In my classes and on the internet, brittle nails and dry hair (or hair loss) are described as symptoms of iron deficiency anemia, but none explains the cause of such symptoms.

Does anyone have any clues or explanation of such symptoms?

  • $\begingroup$ Can you provide the link to the sources that say so? Because frankly I havent heard of these as anemia symptoms $\endgroup$
    Apr 9, 2013 at 14:03
  • $\begingroup$ It would likely depend on the type of anaemia - deficiencies in iron, B12 & folate, anaemia of chronic disease, haemolytic anaemia etc. I haven't heard of this as a symptom of anaemia myself, however it is possible that it could be as a side effect of the problem that is causing anaemia (anaemia never being a spontaneous disease, always having an underlying cause). $\endgroup$
    – Rory M
    Apr 9, 2013 at 18:28
  • $\begingroup$ Another clarification I would like to make. Anemia is a condition which is defined by reduced RBC count. Anemia is one of the things that Iron deficiency causes. Other effects of iron deficiency can be syndromic or even correlated (without dependence) with anemia but cannot be called as symptoms of anemia. And as @RoryM mentioned there can be other reasons for anemia. $\endgroup$
    Apr 10, 2013 at 6:46

2 Answers 2


The molecular basis of copper-transport diseases in Trends in Molecular Medicine, Volume 7, Issue 2, 1 February 2001, Pages 64–69, has a link to a 1973 paper by JM Gillespie entitled "Keratin Structure and Changes with Copper Deficiency," stating

Menkes patients are often diagnosed from their unusual hair structure – termed pili torti – also known as kinky or steely hair, caused by reduced keratin cross-linking, a process that is catalyzed by an uncharacterized copper oxidase.

I haven't been able to find anything further, but since iron and copper levels can both be affected in anemia, this may be the link you're looking for. There may also be other enzymes involved that use iron-mediated catalysis. Since there are so many different kinds of keratins (the major protein that makes up hair and nails, among diverse other functions in the body), there may easily be multiple cross-linking and assembly pathways.

Other websites I found have also claimed that anemia-associated pathologies with hair and/or nails may be related to reduced oxygenation as a result of low iron levels, but they don't give any citations, and given the nature of the sites (nail care, fashion, etc.) it may just be an educated guess.

  • 1
    $\begingroup$ "but since iron and copper levels can both be affected by anemia" ..... It is the other way round. Iron deficiency causes anemia not vice versa. A small addition to your answer (some guesswork): proline and lysine hydoxylase require iron cofactor and this enzyme helps in forming mature collagen. Nonetheless the symptoms mentioned in the question are unlikely to be first signs of iron deficiency $\endgroup$
    Apr 9, 2013 at 14:52
  • $\begingroup$ sorry, I could have worded it better, I was in a hurry :) Yes, anemia (in general) is defined as a deficiency in something, and in common usage the word anemia alone is typically taken to mean iron anemia or iron deficiency. What I meant is that copper levels can also be affected by iron anemia. $\endgroup$
    – MattDMo
    Apr 9, 2013 at 18:25
  • $\begingroup$ But do you think collagen synthesis can be affected ?? $\endgroup$
    Apr 9, 2013 at 18:52
  • $\begingroup$ @WYSIWYG I'm not sure what collagen has to do with it - fingernails and hair are make up primarily of keratins... $\endgroup$
    – MattDMo
    Apr 9, 2013 at 18:55
  • $\begingroup$ it has got nothing to do with fingernails but the thought just popped in my head that iron deficiency may affect ECM. NOnetheless, all this fingernail and hair symptoms seem dubious to me.. I cant find any reliable source which claims so $\endgroup$
    Apr 9, 2013 at 19:06

I did some searches on the relationship between iron deficiency anemia (IDA) and hair loss. Surprising, there are lots of debates about this and I don't think anyone has a solid reason.

If iron deficiency is related to hair loss then taking iron supplement may potentially reverse the effect. However, this article pointed out that:

....there is insufficient evidence to recommend giving iron supplementation therapy to patients with hair loss and iron deficiency....

My understanding is, human body actually contains very little amount of iron. And most of the iron are involved in cellular respiration and oxygen exchange. Free floating iron is very toxic and bad for the body. Therefore most of the iron storage are in Hemoglobin (2/3), followed by ferritin+hemosiderin (about 1/3), some are utilized by the mitochondria (those awesome cytochromes and electron transport chains), lastly the transport vessel trans-ferritin.

I think Hair loss and brittle nail are just indirectly caused by IDA. Because most of the time IDA is cause by malnutrition. And usually the food sources that are contained the most iron are meat, poultry and egg. These food are also rich in protein. I think lack of meat protein-rich diet is the main reason of hair loss and brittle nail, and such diet leads to IDA. (Strict vegans, be careful about your food choices!)

  • $\begingroup$ There are several non-animal sources of iron- spinach, beans etc. $\endgroup$
    Apr 10, 2013 at 4:19
  • $\begingroup$ @WYSIWYG You are right. But as I said above, I think hair loss and brittle nails are not directly caused by IDA. It's caused by malnutrition. $\endgroup$
    – ohcanada
    Apr 10, 2013 at 4:29
  • $\begingroup$ Roger that.. :) [somehow the name tagging is not working] $\endgroup$
    Apr 10, 2013 at 4:31

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