Fatigue, breathlessness on stairs, pale skin, brittle nails, cold hands, craving ice or clay — in Pakistan these are so common in women they're treated as normal. They are not. Around 40–50% of Pakistani women are anemic, mostly from iron deficiency.

Why it matters

Anemia steals energy and concentration, complicates pregnancy (it's a major factor in maternal deaths), and in children impairs growth and learning. And it is almost always fixable.

Confirming it

A CBC (hemoglobin) costs a few hundred rupees anywhere. Below ~12 g/dL in women (11 in pregnancy) is anemia; a ferritin test confirms iron deficiency. Heavy periods, frequent pregnancies, and tea-with-every-meal (tea blocks iron absorption) are the usual culprits — but new anemia in an older adult needs a doctor's evaluation, not just iron tablets.

Fixing it properly

  • Iron tablets daily for at least 3 months — hemoglobin normalizes first, but stores take longer; stopping early is why it comes back
  • Take iron with vitamin C (a glass of lemon water), not with tea or milk
  • Iron-rich foods help maintain: kaleji, red meat, spinach, lentils, dates
  • Recheck CBC after 6–8 weeks

Source: National Nutrition Survey of Pakistan; WHO — Anaemia. This article is general guidance, not a diagnosis.