A study published in Blood Advances revealed that over half of people diagnosed with iron deficiency still had low iron levels three years after diagnosis. Iron deficiency is a common condition that may affect up to 40% of adolescents and young women. If left untreated, it can lead to various symptoms such as mood changes, fatigue, hair loss, and eventually anemia. Treatment generally involves oral iron supplementation, with intravenous iron being considered if low iron levels persist. Despite its prevalence and impact on quality of life, iron deficiency can be challenging to diagnose but easy to treat.
The study, conducted by Dr. Jacob Cogan and his team, analyzed electronic medical records from a Minnesota health system to assess the recognition and treatment of iron deficiency. Over 13,000 adults with laboratory-diagnosed iron deficiency were included in the study, with follow-up data available for three years. In this study, iron deficiency was defined as a ferritin value of 25 ng/mL or less, and adequate treatment was defined as a subsequent ferritin value of at least 50 ng/mL. Most patients received some form of treatment, with similar rates across sex.
Of the patients included in the study, 42% had normal iron levels restored within three years, while 58% continued to have persisting iron deficiency based on low ferritin levels. Only 7% of patients had their iron levels return to normal within the first year of diagnosis. Factors associated with a higher likelihood of resolving iron deficiency included older age, male sex, Medicare insurance, and treatment with IV iron alone. Younger patients, females, and Black individuals were more likely to remain iron deficient or experience longer delays in resolving their iron deficiency.
Even among patients whose iron levels were restored to normal, it took almost two years, which researchers note is longer than expected. This suggests missed opportunities for more effective management of iron deficiency. Dr. Cogan stresses the need for better systems to identify and treat patients efficiently, reducing the time it takes to resolve iron deficiency. He suggests the need for education about non-anemic iron deficiency, agreed-upon ferritin cut-offs for diagnosis, and the establishment of iron deficiency clinics to assess and treat patients more effectively.
The study faced limitations due to its reliance on electronic medical records and a retrospective design, which prevented researchers from determining why ferritin tests were ordered or the underlying cause of iron deficiency in patients. However, the findings highlight significant gaps in recognizing and treating iron deficiency efficiently in clinical practice. Dr. Cogan emphasizes the need for improved coordination in diagnosing and treating iron deficiency to enhance the quality of life for affected individuals and reduce the impact of this common yet often overlooked condition.