Addressing the Silent Threat: Iron Deficiency and Its Impact on Women
Iron deficiency (ID) is the most widespread and common nutritional disorder worldwide and accounts for approximately one-half of anemia cases, with a clear predominance in adolescents and menstruating females.
Disorders of iron metabolism are among the most frequently seen in pre-menopausal women, yet thousands of patients still move through Canadian doctors’ offices and hospitals each year with chronic iron deficiency conditions that go undiagnosed and untreated. The results of this chronic endemic are devastating, affecting physical, mental, and socioeconomic health.
In this month's newsletter, we delve deeper into the apparent lack of education and awareness around iron deficiency and its toll on women throughout North America1. Through continued research and insightful interviews, we shed light on this silent threat's prevalence, factors, and surprising consequences.
Throughout our continued exploration of iron deficiency, we encountered Alisha Haridasani Gupta
Gupta is a reporter on The New York Times Well desk, focused on women’s health, health inequities, and functional medicine and wellness trends. She recently published two articles on this topic2. We caught up with Gupta this month to get her insights on the chronic health condition and perhaps why iron deficiency continues its prevalence among so many women.
Mainline Wellness: Your article mentions that iron deficiency affects more than a third of adult women of reproductive age in the United States. Could you elaborate on the specific geographical regions or populations that experience the highest prevalence of iron deficiency? Did you also come across any other factors contributing to this condition?
Alisha Haridasani Gupta: It is difficult to answer this question because of the main issue that I highlighted in my story: the fact of the matter is that iron deficiency is so rarely tested in the U.S. and therefore there is little good data on it, let alone geographic breakdowns. We have better data on anemia but, of course, in many cases iron deficiency precedes anemia so that presents us with an incomplete picture. What we do know is that iron deficiency is more common among women than men, particularly pregnant women, and likely among those who eat vegetarian or vegan diets. Heavy menstrual bleeding is the main driver of iron deficiency and we know this because prevalence of iron deficiency is lower among girls before they start their period and among menopausal women who are no longer menstruating.
Mainline: While discussing treatment options for iron deficiency, you touched upon dietary changes and iron supplementation. Can you further explore alternative approaches, and are there complementary therapies in the US that could potentially enhance the effectiveness of traditional treatments?
Gupta: I think one important approach to treating iron deficiency is to control or lower the amount that women bleed every month. There are a variety of effective methods, which we highlight in the article, that can even reduce blood loss by a half. That can truly help women get their iron levels back on track. There are also transfusion options in the U.S. but I'm not sure how often it is covered by insurance and how easily accessible it is, compared with oral supplements.
Mainline: While researching iron deficiency and speaking with experts, was there anything you learned about the condition that was a surprise to learn?
Gupta: As a person who has been iron deficient for much of her life, many things were surprising even to me: the first was just how little testing is done for it, how little attention is paid to this issue and also how little agreement there is among healthcare providers of what is even considered a healthy iron count. Many times, researchers and experts told me that the reason all of this is overlooked is because of misogyny.
The second is the long term consequences of letting this get out of hand — I always thought a little iron deficiency wouldn't really matter to my overall health when it can indeed have a big impact. In fact, after publishing, I received a comment from a reader who said her iron deficiency symptoms mimicked a heart attack and she spent 10 hours in urgent care undergoing tests. Not one of those tests looked at iron levels when, in the end, all she needed was iron supplements.
To read Alisha Haridasani Gupta’s latest articles on iron deficiency or other topics she covers, visit her bio page on newyorktimes.com.
[1] In British Columbia, for example, the ‘Iron Deficiency Diagnosis and Management’ guidelines appear not to have been updated since 2019, and current Canadian research is sorely lacking. In 2022, Mainline Wellness conducted a Quality Improvement Project (QIP), examining the health benefits of IV iron as a treatment for ID and Iron Deficiency Anemia (IDA). The project also sought to determine the current major barriers for patients seeking to improve their symptoms with IV iron. In December last year, the Clinic released a report with findings pointing to a clear need for greater research, awareness, and action.
[2] ‘More Than a Third of Women Under 50 Are Iron Deficient: The condition can cause fatigue and other symptoms but is rarely tested for. Here’s what to know.’ By Alisha Haridasani Gupta and ‘How to Know if You’re Iron Deficient, and What to Do About It: Testing is fairly easy, and treatment can improve symptoms within months.’ By Alisha Haridasani Gupta and Alice Callahan
Do you think you might be iron deficient?
Here are some symptoms to look for:
Low energy
Chronic napping
Pale skin
Heavy or irregular periods
Cold hands and/or feet
Restless legs
If you experience any of these symptoms, you may have low iron or be anemic. Make an appointment with your health care provider to get your iron checked. Taking steps to treat iron deficiency and anemia is simple. If you have questions or wish to find out more about how an iron infusion may help to address iron deficiency and anemia, the team at Mainline Wellness is happy to help and can be reached by phone at 604-876-2344 or email at info@mainlinewellness.ca.
How Does Mainline Wellness Fit In?
At Mainline Wellness, we are focused on improving the awareness and understanding of iron deficiency and iron deficiency anemia in Canada to help more patients get the help they need – preoperative or otherwise.
We are committed to offering safe, timely, and accessible ER physician and nurse supervised iron infusions. Speak to your healthcare provider to see if iron infusions may be helpful for you. Treatment can begin within one week.
I don't have a doctor but suspect I'm low iron, what do I do?
If you think you may be a candidate for IV iron but don't have a GP or your care provider is not comfortable referring for IV iron, request a consult with an independent specialist from Well Health. Our new referral system will help you with the access you need.
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