, to your bones tired. Well, I am here to tell you, you are not alone. Today we are going to talk about surprising signs of iron deficiency in pregnancy tiredness being just one symptom.

Hi, I am Suzzie Vehrs, not a medical practitioner, but a doula who helps her moms advocate for themselves in the midst of busy systems, where it never feels like there is time to get to the bottom of why things feel so different than expected. Over the years, it has surprised me how vocal moms need to become about feeling overly tired during pregnancy. Yes, being tired is normal. But no, being extremely tired is not a sign to ignore. This plus others can be potential signs of an iron deficiency you should address.

This article will go over signs you might have an iron deficiency, what normal levels of iron are and how to ask you medical provider for a blood test. I hope it helps you advocate for better care, centered around you.

5 Surprising Signs Of Iron Deficiency In Pregnancy

Sign of Iron Deficiency #1: Extreme Tiredness Or Getting Worn Out Extremely Easily

“I used to walk every day, but now I feel like I walk from my bedroom to living room and need to sit down to catch my breath.”

This is what one of the mothers I worked with told me right before she found out she was Iron Deficient. Becoming easily exhausted is a sign of iron deficiency because your body need iron to help carry oxygen to your muscles and brain. How? Iron is an essential building block of red blood cells. Red blood cells pick up oxygen in the lungs and deliver it throughout your body. When your iron levels are low, it means less red blood cells which means less oxygen delivered throughout your body. This means that your body can’t work at it’s normal capacity. Things that once seemed easy, such as walking up the stairs or doing your favorite exercises might feel harder or nearly impossible.

Sign of Iron Deficiency #2: Shortness Of Breath And Rapid Heartbeat

If you notice you are huffing and puffing or you feel your heart beating faster than normal, you have identified another potential symptom of iron deficiency. In your body’s infinite wisdom, when the blood is not transporting as much oxygen as normal, the body compensates. To do this, your heart pumps faster so that more blood can circulate through the body each minute. Your breathing may also become faster or feel more difficult because your body is trying to increase the amount of oxygen available. These are symptoms that are definitely worth mentioning to your health care provider.

Sign of Iron Deficiency #3: Migraines And Sensitivity To Light

During pregnancy, your body’s iron needs increase substantially to support both your growing baby and the expansion of your own blood supply. Research has found that women with lower hemoglobin levels and lower ferritin levels (a measure of iron stores) are more likely to experience migraines. Like shortness of breath, migraines would be caused by reduced oxygen circulation in this case, specifically to the brain. The good news: for some mothers, treating iron deficiency or iron-deficiency anemia may help reduce the frequency or severity of migraines. Researchers found that comprehensive treatment, including nutritional management and non-pharmacological interventions can significantly improve outcomes and reduce symptoms! It’s a great thing to get to the root of a problem!

Sign of Iron Deficiency #4: Craving Ice

We all love a good ice cold drink – especially in the summer. But what if you find yourself repeatedly and compulsively looking for ice to chew? It’s actually a sign of iron deficiency (especially if you’re pregnant.) Chewing ice changes blood flow that temporarily increases blood flow to the brain. (As someone who loved a good brain freeze as a child, I would have expected the exact opposite!) If your iron is low, you may find that chewing ice briefly makes you feel more alert and mentally sharp. It’s also a sign you should check your iron levels, especially if you are experiencing other symptoms in addition to the ice cravings.

Sign of Iron Deficiency #5: Having A Hard Time Sleeping

Iron deficiency during pregnancy can affect the brain and nervous system in ways that disrupt normal sleep regulation. Research shows it is linked to sleep and movement-related conditions like restless legs syndrome, periodic limb movements during sleep, and overall restless or fragmented sleep. These symptoms can make it harder to fall asleep, stay asleep, and feel rested, which may add to fatigue that is already common in pregnancy. In many cases, improving iron levels can help reduce these sleep disturbances.

How Much Iron Is Needed In Pregnancy?

During pregnancy, your blood volume is expanding by almost 50%! That means that most mothers need to think about their nutrition to make sure they are getting enough nutrients to support this expansion. Most people who aren’t pregnant need 18 mg of iron per day. During pregnancy, you need 27 mg of iron or more.

How can you make sure you are meeting this goal? Try the Brewers Diet. The Brewer’s Diet is a popular diet focused on supporting blood expansion. It focuses on a healthy amount of protein, lots of fruits and vegetables and salt to taste. Many women are able to get enough iron through their diet in their pregnancy if they are eating with focus and intention. Others find that an iron supplementation is necessary. Our guide to iron supplementation in pregnancy will help you know which prenatal vitamins have iron and which don’t.

A Word Of Caution About Iron Supplementation

The reality is that we are all individuals and one recommendation or supplement dose is not going to be right for everyone. Before I say goodbye, I’d like to add one small word of caution. It may seem like a good idea to supplement ‘just in case’ but the reality is you should be looking for the right amount for you. Why? Because too much of a good thing can also be a problem.

High ferritin (a measure of iron levels) can also cause damage. For example, one study found that women who have high levels of iron at the beginning of pregnancy (above 64 ng/mL in early pregnancy) were more likely to have hypertensive disorders like preeclampsia in the end of pregnancy.

How To Get Your Iron Levels Tested

In 2024 the US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the evidence on the benefits and harms of screening and supplementation for iron deficiency with and without anemia. They decided that if a woman was not experiencing symptoms, it was not important for her to have a blood test.

Personally, I am not a medical professional, so I can’t really agree or disagree with this, but one thing I have noticed is that while it may not make sense for women without symptoms to get a blood test, even women experiencing symptoms are struggling to get a proper evaluation. Too often these symptoms are seen as not important enough to warrant investigation. Is a blood draw too difficult or time consuming to order? Unfortunately, many of the mothers I work with have had to ask their doctors and ask their doctors again to get a blood test + recommendations for how to move forward. Luckily, persistence has often led to better conversations with their providers. Ultimately these blood tests have led to solutions ranging from supplementation, to infusions to changes in nutrition.

Because I’ve had client whose symptoms have been ignored when brought up with their medical providers, I’d like to offer another way for you to look into your iron levels. Did you know that dieticians can also do lab work? Many insurance companies fully cover mothers who want to work with a dietician in their pregnancy through a company like Nourish. They can also order blood work and help you get to the bottom of underlying causes of fatuge. If you have a preference for food first solutions, or are having troubles getting the proper blood work done through your provider, this is often a perfect complimentary resource!

That said, you should always consult your medical provider if you feel something is off in your pregnancy. Especially if you see symptoms like these piling up. Iron deficiency can continue into postpartum if not addressed in pregnancy. The sooner it’s discovered and treated, the better.

I hope this article gave you a bit of clarity on if what you’re feeling could be signs of iron deficiency in pregnancy and the motivation to bring it up in your next appointment if needed.

Works Cited

Al-Qassab ZM, Ahmed O, Kannan V, et al. Iron Deficiency Anemia and Migraine: A Literature Review of the Prevalence, Pathophysiology, and Therapeutic Potential. Cureus. 2024;16(9):e69652. Published 2024 Sep 18. doi:10.7759/cureus.69652

Hunt MG, Belfer S, Atuahene B. Pagophagia improves neuropsychological processing speed in iron-deficiency anemia. Med Hypotheses. 2014 Oct;83(4):473-6. doi: 10.1016/j.mehy.2014.07.016. Epub 2014 Aug 5. PMID: 25169035.

Ipsiroglu OS, Pandher PK, Hill O, et al. Iron Deficiency and Restless Sleep/Wake Behaviors in Neurodevelopmental Disorders and Mental Health Conditions. Nutrients. 2024;16(18):3064. Published 2024 Sep 11. doi:10.3390/nu16183064

Fang Z, Zheng S, Xie Y, Lin S, Zhang H, Yan J. Correlation between serum ferritin in early pregnancy and hypertensive disorders in pregnancy. Front Nutr. 2023 Apr 17;10:1151410. doi: 10.3389/fnut.2023.1151410. PMID: 37139443; PMCID: PMC10149942.

US Preventive Services Task Force. Screening and Supplementation for Iron Deficiency and Iron Deficiency Anemia During Pregnancy: US Preventive Services Task Force Recommendation Statement. JAMA. 2024;332(11):906–913. doi:10.1001/jama.2024.15196