TOO LITTLE IRON

About Too Little Iron

Iron deficiency with and without anemia are key focus areas for Iron Disorders Institute (IDI), we estimate that as many as 70 million individuals lack enough iron for healthy function. The most at risk are the elderly, women of childbearing age, and toddlers whose only source of nourishment is cow’s milk. 

In 2002 the US Centers for Disease Control and Prevention, (CDC) reported the prevalence of iron deficiency as being 2 percent in adult males, 9 to 12 percent in non-Hispanic white females*, and nearly 20 percent in black and Mexican-American females*. Nine percent of toddlers aged 1 to 2 years and 9% to 11% of adolescent girls and women of childbearing age were iron deficient; of these, iron deficiency anemia was found in 3% and 2% to 5%, respectively. These prevalences correspond to approximately 700,000 toddlers and 7.8 million women with iron deficiency; of these, approximately 240,000 toddlers and 3.3 million women have iron deficiency anemia. Iron deficiency occurred in no more than 7% of older children or individuals older than 50 years, and in no more than 1% of teenage boys and young men. Among women of childbearing age, iron deficiency was more likely in those who are minority, low income, and multiparous (producing many or more than one offspring at a birth.) 

[LOOKER, et.al.,https://pubmed.ncbi.nlm.nih.gov/9091669/]

*Of childbearing age.

Consequences of iron deficiency (ID) can include diminished cognitive development in children, reduced strength and stamina in exercise and physical performance. ID is also a red flag for physicians to identify gastrointestinal cancer. In an American Academy of Family Physicians article authored by Shersten Killip, M.D., M.P.H., John M. Bennett, M.D., M.P.H., and Mara D. Chambers, M.D., University of Kentucky, Lexington, investigators reported a critical finding: ” Nine percent of patients older than 65 years with iron deficiency anemia have a gastrointestinal cancer when evaluated.”

Another critical finding involves hemoglobin values and how these values differ for non-whites. In two studies led by Dr. Ray Yip investigators reported the finding of hemoglobin differences between black and white women with comparable iron status. These researchers did not attribute dietary/nutritional differences, suggesting that genetics plays a significant role, more so than food choices.  Dr. Yip noted that in blacks the hemoglobin value was lower, where the serum ferritin level was higher as compared with whites. These are important findings and need to be considered in the management of iron deficiency in these populations. 

Iron supplementation is often used to correct iron deficiency and in some practices this approach is still used to diagnose iron deficiency, which could be harmful to a patient. Serum ferritin evaluation and tracking is vital to knowing the difference between iron deficiency with or without anemia, and anemia of inflammatory response. Giving an iron supplement to someone with a fever or without knowing their iron reserve level in ferritin could be deadly.

Shersten Killip, M.D., M.P.H., John M. Bennett, M.D., M.P.H., and Mara D. Chambers, M.D., “Iron deficiency anemia.” American Family Physician. 2007 Mar 1;75(5):671-678.

https://www.aafp.org/afp/2007/0301/p671.html#:~:text=The%20prevalence%20of%20iron%20deficiency,a%20gastrointestinal%20cancer%20when%20evaluated.

Johnson-Spear MA, Yip R. Hemoglobin difference between black and white women with comparable iron status: justification for race-specific anemia criteria. Am J Clin Nutr. 1994;60:117–21.

Perry GS, Byers T, Yip R, Margen S. Iron nutrition does not account for the hemoglobin differences between blacks and whites. J Nutr. 1992 Jul;122(7):1417-24. doi: 10.1093/jn/122.7.1417. PMID: 1619469.