Many people with iron deficiency anaemia only have a few symptoms. The severity of the symptoms largely depends on how quickly anaemia develops. You may notice symptoms immediately, or they may develop gradually if your anaemia is caused by a long-term problem, such as a stomach ulcer. The most common symptoms include: tiredness and lack of energy (lethargy) shortness of breath noticeable heartbeats (heart palpitations) a pale complexion Less common symptoms include: headache hearing sounds that come from inside the body, rather than from an outside source (tinnitus) an altered sense of taste feeling itchy a sore or abnormally smooth tongue hair loss a desire to eat non-food items, such as ice, paper or clay (pica) difficulty swallowing (dysphagia) painful open sores (ulcers) on the corners of your mouth spoon-shaped nails