Current testing may not catch low iron in teen girls

Young women should get blood tests for iron deficiency within a few years of starting their periods, new research suggests.

The researchers used data from more than 6,000 women 12 to 49 years old who took part in the National Health and Nutrition Examination Survey (NHANES) between 2003 and 2010. As part of the survey, female participants had blood testing for iron deficiency as well as hemoglobin testing to identify anemia.

Women are typically tested some time in their teens for anemia—the severe form of iron deficiency—using a quick and affordable hemoglobin test. However, iron deficiency can develop years before anemia and can be missed by hemoglobin testing alone.

The appropriate age may be 16 years old, when most females will have been menstruating for at least three years.

“If you think about your car, you have to run your gas tank all the way down before the red light goes on, and that’s similar to the way we’re screening for iron deficiency,” says Deepa L. Sekhar, physician and associate professor of pediatrics at the Penn State College of Medicine. “We’re basically waiting until their red light goes on. You have to be really low on your iron storage before you’re going to flag as anemic.”

Iron deficiency without anemia has been associated with lower standardized math scores, attention deficit disorder, and restless leg syndrome in children and adolescents. Among iron-deficient adolescent women there is a future risk of maternal iron deficiency and negative effects on infant health.

Blood tests for iron deficiency without anemia have been developed but they are more costly and difficult to obtain in the doctor’s office compared to hemoglobin testing for anemia. Sekhar and colleagues hoped to determine risk factors for iron deficiency without anemia that could pinpoint which women could benefit most from this more costly testing.

In the first study, when the researchers analyzed the…

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