Medical experts report that iron deficiency and iron deficiency anemia affect approximately one-third of menstruating women in the United States. Dr. Steven Fein, a hematologist at HemeOnCall, and Dr. Joseph Shatzel, an associate professor at Oregon Health and Science University, noted that while iron is essential for energy utilization in every cell, the U.S. does not currently have a routine recommendation for iron deficiency screening.
Iron deficiency anemia occurs when iron levels are too low for the bone marrow to produce sufficient red blood cells. Fein estimated that about 15% of American women have iron deficiency anemia, while another 15% to 20% have iron deficiency without anemia. Common symptoms include fatigue, brain fog, difficulty concentrating, memory impairment, and mood complications such as increased anxiety or depression. Other indicators can include shortness of breath, hair thinning, restless leg syndrome, or cravings for ice.
In menstruating women, the primary cause of iron deficiency is blood loss during cycles, which can be exacerbated by heavy periods. Other contributing factors include inflammatory bowel disease, Crohn’s disease, celiac disease, and malabsorption following gastric bypass surgery. In men, iron deficiency is less common but often indicates a more severe underlying issue, such as a gastric ulcer or colon cancer. Treatment typically involves oral iron supplements or intravenous (IV) therapy, along with addressing the underlying cause of the deficiency.
The economic and social impact is concentrated on women, as experts like Fein characterize it as a gender inequality issue that may influence job promotions and salary outcomes due to untreated symptoms like brain fog and fatigue. While the specific cost of iron supplements or IV therapy was not reported, the physical toll is noted in the loss of red blood cell production when bone marrow lacks necessary supplies. Individuals who experience these symptoms must often initiate the conversation with a provider because there is no mandatory federal screening program for the general population.
Next steps for patients involve requesting blood tests from a primary care provider to diagnose iron levels. For those diagnosed with a deficiency, doctors may order gastrointestinal (GI) workups or recommend medical interventions such as birth control to manage heavy periods. Future policy changes regarding routine screening recommendations remain a matter of medical community discussion, as experts suggest the prevalence of the condition in women has historically led to less medical attention than other common ailments. No specific dates for new screening guidelines were reported.