Iron Deficiency Anemia

Iron deficiency, with or without anemia, is common in adolescent girls both globally and within the United States. Iron is a key nutrient that supports critical functions such as erythropoiesis, oxygen transport, aerobic metabolism, and neuronal myelination. Therefore, in addition to the progression to anemia, the non-hematologic effects of iron deficiency are diverse. Affected girls may report fatigue, poor concentration, restless legs, and pica. Low iron diet and menstrual blood loss are the most common etiologies of iron deficiency in adolescent girls, and these risk factors should be thoroughly assessed in all presenting patients. In addition, the presence or absence of gastrointestinal symptoms suggestive of blood loss or malabsorption, as well as acute or chronic inflammation, should be evaluated. The diagnosis of iron deficiency is based on clinical risk factors in the presence of a microcytic anemia. It can be confirmed with additional iron studies, if necessary. Iron replacement therapy may be provided with oral iron preparations administered once daily. Alternatively, intravenous iron preparations can be considered for those girls with complicated, recurrent, or refractory iron deficiency.