Iron deficiency is often overlooked, yet it’s a condition that can quietly wreak havoc on health. A new study suggests that nearly one-third of adults in the United States may be suffering from iron deficiency, even though they don’t have any of the typical conditions for which they would usually be screened. This issue, which is far more prevalent than many realize, affects adults across all age groups and genders, raising alarms in the medical community about the need for greater awareness and screening.
Understanding Iron Deficiency
Iron is essential for the body to function properly. It plays a crucial role in making hemoglobin, the protein in red blood cells that carries oxygen throughout the body. Without enough iron, the body can’t produce enough hemoglobin, leading to anemia and a host of other health issues. However, what’s often not discussed is that iron deficiency can occur even before anemia develops.
In the study published in JAMA Network Open, researchers reveal that iron deficiency can manifest in two forms: absolute and functional iron deficiency.
- Absolute Iron Deficiency occurs when the body’s iron stores are severely reduced or absent.
- Functional Iron Deficiency happens when the body has enough iron stores, but they aren’t mobilized effectively to meet the body’s needs.
These findings suggest that iron deficiency may be a “widespread” and “underrecognized” public health issue that is affecting a significant portion of the population, even those who may not have conditions commonly linked to iron deficiency, such as anemia, heart failure, or chronic kidney disease.
The Numbers: A National Concern
The study conducted by Brigham and Women’s Hospital in Boston analyzed data from 8,021 adults across the United States. According to the research, approximately 14% of adults met the criteria for absolute iron deficiency, and another 15% exhibited signs of functional iron deficiency. These numbers are particularly concerning because they reveal that a significant portion of the population may be unknowingly suffering from iron deficiency.
The problem is not just limited to one demographic. According to Dr. Leo Buckley, the lead author of the study and a clinical pharmacy specialist at Brigham and Women’s Hospital, functional iron deficiency was common across all age groups and genders. Conditions such as obesity, diabetes, and kidney disease—which are increasingly prevalent in the U.S.—can lead to functional iron deficiency.
Interestingly, absolute iron deficiency was found to be most common in pre-menopausal women, which aligns with prior research. Older men and women also exhibited high rates of absolute iron deficiency, likely due to factors such as gastrointestinal blood loss and inadequate dietary intake, as well as the presence of chronic conditions that impair iron absorption.
Symptoms and Risks of Iron Deficiency
Iron deficiency can present a variety of symptoms, some of which may be subtle and easily overlooked. Fatigue, pale skin, brittle nails, hair loss, and shortness of breath are common symptoms. Restless leg syndrome and heart palpitations may also be signs of an iron deficiency. However, because these symptoms can be attributed to a wide range of other health issues, it’s easy for iron deficiency to go undiagnosed.
Iron deficiency has been linked to a number of serious health outcomes, including:
- Anemia: The most well-known consequence of iron deficiency, where the blood lacks enough healthy red blood cells to carry oxygen.
- Heart Failure: Studies have linked iron deficiency to worse outcomes in heart failure patients.
- Restless Leg Syndrome: This condition has been associated with low iron levels.
- Cognitive Impairments: Iron is critical for brain function, and a deficiency can lead to cognitive challenges, especially in children and older adults.
Certain groups are at higher risk for iron deficiency, including menstruating women, pregnant individuals, children, vegetarians, and frequent blood donors. A 2022 study found that more than 70% of iron deficiency cases may go undiagnosed among pregnant women and children.
The Diagnostic Gap
Perhaps one of the most concerning findings in the study is the lack of screening for iron deficiency. Among adults with absolute iron deficiency, only 33% were being screened due to a medical condition, and only 14% of those with functional iron deficiency had a reason to be tested. This suggests that many adults with iron deficiency are flying under the radar, as they do not exhibit the typical conditions that would prompt a doctor to check their iron levels.
Dr. Jacob Cogan, an assistant professor at the University of Minnesota, who was not involved in the study, pointed out that many healthcare providers may not go beyond basic blood tests if a patient doesn’t show signs of anemia. This could mean that the true prevalence of iron deficiency in the general population is higher than reported, as many individuals could be experiencing symptoms without being diagnosed.
Cogan’s own research, published recently, found that 58% of people diagnosed with iron deficiency still had not resolved their condition three years later. This highlights the chronic nature of the issue and the need for long-term monitoring and treatment.
The Role of Diet and Supplements
One of the simplest ways to prevent or treat iron deficiency is by incorporating more iron-rich foods into your diet. Foods such as lean meats, seafood, nuts, beans, lentils, and spinach are great sources of iron. For those who struggle to get enough iron from food alone, supplements may be necessary.
Unfortunately, the study found that the use of iron supplements was relatively low among individuals with iron deficiency. Only 35% of women and 18% of men with iron deficiency reported taking supplements.
Iron supplements are widely available in both prescription and over-the-counter forms. For individuals with severe deficiency or absorption issues, intravenous iron infusions may be necessary. But as the study points out, many people may not even be aware that they have an iron deficiency, let alone be proactive about taking supplements.
What You Can Do
If you suspect that you may be iron deficient, it’s important to speak with your healthcare provider. Although routine checkups often include a complete blood count (CBC), which can indicate whether you’re anemic, it may not reveal an iron deficiency unless further tests are ordered. You can ask your doctor to specifically test for iron levels if you’re experiencing symptoms such as fatigue, hair loss, or restless leg syndrome.
Moreover, paying attention to your diet is critical. Iron-rich foods should be a regular part of your meals, and if necessary, supplements can help fill the gap. For those with chronic conditions like diabetes or kidney disease, managing those underlying issues is key to preventing functional iron deficiency.
The study’s findings are a wake-up call for both the medical community and the general public. Iron deficiency is not just an issue for people with anemia or chronic illnesses—it’s a widespread problem that could be silently affecting millions of adults across the country. With greater awareness and more proactive screening, we can better address this hidden epidemic.