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Iron deficiency in women: assessment, causes and consequences

Coad, Janea; Conlon, Cathrynb

Current Opinion in Clinical Nutrition and Metabolic Care: November 2011 - Volume 14 - Issue 6 - p 625–634
doi: 10.1097/MCO.0b013e32834be6fd
Micronutrients: Edited by Henry Lukaski and Gil Hardy

Purpose of review Iron deficiency is the most common nutritional disorder affecting about 20–25% of the world's population, predominantly children and women. There is emerging evidence that depletion of iron stores may have adverse consequences for adults even in the absence of anaemia. This raises issues about the most appropriate method of assessing iron status.

Recent findings Although the effects of iron-deficiency anaemia are well characterized, emerging evidence suggests that iron deficiency without anaemia can have negative consequences in adults, particularly for neurocognitive outcomes. Iron deficiency is more likely in women of reproductive age because of menstrual blood loss. However, extremes of blood loss such as regular blood donation, diets of low bioavailability and the challenges of pregnancy all markedly increase the risk of iron deficiency. In addition, the physiological changes in pregnancy affect the normal reference ranges used in laboratory assessment. The use of haemoglobin as a marker of iron deficiency is limited by its low specificity and sensitivity and although the use of alternative biomarkers is becoming more common, interpreting results in conditions of chronic inflammation, including that associated with increased adiposity, needs more investigation.

Summary By understanding the physiology of iron metabolism alongside the limitations and interpretation of biomarkers of iron deficiency, clinicians and nutritionists are better equipped to identify changes in iron balance and to further investigate the functional outcomes of iron deficiency.

aInstitute of Food, Nutrition and Human Health, Massey University, Palmerston North

bInstitute of Food, Nutrition and Human Health, Massey University, Albany, Auckland, New Zealand

Correspondence to Jane Coad, PhD, Institute of Food, Nutrition and Human Health, Massey University, Palmerston North 4442, New Zealand Tel: +64 6350 5962; e-mail:

© 2011 Lippincott Williams & Wilkins, Inc.