Iron Deficiency and Shortness of Breath: What’s the Connection?

Feeling short of breath can be really hard, especially when it seems to come out of nowhere. While there are many possible reasons for breathlessness, one commonly missed cause is anemia. When you’re anemic, your body struggles to transport oxygen efficiently, and your breathing often gets affected. Understanding the connection between iron deficiency and shortness of breath can help you take the right next steps. 

Understanding Anemia

Anemia is a common blood disorder, affecting approximately one-fourth of the global population. It is the condition that occurs when your body doesn’t have enough healthy Red Blood Cells (RBCs) to carry oxygen efficiently. 

Iron deficiency is the most common cause of anemia (iron-deficiency anemia). When your body doesn’t have enough iron, your bone marrow cannot synthesize hemoglobin. Hemoglobin, a protein in your red blood cells, carries oxygen from your lungs to the tissues. When hemoglobin levels are low, your blood cannot transport oxygen throughout your body. 

Symptoms

The symptoms include:

• Fatigue
• Lightheadedness
• Dizziness 
• Irritability
• Shortness of breath 
• Muscle cramps
• Pale skin
• Faster heart rate
• Craving for non-edible items (paper, ice, etc.)

Causes and Risk Factors

The causes may include:

• Not getting adequate iron from the diet
• Malabsorption of iron
• Blood loss while menstruating or from gastrointestinal diseases

The main risk factors for this type of anemia are pregnancy, breastfeeding, frequent blood donations, a history of gastrointestinal surgery, and menstruation. 

How Iron Deficiency Affects Breathing?

Now that you know iron helps your body make hemoglobin, it’s easier to see the connection. When iron levels are low, hemoglobin levels drop, and less oxygen is delivered to your muscles and tissues. As a result, you may experience shortness of breath because there are not enough red blood cells to carry oxygen. 

When your body isn’t getting the oxygen it needs, it compensates by making you breathe faster or harder. This is why iron deficiency and iron-deficiency anemia can leave you feeling short of breath, even during daily activities.

You might notice that your shortness of breath feels worse at night. Wondering why? The reason is simple: lying down can make it difficult to breathe. The condition is known as orthopnea, which refers to the shortness of breath that occurs when you lie down. In this position, extra pressure is placed on the diaphragm, and breathing becomes more effortful. 

That said, orthopnea can also be caused by other medical conditions, including heart failure. So it’s important to discuss with your healthcare professional if you observe increased shortness of breath when lying down. This can help them determine whether iron-deficiency anemia is the contributing factor or if there’s any other underlying issue. 

When to Take Shortness of Breath Seriously?

Shortness of breath should always be taken seriously and evaluated, as it can indicate serious underlying conditions.

However, if breathlessness is caused by anemia, it is generally treatable once properly identified. 

If shortness of breath is accompanied by symptoms such as paleness, dry skin, dizziness, fatigue, heart palpitations, or brittle fingernails, iron deficiency may be a possibility. That said, the only way to know for sure what’s causing your symptoms is through proper testing. You should never assume anemia is the cause without confirmation.

Treating Shortness of Breath From Iron Deficiency

If your shortness of breath is due to iron deficiency, correcting your iron levels can help you feel better. You can support iron levels through the food you eat, alongside medical guidance. 

Here are some iron-supportive foods:

• Red meat: A small serving (100 grams) provides a significant amount of iron (15% of the daily recommended iron intake), along with protein, zinc, and B vitamins.
• Spinach: A 100-gram serving of raw spinach gives you 15% of the daily recommended iron intake. 100 grams of raw broccoli contains 
• Shellfish: Oysters, clams, and mussels are good sources of iron. A 100 g serving of clams gives you 17% of the recommended daily iron intake.
• Blackstrap molasses: It is made from the sugarcane plant and is an excellent source of plant-based iron. One tablespoon of molasses amounts to about 20% of your recommended daily iron intake.
• Legumes: Legumes (lentils, chickpeas, and beans) are an excellent source of iron. For instance, one cup of cooked lentils gives you 37% of the recommended daily iron intake. 

Sometimes food isn’t enough, especially if iron levels are very low. In those cases, a healthcare provider may recommend iron supplements. 

Your healthcare provider may also recommend oxygen therapy, breathing techniques, or bronchodilators to help manage shortness of breath. 

You can also try the Shortness of Breath Program included in our Optimal Breathing Self-Mastery Kit, a structured breathing improvement course designed to help you address and overcome shortness of breath.

The Bottom Line

If you feel short of breath on a regular basis, especially if it’s new, worsening, or more noticeable at night, don’t ignore it. Talk to a healthcare professional who can run bloodwork and look at the full picture. 

It might be anemia, and it might be something that can be improved with dietary changes. But it could also be something more serious. Either way, getting checked is the right next step.