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Four in 10 teenage girls and young women may have iron levels low enough to cause symptoms such as low energy and dizziness, a new study suggests.
But most of them probably don’t know, because regular health screenings for their age group don’t include a blood test that measures the body’s iron reserves, called a ferritin test, the study’s lead author says.
On the more serious side, the study finds that one in 17 women ages 12 to 21 has iron levels low enough to qualify them for a diagnosis of iron deficiency anemia, which can cause life-limiting symptoms if not treated. treated.
The study, published in JAMAused national data from a broad sample of young women who participated in a health survey conducted by the Centers for Disease Control and Prevention.
While total iron deficiency in the study group was 40%, the rate was approximately 30% higher in both black and Latina young women compared to their non-Hispanic white peers. Women of other racial and ethnic backgrounds, taken as a group, were also slightly more iron deficient.
Meanwhile, those with household incomes close to or below the poverty line had 24% more iron deficiency than those with higher incomes.
While the study confirms the general link between menstruation and lower iron levels, it also shows that 27% of girls who had not yet had their first period already had low iron levels. Meanwhile, the rate of iron deficiency in the rest of the study group did not change with the number of years the young women had menstruated.
Lead author Angela Weyand, MD, a clinical associate professor of pediatrics at the University of Michigan Medical School, says the findings suggest it’s high time to consider routine screening of iron levels in adolescents and young women, even if they don’t have symptoms such as such as tiredness, cognitive or mental health problems, shortness of breath with exercise, pale or sallow skin, rapid heartbeat, or headache.
“Iron deficiency is an under-recognized problem with adverse outcomes, but the symptoms and even those of anemia have normalized in young women,” said Weyand, a Michigan Medicine pediatric hematologist who practices at the University of Michigan Health CS Mott Children’s Hospital. “Why don’t we screen for a condition that is common, easily diagnosed, easily treated, and associated with severe symptoms and an increased risk of death if left unaddressed?”
She notes that current testing recommendations focus on toddlers and people who are pregnant or have a cluster of symptoms suggestive of anemia.
In addition to the lack of screening at routine health care visits, Weyand notes that both young women and their health care providers do not routinely discuss menstrual bleeding. Thus, a young woman may not be aware that she has abnormally heavy periods that can accelerate iron loss.
For the new study, Weyand and her colleagues used ferritin and hemoglobin blood test data and other information from a national survey called NHANES. They analyzed data from 3,490 women ages 12 to 21 who participated between 2003 and 2020, with the exception of some years when ferritin levels were not collected. The analysis ruled out young women who were pregnant or showed signs of conditions that can interfere with iron levels, including diseases involving chronic inflammation, the kidneys or the liver.
The study focused on ferritin, the form of protein-coated iron that is stored in the liver and called up in the blood when the body needs more iron to help send oxygen to tissues and organs, or to make hormones. make and build cells. hair, skin and nails.
The team established a level of less than 25 micrograms per liter of blood (µg/L) as the definition of iron deficiency. But because experts don’t have a clear international standard for what level of ferritin is too low, they also looked at levels below 15 ug/L and 50 ug/L.
They also looked at hemoglobin and classified young women as anemic if they both had less than 12 milligrams per deciliter (mg/dL) of hemoglobin and 25 μg/L of ferritin.
In total, 39% of the young women had a ferritin level of less than 25 µg/L and 17% of less than 15 µg/L. When it came to iron deficiency anemia, 6% qualified for this diagnosis with a combined cutoff of 12 mg/dL hemoglobin and 25 µg/L ferritin.
They then looked at how ferritin and hemoglobin/ferritin levels varied between the young women based on their different characteristics. In addition to race, ethnicity and poverty, the researchers found other connections.
About a third of all young women in the study had a household income below 130% of the poverty line, and a slightly lower percentage reported experiencing food insecurity. Members of the low-income group were more likely to be iron deficient, and those with food insecurity were more likely to be diagnosed with anemia.
The average body mass index for the entire group was 22, but those with a lower BMI were more likely to be iron deficient.
Weyand hopes the findings will encourage health care providers to order ferritin tests from young female patients and advise them on eating foods rich in iron-both the form found in animal foods and those found in fruits, vegetables, nuts and seeds.
If ferritin levels are low, even with a well-rounded diet, health care providers may recommend a multivitamin with iron or oral iron supplements, which are inexpensive and available in formulations designed not to cause digestive problems. For people with more severe iron deficiencies, intravenous iron is also available.
In addition to Weyand, the study authors include her colleagues from the UM Department of Pediatrics Gary L. Freed, MD, MPH and Sung Won Choi, MD, MS, and colleagues from other institutions Alexander Chaitoff, MD, MPH; Michelle Sholzberg, MD, M.Sc. and Patrick T. McGann, MD, Ph.D. Freed is a member of the Susan B. Meister Child Health Evaluation and Research Center.
More information:
Angela C. Weyand et al, Prevalence of Iron Deficiency and Iron Deficiency Anemia in US Women Aged 12-21, 2003-2020, JAMA (2023). DOI: 10.1001/jama.2023.8020
Quote: Study Suggests Need for Iron Testing in Teenage Girls and Young Women (2023, June 28) Retrieved July 2, 2023 from https://medicalxpress.com/news/2023-06-iron-deficiency-common-teens-young.html
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