There were almost 200,000 people admitted to hospital in England last year because of low iron levels, according to a new report. That’s a rise of 11% on the previous year, up almost 10 times on figures from 25 years ago, when only 20,000 were admitted.

Previously, it was thought around 8% of British women and 3% of men have low iron levels, but clearly it’s a problem that is on the rise, and one that the NHS is labelling a significant health issue.

Iron gives us strength and energy for day-to-day life, as Dr Ferras Alwan a consultant haematologist at the Harley Street Clinic, part of HCA Healthcare, explains. “Iron is essential for producing haemoglobin, which is the component of red blood cells that carries oxygen throughout the body.

"Without adequate iron, your body struggles to produce enough healthy red blood cells, leading to fatigue, compromised immune function and even heart complications and hospitalisation.”

But if your iron levels drop, it isn’t always immediately obvious – and many of us could be lacking the essential mineral without even realising it. So what are the signs that you should be looking for, and what should you be doing if you have them?

Dark circles, hair breakage and brittle nails Don’t assume the dark circles under your eyes are simply a sign of too many late nights. And if you have bendy, brittle or breaking nails, don’t blame those gel manicures, or curse your shampoo if your hair is losing shine or condition. “Dark circles, brittle nails, hair loss or hair losing its condition are all physical signs that can point to low iron,” says Dr Alwan.

With an iron deficiency, your haemoglobin levels (a protein in red blood cells that carries oxygen throughout the body) are low, meaning the body's tissues don't receive enough oxygen. As the skin around your eyes is the thinnest anywhere on the body, the impact of this deoxygenation is more visible here, causing the skin around to appear darker.

And it really can give you a bad hair day - or week - too. "Nail and hair cells can’t regenerate effectively if your body’s iron stocks are severely depleted," adds Dr Alwan. “The body prioritises iron for essential functions, so when stores are low, non-vital areas such as hair and nails often show the first tell-tale signs of deficiency."

Feeling anxious You might be feeling more anxious than usual or struggling to keep your concentration. Dr Alwan says mood changes are another possible consequence of low iron. “Iron plays a role in brain function, so low levels can contribute to symptoms such as irritability, poor concentration, and depression.”

Being worn out It’s easy to shrug off feeling exhausted as part of modern life, but if you regularly nod off in the early evening and never feel completely rested, perhaps your iron levels are to blame. “Extreme tiredness can be challenging to gauge, as many of us deal with busy lives and stress,” says Dr Alwan. “However, if your tiredness is persistent and not alleviated by rest, it could be a marker of iron deficiency.”

Dizzy spells If everyday movement leaves you out of breath or dizzy, it could be a sign your iron is low. Similarly, feeling weak, faint or light-headed could be due to anaemia, where the body doesn’t have enough red blood cells to carry oxygen throughout the body. Dr Alwan stresses that it’s important to take these signs seriously. “Symptoms such as dizziness, palpitations and shortness of breath or persistent fatigue should prompt medical attention,” he says. “If you experience these signs, it’s essential to seek advice promptly, as early intervention can prevent the condition from worsening.”

So what’s the cure? After a blood test, you might be prescribed iron tablets. However, these are not an overnight fix, as Dr Helen Wall, a GP from Bolton, explains. “Restoring iron levels with iron tablets is not a quick thing to do. Typically, it takes three to six months to restore. It’s important to manage the cause of the iron deficiency, such as heavy bleeding, otherwise it’s going to continue, regardless of how much iron you take.”

Low iron is more common in women than men because of their monthly cycle, adds senior consultant gynaecologist Dr Nitu Bajekal. “Medically, heavy periods can cause anaemia, making you feel tired and low in energy. If blood loss is more than 80ml, then this is called menorrhagia. Heavy bleeding can be more common in perimenopause as well as in conditions such as endometriosis.”

And while iron tablets will rebuild the body’s iron stocks, they can often bring about side-effects including constipation or loose stools. Iron can turn poo black and tar-like too. Dr Wall says persevere and maybe seek a different medication.

“Many people get gastro side-effects like bowel changes so, if you are affected, discuss with the pharmacist or healthcare provider, don’t just stop taking iron. There are different formulations and dose changes that can help.”

To boost tablets’ effectiveness, Dr Wall advises: “Take them at least 30 minutes before a meal and avoid any other meds for about two hours.” Taking iron with vitamin C such as orange juice can also boost its absorption.

Far gentler on the stomach are supplements containing iron which can be taken pre-emptively as Phil Beard, nutritionist at Viridian Nutrition explains: “By prioritising iron maintenance through supplementation, you’re supporting balanced energy levels and reducing the likelihood of needing intensive iron treatments in the future.”

How diet can help What’s on your plate can certainly give iron levels a helping hand. However, what you eat and when is key. Popeye famously necked spinach for strength, but iron sources from plants don’t always provide as much of the nutrient as animal products.

Beard explains, “A food-first approach to iron can sometimes fall short because dietary iron is not always absorbed efficiently, especially from plant sources, which provide ‘non-heme’ iron. Iron from plant sources like beans, lentils, spinach, and fortified cereals is less effectively absorbed by the body.”

We know meat contains iron, but not everyone consumes enough. “While red meat, poultry, and fish are rich in heme iron, the most bioavailable form, many people don’t eat these foods regularly or avoid them for dietary or ethical reasons,” he adds.

Yet what’s in your kitchen cupboards can still be a good way to bolster iron reserves: hazelnuts, Brazil nuts, peanut butter and dried fruit such as figs, apricots and dates all contain higher levels of iron.

Seeds, too, can be a great addition to meals, especially sesame and sunflower seeds. Tinned goods like butter beans, chickpeas and baked beans all offer iron and most of our breakfast cereals are iron-fortified, too.

Nutritionist and author of Unprocess Your Family Life, Rob Hobson, says what you eat alongside iron-rich foods can play an integral role if trying to boost iron intake.

“Combining plant-based iron sources with foods high in vitamin C, such as red peppers or broccoli, can enhance the absorption of this mineral. It’s also wise to avoid tannins, which are found in tea, and caffeine when taking iron, so postpone your morning cuppa for a couple of hours to allow the iron to get to work in your system.”

You may have heard red wine is an iron-rich alcoholic drink, but Rob is keen to debunk this old wives’ tale. “Regular or heavy drinking can interfere with how well your body absorbs nutrients,” he says.

“Additionally, alcohol can irritate the lining of your stomach and gut, so, if you’re drinking a lot it could impact your iron absorption and how well your body manages iron overall. “For occasional drinkers, however, moderate alcohol intake is unlikely to significantly impact iron absorption.”