Feature Articles

Anemia Myth Busters: Ice Chewing, Hair Loss and Lack of Sleep

November 24, 2009
The Anemia Myth Busters series discusses some commonly recognized symptoms, causes, behaviors and acquired conditions which may have correctly or incorrectly become associated with anemia.

General Anemia Symptoms

Anemia is a lower than normal level of red blood cells in the body that can cause a variety of different signs and symptoms. Traditionally, anemia can make you feel tired, fatigued, weak, dizzy, irritable, short of breath or depressed. With anemia, you may also have pale skin, brittle nails, chest pain, a coldness in your hands or feet, or an irregular heartbeat. Some people with anemia may experience sexual dysfunction or have trouble concentrating or performing mental tasks.

It’s also important to know that with mild anemia you may not experience any symptoms, or the symptoms may be so mild that they are not noticeable. As anemia becomes more severe, your related symptoms can get worse. However, if your anemia develops rapidly, you may notice the symptoms right away.

De-Mystifying Anemia

The following questions cover three different facts or misconceptions about anemia. Each answer presents evidence, or lack of evidence, which discusses the connection each item has with anemia under current, documented medical knowledge.

Does chewing ice represent a symptom of anemia?

Yes, a desire to chew ice is a sign that you may have an iron deficiency and that you could be anemic. This type of abnormal craving for non-food items is called pica. “Ice eating is the most common, but eating starch, paper or clay are also common forms of pica and patients will not usually volunteer this type of behavior,” said Dr. Jerry Spivak, a hematologist and Professor of Medicine and Oncology at the Johns Hopkins University.

Why this craving emerges in iron deficient people is not known. If you recognize a desire to eat these items, or any non-traditional foods, be sure to talk with your doctor about your cravings and habits.

Is hair loss a consequence of anemia?

Anemia does not cause your hair to fall out either temporarily or permanently. But some patients may have anemia when something else causes their hair to fall out. This can happen because, “The same factors that may lead to anemia, such as vitamin deficiency, hyperthyroidism or cancer chemotherapy, may cause hair loss; so an association between hair loss and anemia is fairly common,” said Dr. Lodovico Balducci, Chief of the Division of Geriatric Oncology, Senior Adult Oncology Program at the H. Lee Moffitt Cancer Center & Research Institute.

There are several reasons you may start to lose hair, including a family history of hair loss, diabetes, skin conditions like lupus erythematosus or lichen planus, certain thyroid conditions, hormonal changes, emotional or physical stress, excessive use of hair products or hair-styling techniques which pull the hair, poor nutrition, some extreme diets, and radiation therapy or chemotherapy.1 Discussing unexpected hair loss and any anemia-related symptoms with your doctor may help him or her provide the treatment that is best for you based on what is causing your symptoms.

Does a lack of sleep lead to anemia?

A lack of sleep does not directly cause anemia. Some people may, however, think the two are connected because people with anemia and people who are not getting enough sleep can experience some of the same symptoms. A few of these overlapping symptoms can Dr. Balducci quoteinclude fatigue, weakness, irritability and lack of concentration. Despite no documented direct link, there is a chance that a reason for missing sleep, like an illness or general discomfort, could also be contributing to anemia.

Ultimately, anemia is a condition of the blood that can be caused by nutritional deficiencies, inherited blood disorders, infections, menstruation, blood loss, exposure to a drug or toxin, or chronic diseases like cancer, diabetes, inflammatory bowel disease, kidney disease, heart disease, hepatitis C, HIV/AIDS, and rheumatoid arthritis. There are numerous free resources devoted to several types of nutritional and disease-related anemias, including our Information Handouts, and the Symptoms Quiz.

Consult With Your Doctor

Chronic Conditions Can Lead to Anemia

See the patient handouts which explain how conditions such as cancer, kidney disease, heart disease, diabetes and others can cause patients to get anemia. Information Handouts

Although certain symptoms can alert you to the presence of anemia, only a doctor can determine if you are anemic by performing a routine blood test. The blood test will measure your hemoglobin or hematocrit level which will determine if you have enough red blood cells to distribute oxygen throughout your body. Close communication with your doctor will help him or her provide the treatment that is best for you based on what is causing the anemia.


  1. Mayo Clinic. Diseases and Conditions: Hair Loss. Link. Accessed: November 16, 2009.