More Than a Third of Women Under 50 Are Iron-Deficient

Iron is an essential nutrient for many things our bodies do every day, and yet more than a third of adult women of reproductive age in the United States are deficient.

Menstrual bleeding and pregnancy are the main drivers of the deficiency. Symptoms are often nonspecific and vague, like fatigue, brain fog, lightheadedness, sleep disturbances and a reduced ability to exercise. If left untreated in the long term, iron deficiency can deplete healthy red blood cells in the body, causing anemia. During pregnancy, iron deficiency and anemia can have an adverse effect on the mother and the fetus.

If you have heavy periods, eat a vegetarian diet or are planning to get pregnant, consider asking your doctor to test your ferritin levels, which measures how much iron is stored in your body, said Dr. Malcolm Munro, professor of obstetrics and gynecology at the David Geffen School of Medicine at the University of California, Los Angeles. In annual checkups, most doctors will test only for hemoglobin levels, he said, but that is an indicator of anemia, not iron deficiency. Getting your ferritin levels tested is usually covered by insurance, he added. “It’s not some fancy test.”

据媒体周二(2023-10-17)报道，全美大约有35%的育龄女性体内铁含量不足。

加州大学洛杉矶分校大卫格芬医学院（David Geffen School of Medicine at the University of California, Los Angeles）妇产科教授马尔科姆·蒙罗（Malcolm Munro）表示，营养缺乏会影响从免疫到认知等多种功能，但往往不容易被诊断出来。

蒙罗说，这种疏忽的部分原因是很难确定缺铁的症状，但也因为缺铁很少被认为是一种具有短期和长期后果的紧急情况。

尽管专家和研究人员不断呼吁，但美国并没有建议定期筛查成年女性是否缺铁，因此很少将其纳入年度体检的血液检查中。蒙罗说，铁缺乏症常常被忽视，这可能归结为“女性疾病的正常化”。他补充说，相关症状——如感觉虚弱、疲劳或烦躁——通常被视为女性生活的一部分。

铁用于制造血红蛋白，血红蛋白是红细胞中的一种蛋白质，可将氧气从肺部输送到身体的其他部位。蒙罗说，当身体的铁储存量下降时，剩余的铁就会被重新定向到维持红细胞，从而牺牲心脏、大脑和肌肉的功能。如果身体用完其储存，缺铁会导致血红蛋白和健康红细胞数量减少，称为贫血。

密歇根大学医学院的儿科血液学家安吉拉·韦安德（Angela Weyand）说，缺铁的症状通常不是特别明显，包括呼吸急促、脑雾、疲劳、头晕、对寒冷的敏感性增加和心悸，所有这些也可能是许多其他健康状况的迹象。她说，缺铁还与其他一些负面健康结果有关，包括焦虑、抑郁、睡眠障碍甚至心力衰竭。

在怀孕期间，当母亲、胎盘和成长中的胎儿对铁的需求增加时，铁缺乏导致贫血的风险也会增加。

月经过多是成年非孕妇缺铁率高的主要原因。今年，国际妇产科联合会首次提出建议，所有经期的女性都应定期筛查是否缺铁，而不仅仅是在怀孕期间。

Keep menstrual bleeding in check

Many women don’t know whether their menstrual bleeding might be considered heavy, said Dr. Angela Weyand, a pediatric hematologist at University of Michigan Medical School.

“I see a lot of adolescents who have very heavy menstrual bleeding and end up having severe anemia where they have to be admitted to the hospital,” she said. “Oftentimes, these patients hadn’t even recognized that their bleeding was abnormal.”

Soaking through a pad or tampon every two hours, bleeding for more than seven days or needing double coverage (like a tampon and a pad) are all signs that your period is too heavy.

If you have heavy bleeding and are iron-deficient, talk to your gynecologist to first rule out factors that might be causing the excess bleeding, like endometriosis or fibroids, Dr. Munro suggested. From there you might consider approaches to reduce how much you bleed, such as birth control pills or the hormonal intrauterine device.

Symptoms

If you are experiencing new, severe, or persistent symptoms, contact a health care provider.
Common symptoms include:

• General fatigue
• Weakness
• Pale skin
• Shortness of breath
• Dizziness
• Strange cravings to eat items that are not food, such as dirt, ice, or clay
• A tingling or crawling feeling in the legs
• Tongue swelling or soreness
• Cold hands and feet
• Fast or irregular heartbeat
• Brittle nails
• Headache