Anemia in India: more common than you think

Q: What is the hemoglobin level for diagnosing anemia?

According to WHO, anemia is diagnosed when hemoglobin is <130 g/L for men, <120 g/L for non-pregnant women, and <110 g/L for children. In India, a cutoff of 110 g/L is often used for women of reproductive age.

Q: What are the effects of iron deficiency?

Iron deficiency can cause fatigue, reduced physical performance, cognitive delays in children, impaired immune function, and complications during pregnancy such as low birth weight or premature delivery.

Q: What disease is caused by a deficiency of iron?

The most common disease caused by a deficiency of iron is iron deficiency anemia, where red blood cells become pale and small, reducing oxygen delivery to tissues.

Q: Why does iron deficiency occur?

Iron deficiency occurs due to low dietary intake of iron, poor absorption, blood loss (such as menstruation or hookworm infection), or increased iron needs during pregnancy, childhood, or adolescence.

Q: What are the symptoms of iron deficiency anemia?

Symptoms of iron deficiency anemia include fatigue, cold hands and feet, dizziness, pale skin, shortness of breath, and reduced ability to concentrate or perform physical tasks.

Q: How is iron deficiency diagnosed?

Iron deficiency is diagnosed using blood tests that measure hemoglobin, serum ferritin, transferrin saturation, and red blood cell indices. These tests help identify mild, moderate, or severe anemia.

Q: What is the best test to detect iron deficiency in the community?

The best test to detect iron deficiency in the community is a complete blood count (CBC). For accurate diagnosis, serum ferritin testing is also recommended.

Q: What are the types of anemia?

Common types of anemia include iron deficiency anemia, megaloblastic anemia (due to B12 or folate deficiency), dimorphic anemia (combination), and normocytic anemia (chronic disease).

Q: What is the prevalence of anemia in India?

According to NFHS-5, the prevalence of anemia in India is 67% in children (6–59 months), 57% in women, and 25% in men.

Q: What is the best medicine for iron deficiency?

The best treatment for iron deficiency includes iron supplements, often combined with folic acid and vitamin B12. Nutrition mixes like Good Monk Family Nutrition Mix, Healthy 50+, and Immunity Mix can also support daily iron intake.

September 9, 2025

Key Takeaways

Iron deficiency is the leading cause of anemia in India, especially among women and children.
Anemia is a major nutritional deficiency disease, affecting over half the population in some states.
Lack of iron-rich foods and poor absorption due to infections or poor diet are major contributors.
Untreated iron deficiency can lead to fatigue, poor immunity, and complications during pregnancy.

Anemia: The Silent Nutritional Deficiency Spreading Across India

The word ‘anemia’ may not sound very relevant to you, but it might be impacting your daily life. To find out if it is really affecting your lifestyle and daily lives, you must know what is anemia, who is at risk, and what the causes and symptoms of it are.

There are high chances it could be relevant to you too, as iron deficiency in india is one of the major public health problems that India is fighting. National survey data like NFHS and CNNS data speak about the huge prevalence of anemia in India.

According to NFHS-5 (2019–2021):

67% of children (6–59 months) are anemic
57% of women are anemic
25% of men are anemic

The CNNS (Comprehensive National Nutrition Survey, 2016–2018), conducted among Indian children and adolescents, reported (4):

41% of pre-schoolers are anemic
24% of school-aged children are anemic
28% of adolescents are anemic

What is Anemia?

Let us first understand the definition of anemia. Anemia is a deficiency in the size or number of RBCs (Red Blood Cells) or the amount of Hemoglobin (Hb) they contain. Hemoglobin’s role is to carry oxygen to vital body organs. Hence, in anemia, the oxygen-carrying capacity is reduced due to low Hb levels.

WHO defines anemia as a condition of having low hemoglobin (Hb) concentration, i.e., men having Hb concentration <130g/L, non-pregnant women <120g/L and children (6-59 months) <110g/L, but in the Indian context, a cut-off of 110g/ L is appropriate for women of reproductive age (2).

Types of Anemia:

There are types of anemia which are dependent on the size of RBC (viz., macrocytic, microcytic, normocytic) and Hb concentration (viz., hypochromic, normochromic). As the term suggests, microcytic means small RBC cells, normocytic means normal cell size, macrocytic means large cells, whereas hypochromic means less pale colour from deficiency of hemoglobin, normochromic means normal colour.

Hypochromic and microcytic anemia

Hypochromic and microcytic anemia is caused due to iron or pyridoxine deficiency- RBCs are pale and smaller in size than normal.

Megaloblastic anemia

Megaloblastic anemia is caused due to Vitamin B12 or folic acid deficiency- RBCs are larger in size but normally coloured.

Dimorphic anemia

If both iron and vitamin B12 or folic acid is deficient, it can cause dimorphic anemia- RBCs could be normal or large but pale in colour.

The idea is not to take you back to your biology class but to make you aware of the causes of anemia. Hence, understanding another classification of anemia i.e., nutritional and non-nutritional anemia is important. Nutritional anemia is caused by deficiency of iron, Vitamin B12, Folic Acid, Protein, Copper, etc. Other anemias could result due to hemorrhage, genetic abnormalities, other underlying diseases, certain medications, etc.

Nutritional and Non-Nutritional Causes of Anemia in India

Anemia is one of the most common nutritional deficiency diseases in India, especially among women and children. We all know prevention is better than cure, hence it’s better to know the causes of anemia if we want to prevent it in the first place or to treat the underlying cause. The following are the most common causes of anemia:

Iron deficiency
B12, folate deficiency
Poor nutritional status
Early pregnancy
Inadequate maternal care
Limited access to iron-rich foods
Low body weight

Iron Deficiency: Most Common Cause of Anemia

Among the various types of anemia, Iron Deficiency Anemia (IDA) is the most common one. Causes of IDA are as follows:

Poor diet with low intake of iron-rich foods
Poor iron absorption due to weak gut, gut-related conditions like diarrhea, celiac disease, atrophic gastritis, etc.
Excessive consumption of tea (contains tannins) can also interfere with the absorption of iron
Blood loss due to hemorrhage, menstruation, childbirth, hemorrhoids (piles), hookworm infestation
The body’s iron requirement increases during various life stages, like pregnancy, early childhood, teenagers. If the increased requirement is not met with proper intake of iron, it can lead to deficiency

Who is at Risk? Identifying High-Risk Groups for Iron Deficiency Diseases

Various life stages increase the risk of lack of iron, making some groups more vulnerable to anemia than others. The stages when one needs to be more cautious of anemia are as follows:

Children (especially under 5 years of age), because of rapid growth
Adolescent girls due to blood loss during menstruation
Pregnant women- Increase in blood volume and growth of the fetus
Women in the postpartum stage- due to the blood loss during childbirth

Symptoms Of Iron Deficiency Anemia

The deficiency of iron leads to reduced hemoglobin levels, which affects oxygen supply in the body. The following are the common symptoms that can be felt due to hemoglobin deficiency:

Fatigue, tiredness
Diminished physical work capacity
Shortness of breath
Dizziness (feeling light-headed)
Cold hands and feet
Headache

Effects Of Iron Deficiency Anemia:

Deficiency of iron leads to impaired cognitive and motor development in children
IDA can also affect focus and attention in school-going children
Can reduce work capacity in adults
In pregnancy, lack of iron can lead to perinatal loss, premature birth of child, low birth weight child

Anemia Mukt Bharat: Health Education For Anemia

Recognising the widespread burden of iron deficiency in India, a Public Health campaign called Anemia Mukt Bharat was launched in 2018 to fight against anemia in India (1). It includes the following six interventions, which are noteworthy (3):

Iron and folic acid (IFA) supplementation
Deworming
Behaviour change communication
Testing and treating anemia
Provision of fortified foods through public health programmes
Addressing non-nutritional causes such as malaria, hemoglobinopathies, and fluorosis.

Simple Diet and Lifestyle Tips to Prevent Deficiency of Iron

Sharing a few tips that can be easily incorporated into your daily routine to prevent anemia. Make sure you make the most out of it!

Vitamin C helps improve iron absorption. Squeezing some lemon juice in your dals, curries may help improve the bioavailability of iron in your diet. Including around 30g of fruits like Guava, which are a good source of vitamin C in diet, may also help.
Keep a gap of 20-30 minutes between your tea and meal consumption to prevent malabsorption of iron

Supplementation with iron, vitamin B12 and folic acid may prevent nutritional anemias. Good Monk Family Nutrition Mix, Healthy 50+ and Immunity Mix contains these nutrients, which can be taken by members of various age groups in the family.
Include rich sources of iron in your diet- Lentils (masoor dal), moth beans, black raisins, dates, green leafy vegetables (amaranth leaves, methi leaves, drumstick leaves, etc.)
Vitamin B12 can be sourced from eggs, milk, cheese, yoghurt, paneer, and fortified cereals in your diet.
Liver, legumes, spinach, green leafy vegetables, broccoli, cabbage, cauliflower, and oranges are common and good sources of folic acid.

References:

1. Ministry of Health and Family Welfare. (2025). India’s Fight Against Anemia Nourish, Prevent, Protect.

https://www.pib.gov.in/PressReleasePage.aspx?PRID=2122623

2. Givens DI, Anitha S, Giromini C. Anaemia in India and Its Prevalence and Multifactorial Aetiology: A Narrative Review. Nutrients. 2024 May 29;16(11):1673. doi: 10.3390/nu16111673. PMID: 38892606; PMCID: PMC11174870.

https://pmc.ncbi.nlm.nih.gov/articles/PMC11174870/#sec3-nutrients-16-01673

3. UNICEF. Anemia and its determinants from 2015-16 to 2019-21 in India.

https://www.unicef.org/india/stories/anemia-and-its-determinants-2015-16-2019-21-india

4. Ministry of Health and Family Welfare (MoHFW), Government of India, UNICEF and Population Council. 2019. Comprehensive National Nutrition Survey (CNNS) National Report. New Delhi

5. Chadha, R. & Mathur, P. (2018). Nutrition: A Lifecycle Approach. Orient BlackSwan.

6. Soldavini, J. (2019). Krause's food & the nutrition care process. Journal of Nutrition Education and Behaviour, 51(10), 1225.

FAQs on Iron Deficiency Anemia

1. What is the hemoglobin level for diagnosing anemia?

Anemia is diagnosed based on hemoglobin (Hb) concentrations in the blood. Accoring to WHO, the thresholds are:

<130g/L for men
<120g/L for non-pregnant women
<110g/L for children.

In India, a cutoff of 110g/L is often used for women of reproductive age.

2. What are the effects of iron deficiency?

Effects of iron deficiency include fatigue, reduced physical performance, cognitive delays in children, impaired immune function, and complications during pregnancy such as low birth weight or premature delivery.

3. What disease is caused by a deficiency of iron?

The most common disease caused by a deficiency of iron is iron deficiency anemia, where red blood cells become pale and small, reducing oxygen delivery to tissues.

4. Why does iron deficiency occur?

Why iron deficiency occurs can be due to low dietary intake of iron, poor absorption, blood loss (like menstruation or hookworm), or increased iron needs during pregnancy, childhood, or adolescence.

5. What are the symptoms of iron deficiency anemia?

Symptoms of iron deficiency anemia include fatigue, cold hands and feet, dizziness, pale skin, shortness of breath, and reduced ability to concentrate or perform physical tasks.

6. How is iron deficiency diagnosed?

Iron deficiency is diagnosed using blood tests that measure hemoglobin, serum ferritin, transferrin saturation, and red blood cell indices. These help identify mild, moderate, or severe anemia.

7. What is the best test to detect iron deficiency in the community?

The best test to detect iron deficiency in the community is a complete blood count (CBC). For accurate diagnosis, serum ferritin testing is also recommended.

8. What are the types of anemia?

Common types of anemia include:

Iron deficiency anemia
Megaloblastic anemia (B12 or folate deficiency)
Dimorphic anemia (combination)
Normocytic anemia (chronic disease)

9. What is the prevalence of anemia in India?

According to NFHS-5, the prevalence of anemia in India is:

67% in children (6–59 months)
57% in women
25% in men

10. What is the best medicine for iron deficiency?

The best medicine for iron deficiency includes iron supplements and combinations with folic acid and vitamin B12. Good Monk Nutrition Mixes like Family Nutrition Mix, Healthy 50+ and Immunity Mix can support daily iron intake.

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About the author:

This blog was written by Sreya Damani, Assistant Manager- Nutrition and Comms at Good Monk - a clean and honest nutrition brand supported by doctors and food scientists. Every product is backed thorough clinical evidence and clinically proven ingredients and made to help families eat better, feel better, and live healthier every day.

Disclaimer: The content of this blog reflects the author’s summary and interpretation of the topic. It is intended for informational purposes only and should not be considered a substitute for professional advice. The views expressed are not personal opinions but are based on existing research or expert insights, where referenced.

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