Approximately 1 out of every 13 Canadian women has low iron levels in her bloodstream indicating an iron deficiency.[i] That might not sound like a lot, but it adds up to over 1.2 million of Canadian women aged 20 or more! [ii] Many women don’t make the connection with some of the generalized signs and symptoms. Iron deficiency can cause all sorts of problems, from fatigue and weakness to irritability and depression[iii]. It’s even been shown that specific motor and cognitive deficits resulting from iron deficiency or iron-deficiency anemia may be irreversible in the neonatal period and early childhood.[iv] So, it’s important to know who is at risk. Check out the symptoms checker (link)
Although toddlers and females of childbearing age represent the highest risk of iron deficiency there are other particular groups of people who are also at greater risk of iron deficiency and, consequently, iron-deficiency anemia than others[v]. These can be grouped as those with Increased iron needs and those with decreased iron availability[vi]:
INCREASED IRON NEEDED
Physical Conditions and Life stages:
- Menstruation or having periods with blood loss
- Rapid growth spurts such as infants, children, adolescents
- Pregnancy, especially 2nd/3rd trimester. During pregnancy, blood volume increases by 45% above non-pregnant values. By the late third trimester the plasma volume increases by more than 50–60%.[vii]
- Lactation or breastfeeding
Blood Loss:
- Gastrointestinal (GI) bleeding this includes GI cancer, hemorrhoids, peptic ulcer disease, irritable bowel disease (IBD), angiodysplasia, chronic/ high dose use of salicylates or non-steroidal anti-inflammatory drugs (NSAIDs)
- Genitourinary blood loss including menorrhagia which is higher level of blood loss during periods or menstrual cycles. Hematuria is passing blood in the urine is also a type of blood loss
- Intravascular hemolysis
- Regular blood donation
- Post-operative patients with significant blood loss
- Endurance athletes
DECREASED IRON AVAILABILITY
Decreased Intake:
- Low socioeconomic status
- Diet (vegetarian/vegan, iron-poor, malnutrition)
- Eating disorder
- Alcohol use disorder
- Age above 65 years old
Decreased Absorption:
- Diet (carbonated drinks, coffee, etc.)
- Upper GI pathology (chronic gastritis, gastric lymphoma, celiac disease)
- Medications that decrease gastric acidity or bind iron (e.g. antiacids/PPIs)
- Gastrectomy or duodenal bypass
- Bariatric surgery
- Chronic renal failure
- Pediatric short bowel syndrome
– Toddlers who are breastfed beyond 6 months. Cereals are iron-fortified in Canada. Therefore, the Government of Canada recommends that infants and toddlers who are breastfed up to 24 months should be given iron-rich meat or iron-fortified cereal as the first complementary foods. Canada Food Guide.
– Infants who are less than 6 months, premature birth, those with low birth weight, or those who were not breastfed
The American Academy of Pediatrics (AAP) states that 80 % of the iron available in a newborn is accumulated during the third semester of pregnancy. Various medical concerns can result in low fetal iron stores in both term and preterm infants during pregnancy. The AAP recommends that children be screened for iron deficiency at one year of age. [AAP, 2010]
There are multiple factors that increase one’s risk of iron deficiency, particularly for women. If you fall into a group that puts you at greater risk for iron deficiency, then paying attention to your iron levels is important. Use our iron deficiency symptoms tracker. You can then print out the results and discuss them with your physician or pharmacist. They may recommend you increase your intake of iron-rich foods or suggest an iron supplement.
Resources
[i] Canadian Health Measures Survey, p.2 https://www150.statcan.gc.ca/n1/pub/82-003-x/2012004/article/11742-eng.htm
[ii] https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1710000501&pickMembers%5B0%5D=1.1&pickMembers%5B1%5D=2.3&cubeTimeFrame.startYear=2022&cubeTimeFrame.endYear=2022&referencePeriods=20220101%2C20220101].
[iii] Alberta Guidelines
[iv] BC Guidelines p. 7
[v] Canadian Health Measures
[vi] BCGuidelines.ca, p.7]
[vii] Soma-Pillay P, Nelson-Piercy C, Tolppanen H, Mebazaa A. Physiological changes in pregnancy. Cardiovasc J Afr. 2016 Mar-Apr;27(2):89-94. doi: 10.5830/CVJA-2016-021. PMID: 27213856; PMCID: PMC4928162.