You need iron to make hemoglobin. Hemoglobin is the protein your red blood cells need to carry oxygen to all the cells of your body. If you have iron-deficiency anemia, your red blood cells are not carrying enough oxygen. Since all your cells need oxygen to function, iron-deficiency anemia can have many signs and symptoms. It’s possible to have mild iron-deficiency anemia without any symptoms. When you do get symptoms, fatigue, or feeling very tired is the most common because your body is getting less oxygen and everything slows down. There are several other symptoms and signs your doctor may look for. Some of the symptoms may be surprising, and complications of iron-deficiency anemia can be severe and long-lasting. Common Symptoms of Iron-Deficiency Anemia Along with fatigue, you may notice: Shortness of breath Chest pain Weakness Whooshing in your ears Headache Sore tongue Cold hands and feet Lightheadedness Common Signs of Iron-Deficiency Anemia During a physical exam, your doctor may look for signs of iron-deficiency anemia. These can be caused by low hemoglobin and by the fact that you need iron for healthy skin, hair and nails. Common signs include: An abnormal heart sound or heartbeat Pale color of your skin, gums or nail beds Enlargement of your liver or spleen Brittle nails Hair loss Surprising Symptoms of Iron-Deficiency Anemia One of the most unusual symptoms of iron-deficiency anemia is a strange craving for chewing or eating. This craving is called pica. Doctors have recognized pica as a symptom of iron-deficiency anemia for centuries. They still don’t know why it happens. People with pica may crave chewing on ice or a rubber band. They may crave eating clay, starch, dirt, or paint chips. Children with pica may be in danger of lead poisoning from chewing lead paint chips. Women with iron-deficiency anemia may experience anxiety when it comes to sex. This may cause sexual problems and avoidance of sex. Although doctors don’t know the cause, treating the anemia with iron supplements relieves this symptom. Men and women with iron-deficiency anemia may be more likely to suffer from a condition called restless legs syndrome (RLS). RLS is a constant urge to move your legs. Your legs may feel strange and unpleasant. RLS can make it hard to sleep. RLS may be due to a lack of iron in certain brain cells. Complications of Iron-Deficiency Anemia Are Serious Untreated iron-deficiency anemia can have long-term or dangerous complications. These complications may be especially serious for pregnant women and children. They include: Children may develop long-term mental, physical and behavior problems. Pregnant women may be in danger of early delivery. Babies may be born with low birth weight. Mothers may develop depression after birth (postpartum depression). Iron deficiency may weaken your immune system and lead to increased infections. Abnormal or rapid heartbeat can eventually lead to heart failure. Considering the long-term health effects of untreated iron deficiency, it’s important to see your doctor if you experience symptoms of anemia. Your doctor can test your blood and look for signs of iron-deficiency anemia.