For many women and teenagers, feeling tired all the time has quietly become part of everyday life. Fatigue, hair fall, dizziness or poor concentration are often brushed aside as stress, busy schedules or hormonal changes. Yet, behind these seemingly ordinary complaints, anaemia continues to run deep, even among educated urban families who believe they are eating well and doing the right things.
Doctors say that the issue today is more complex than just low iron intake. Dr Kona Lakshmi Kumari, minimal access and robotic GI surgeon, metabolic and bariatric surgeon at Yashoda Hospitals, Hyderabad, explains that the problem often begins in the gut. “Low iron consumption is a common cause for anaemia, but in many cases, particularly in women and teenagers, the problem lies not only in nutrition but also in the gut’s ability to absorb minerals. Poor gut health can make it more difficult for the body to use iron, and other vital nutrients, even with regular meals, which can result in chronic anaemia,” Dr Kona says.
She points out that inflammation, infections and bacterial imbalance in the digestive system can interfere with absorption. “Nutrient absorption may be hampered by poor gut health, including inflammation, infections, or bacterial imbalances. Even with regular meals, the body finds it more difficult to take iron from food due to hormonal changes, stress, and dietary habits (such as consuming junk food frequently),” Dr Kona explains.
This challenge is something Dr Venkata Krishna Kumar Talluri, consultant physician and diabetologist at Renova Century Hospitals, Banjara Hills, sees almost daily. “As a physician, anaemia is one of the most common diagnoses seen in adolescent girls and young women. What is striking today is not just how prevalent it remains, but how often it is seen in students, professionals, and women from educated urban families — despite years of public health messaging and iron supplementation programmes,” Dr Venkata says.
While many patients take iron tablets, improvement is often slow or absent. Dr Kona explains why supplements sometimes fail. “Indeed, digestive issues including acid reflux, IBS, celiac disease, and persistent inflammation can all subtly cause anaemia. For instance, the small intestine is harmed by celiac disease, which hinders the absorption of iron and other nutrients. In addition to decreasing iron absorption, chronic inflammation raises the body’s need for iron,” she says.
Lifestyle habits add another layer to the problem. Dr Venkata notes: “A recurring challenge in practice is poor iron absorption. Many patients take iron with tea or coffee, unaware that this significantly reduces its efficacy. Others take it alongside milk, calcium supplements, or antacids. We encounter underlying causes such as chronic gastritis, helicobacter pylori infection, celiac disease, vitamin B12 or folate deficiency, or ongoing blood loss from heavy menstrual bleeding — conditions that are easily missed unless specifically looked for.”
When anaemia keeps returning despite diet changes, doctors urge a deeper look. Dr Kona stresses, “An assessment of the digestive system should be prompted by recurrent or inexplicable anaemia, particularly if dietary modifications and supplements are ineffective.”
Both doctors agree that anaemia today cannot be fixed with tablets alone. It needs sustained dietary care, attention to gut and menstrual health, and timely medical evaluation. More than just a nutritional issue, anaemia has become a reflection of modern lifestyles, silent symptoms and delayed diagnosis, especially among young girls and women who continue to power through exhaustion without realising their bodies are asking for help.