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Tired all the time? The 3 subtle warning signs to look out for in your mouth or risk life-threatening heart problems

IT’s dark when you wake up in the morning and it’s pitch black by the time you get home from work, so it’s no wonder you feel tired all the time.

But something far more serious than the weather could be causing your fatigue.

Nutrient deficiencies you didn’t know you had could be sapping your energy and putting you at risk of serious complications, experts warn.

While headaches and heart palpitations can be symptoms, you can also spot several tell-tale warning signs in your mouth.

Dr Andrej Bozic, an oral surgeon at Dentum, says: “The mouth can be a mirror of what’s happening in the body and is often the first to show signs of deeper issues.

“Pay attention to it – it could save your health.

“For example, iron deficiency anaemia, a condition where the body lacks the necessary iron to produce healthy red blood cells, often shows subtle signs in the mouth.

“When iron levels drop, reduced oxygen delivery affects oral tissues, leading to noticeable changes.

“Despite its potential impact on oral health, many people don’t recognise these early signs until the deficiency becomes more serious.”

Key oral symptoms include pale gums, a smooth or sore tongue (atrophic glossitis), and cracks at the corners of the mouth (angular cheilitis).

“Atrophic glossitis, where the tongue appears smooth and inflamed, is one of the more striking signs of iron deficiency,” Dr Bozic says.

“It occurs because the body lacks the haemoglobin needed to repair and maintain tissues.”

Pale gums, another common indicator, result from a reduced red blood cell count.

“Patients often don’t realise pale gums could signal a systemic issue like anaemia,” he says.

“It’s something dentists spot during routine check-ups.”

Angular cheilitis, or painful cracks at the mouth’s corners, is also linked to anaemia.

Left untreated, anaemia can lead to serious health issues, including heart problems

Dr Andrej BozicOral surgeon

“Iron deficiency weakens the immune system, making infections more likely and causing these cracks to persist,” Dr Bozic says.

Deficiencies like anaemia can usually be treated with iron tablets.

You can also make small changes to your diet.

“Eat foods like spinach, beans, red meat, or fortified cereals,” he says.

“For vegetarians or vegans, find plant-based iron sources like beans, peas and lentils, and consider supplements if needed.”

'Troubling' rise in hospital admissiosn for deficiencies

By Eliza Loukou, Health Reporter

THERE has been a “troubling” increase in the number of people being admitted to hospital with health problems caused by dangerous vitamin deficiencies, fresh data shows.

In 2023/24, there were 191,927 hospital admissions in England due to a lack of iron – this number was up 11 per cent on the previous year’s 173,227.

The figure is also almost 10 times higher than the 20,396 hospital admissions for a lack of iron in 1998/99.

Meanwhile, there were 2,630 admissions in 2023/24 whose main reason was B vitamin deficiency (other than folate), up 15 per cent on the 2,236 recorded in the previous year and more than triple the 833 in 1998/1999.

Vitamin B12 or folate deficiency anaemia led to 3,490 hospital admissions in 2023/24, similar to the previous year, but up four-fold from 836 in 1998/99.

The numbers were even higher when taking into account patients admitted for any reason but also recorded as having a vitamin deficiency.

In 2023/24, there were 804,936 courses of NHS treatment involving people who had iron deficiency anaemia, up from 721,650 the year before.

There were also 38,140 courses of treatment involving people with vitamin B12 deficiency anaemia, up from 35,983 the year before, alongside 227,097 for other B vitamin deficiency, up from 201,320.

The data further showed 486 courses of treatment involved people with vitamin C deficiency, up from 338 the previous year, while 773 involved a lack of calcium, up from 758.

Professor Kamila Hawthorne, chairwoman of the Royal College of GPs, said: “It is very concerning that cases of nutrition-related anaemia serious enough to warrant hospital admission have seen such a substantial increase over the past 25 years.

“The near 10-fold rise in admissions for patients with a diagnosis of iron deficiency and a four-fold increase in folate deficiencies – primarily caused by a lack of nutrition in the diet – is particularly troubling.

“While treatable with supplements or dietary changes, it comes with the risk of complications – in children, iron deficiency can be detrimental to development and has been linked to poorer attainment at school.”

But the most important thing to remember, Dr Bozic says, is early detection is “crucial”.

“Left untreated, anaemia can lead to serious health issues, including fatigue, heart problems and delayed healing of oral tissues,” he adds. 

“Don’t dismiss signs like sore gums or unusual tongue appearance.

“Your dentist may be the first to notice these subtle signs, so it’s vital to take them seriously.

“We recommend further tests to rule out anaemia or other underlying conditions if we see these signs.

“Dentists don’t just care for your teeth.

“Routine check-ups can uncover broader health concerns, like iron deficiency.”

How to spot an iron deficiency - and the dangers of leaving it untreated

IRON deficiency anaemia is caused by lack of iron.

This is often due to pregnancy or blood loss, but it can have many causes.

The most common symptoms are:

  • Tiredness and lack of energy
  • Shortness of breath
  • Heart palpitations
  • Paler than usual skin
  • Headaches

But many people also experience: a ringing, buzzing or hissing inside the head, food tasting strange, itchiness, a sore tongue, hair loss, wanting to eat non-food items, painful sores (ulcers) in the corners of the mouth, nail changes, pale gums, and restless leg syndrome.

If you think you might be iron deficient, speak to your GP. They will ask you questions about your lifestyle and medical history.

If the reason for the anaemia is not clear, they might order some tests to find out what might be causing the symptoms. They might also refer you to a specialist for further checks.

This will usually involve a full blood count test, which will find out if the number of red blood cells you have is normal.

If not, taking iron tablets for six months will likely be recommended. But you can also eat more dark green leafy vegetables, fortified breads and cereals, meat, dried fruit and pulses, and consume less tea, coffee, milk and dairy.

If left untreated, iron deficiency anaemia can:

  • Put you at increased risk of illness and infection
  • Make you more likely to develop complications that affect the heart or lungs, such as an abnormally fast heartbeat or heart failure
  • Cause a greater risk of complications before and after birth if you’re pregnant

Source: NHS

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