Why We Should Take A Women-Centered Approach To Diagnosing And Treating Iron Deficiency

Why We Should Take A Women-centred Approach To Diagnosing And Treating Iron Deficiency Florian Gaertner/Getty Images

Iron deficiency is a common nutritional disorder worldwide, and pre-menopausal women are most at risk of being diagnosed with it.

New Zealand’s most recent nutritional survey (from 2008/09) shows 12% of women may suffer from iron deficiency. But more recent research in New Zealand suggests up to 55% of women of a similar age but of various ethnicities (Caucasian, Middle Eastern and South Asian) present with depleted iron levels.

This higher incidence of iron deficiency in women is often explained as a result of blood loss during menstruation. But my research, which analyses the iron status of athletic and active women, suggests female physiology has evolved to counter iron loss through complex interactions between female reproductive hormones and the hormone that influences iron regulation.

The research shows variations in iron status during a woman’s monthly cycle, and based on this, we would recommend doctors note what phase of the menstrual cycle a women is in when conducting iron-screening blood tests. In addition, before interpreting test results, they should ask women if they have a natural menstrual cycle, not influenced by any hormonal contraceptives (pill or IUD).

Iron in the body

Iron is fundamental for optimal health and well-being. It is an essential part of haemoglobin, the pigment in red blood cells, and transports oxygen throughout the body.

Even though iron is important for healthy and normal functioning, we can’t make the mineral and rely on recycling it within the body and getting enough from food. Dietary sources of iron include whole grain cereals, legumes, fish, poultry and meat.

The body controls and regulates iron well. Daily iron losses are only 1-2mg. Research suggests women will lose an additional 1mg of iron each day of their menses, which may bring the total iron loss to 3-5mg during the time of menstrual blood loss (which may last 1-5 days). This can be exaggerated in women who experience heavy or extended menstrual bleeding.

The primary iron regulatory hormone is hepcidin. It works on the only known iron export channels in the body — found in the small intestine (iron absorption from foods), on the surface of white blood cells (iron recycling in the body) and in liver cells (iron release from its reservoir in the liver).

Higher levels of hepcidin lead to a degradation of the iron export channels, effectively stopping the movement of iron from the gut and the release from its storage sites. This also limits the body’s ability to recycle iron from dead red blood cells, either for the production of new red blood cells or to store it in the liver.

Female physiology and iron status

To date only two research investigations have sought to clarify the changes in iron status and hepcidin across the menstrual cycle in pre-menopausal women.

My research shows a dramatic fall in hepcidin (and some other iron-related factors) during menstruation (days 1-5 of the monthly cycle). Hepcidin remains depressed for the few days following the period and then gradually starts rising at ovulation (at about day 14).

After ovulation, as women enter their luteal phase (days 15-28), hepcidin appears to increase and plateau before repeating the cycle the following month.

Research using isolated cells and studies with women undergoing in-vitro fertilisation show that oestrogen tends to suppress hepcidin activity, while progesterone stimulates it. This explains the low levels of hepcidin in the follicular phase (days 1-14 of the menstrual cycle) and the rebound in the luteal phase (days 15-28).

These results suggest that in response to the blood loss that accelerates iron loss, female physiology is primed for maximising iron absorption in the first half of the menstrual cycle by reducing the activity of hepcidin. This could be a physiological counter mechanism to menstrual blood loss.

It is worth noting that a few studies have also shown that serum iron, transferrin and haemoglobin — all markers used to measure a person’s iron status — fluctuate throughout the menstrual cycle. In one study, 23% of women were classified as iron deficient during menstruation, but this dropped to 8% in the luteal phase.

Transferrin saturation is a measure of the percentage of iron being transported and used in the body. During the luteal phase, when iron levels may rebound, some women may reach transferrin saturation levels of 45%. This typically indicates excess iron or haemochromatosis, a genetic disorder that results in excessive absorption and storage of iron and can be toxic for vital organs.

Some may say research into iron deficiency is well established and we have covered our bases on how to detect and treat this micro-nutrient deficiency. But 18-55% of pre-menopausal women in New Zealand have sub-optimal iron levels.

Researchers have explored many lifestyle factors that affect a person’s iron balance, including dietary preferences, meat intake and exercise. But we have yet to fully consider female physiology and how the menstrual cycle influences the intricacies of iron deficiency diagnosis and effective treatment.

At a time when many call for female-centred research to identify specific health outcomes and treatments, it might be time to reopen the box on iron deficiency.The Conversation

About The Author

Claire Badenhorst, Lecturer at Massey University, Massey University


Recommended Books: Health

Fresh Fruit CleanseFresh Fruit Cleanse: Detox, Lose Weight and Restore Your Health with Nature's Most Delicious Foods [Paperback] by Leanne Hall.
Lose weight and feel vibrantly healthy while clearing your body of toxins. Fresh Fruit Cleanse offers everything you need for an easy and powerful detox, including day-by-day programs, mouth-watering recipes, and advice for transitioning off the cleanse.
Click here for more info and/or to order this book on Amazon.

Thrive FoodsThrive Foods: 200 Plant-Based Recipes for Peak Health [Paperback] by Brendan Brazier.
Building upon the stress-reducing, health-boosting nutritional philosophy introduced in his acclaimed vegan nutrition guide Thrive, professional Ironman triathlete Brendan Brazier now turns his attention to your dinner plate (breakfast bowl and lunch tray too).
Click here for more info and/or to order this book on Amazon.

Death by Medicine by Gary NullDeath by Medicine by Gary Null, Martin Feldman, Debora Rasio and Carolyn Dean
The medical environment has become a labyrinth of interlocking corporate, hospital, and governmental boards of directors, infiltrated by the drug companies. The most toxic substances are often approved first, while milder and more natural alternatives are ignored for financial reasons. It's death by medicine.
Click here for more info and/or to order this book on Amazon.


This article is republished from The Conversation under a Creative Commons license. Read the original article.

 


 Get The Latest By Email

Weekly Magazine Daily Inspiration

You May Also Like

INNERSELF VOICES

illustration of a film strip with various scenic pictures on each frame
Designing a New Future for Yourself
by Carl Greer PhD, PsyD
In the physical world, things have a past and a future, a beginning, and an end. For example, I’m…
teacher standing in front of students in an open classroom
Becoming Passionate About Public Education Again
by Robert Jennings, InnerSelf.com
We are almost all lucky to have someone in our lives to encourage and motivate us and try to show…
Aurora photo by Valerie Pond, October 10, 2021, Yellowknife, NT, Canada
Horoscope Current Week: October 11 - 17, 2021
by Pam Younghans
This weekly astrological journal is based on planetary influences, and offers perspectives and…
Flower growing through a chain-link fence
So Many Questions... So Many Answers?
by Marie T. Russell, InnerSelf.com
We go through life with so many questions. Some are simple. What day is it? What will I have for…
rainbow over a field
Give Yourself Time, Be Kind, and Heal in Your Own Way
by Marie T. Russell, InnerSelf.com
Unfortunately many of us have become victims of instant gratification. We want to succeed and we…
woman's head with a crack and with tree growing from the back of her head
Opening to a Whole New Way of Being
by Rabbi Wayne Dosick
Sometimes a pandemic—no matter how devastating—is just a pandemic. But sometimes— most times—it is…
Image of an open book floating in the sky with a tree growing out of the open book
Do You Believe in Miracles?
by Barry Vissell
Albert Einstein famously said, "There are only two ways to live your life. One is as though nothing…
a rainbow in the palm of an open hand
Finding Silver Linings and Rainbows
by Marie T. Russell, InnerSelf.com
Be open to discovering the gifts life is offering you -- expect silver linings and rainbows, be on…
Is It Luck, Coincidence, Synchronicity, or Just Life?
Is It Luck, Coincidence, Synchronicity, or Just Life?
by Marie T. Russell
I love how the Universe (a.k.a. God/Goddess/All That Is, Creator, Divine, etc.) works. Things just…
Dogs Teach Us To Listen, Even After They've Died
Dogs Teach Us To Listen, Even After They've Died
by Elena Mannes
One day not long after Brio passed, I was driving on the highway, alone in the car. I’d been…
What Is The Highest and Best Form of Selfishness?
Is There Such A Thing As Good Selfishness?
by Alan Cohen
I have been rethinking selfishness, the ego, and self-centeredness. In some schools of thought…

MOST READ

How Living On The Coast Is Linked To Poor Health
How Living On The Coast Is Linked To Poor Health
by Jackie Cassell, Professor of Primary Care Epidemiology, Honorary Consultant in Public Health, Brighton and Sussex Medical School
The precarious economies of many traditional seaside towns have declined still further since the…
The Most Common Issues for Earth Angels: Love, Fear, and Trust
The Most Common Issues for Earth Angels: Love, Fear, and Trust
by Sonja Grace
As you experience being an earth angel, you will discover that the path of service is riddled with…
How Can I Know What's Best For Me?
How Can I Know What's Best For Me?
by Barbara Berger
One of the biggest things I've discovered working with clients everyday is how extremely difficult…
What Men’s Roles In 1970s Anti-sexism Campaigns Can Teach Us About Consent
What Men’s Roles In 1970s Anti-sexism Campaigns Can Teach Us About Consent
by Lucy Delap, University of Cambridge
The 1970s anti-sexist men’s movement had an infrastructure of magazines, conferences, men’s centres…
Honesty: The Only Hope for New Relationships
Honesty: The Only Hope for New Relationships
by Susan Campbell, Ph.D.
According to most of the singles I have met in my travels, the typical dating situation is fraught…
Chakra Healing Therapy: Dancing toward the Inner Champion
Chakra Healing Therapy: Dancing toward the Inner Champion
by Glen Park
Flamenco dancing is a delight to watch. A good flamenco dancer exudes an exuberant self-confidence…
Giving Up All Hope Could Be Beneficial For You
Giving Up All Hope Could Be Beneficial For You
by Jude Bijou, M.A., M.F.T.
If you're waiting for a change and frustrated it's not happening, maybe it would be beneficial to…
An Astrologer introduces the Nine Dangers of Astrology
An Astrologer introduces the Nine Dangers of Astrology
by Tracy Marks
Astrology is a powerful art, capable of enhancing our lives by enabling us to understand our own…

follow InnerSelf on

facebook icontwitter iconyoutube iconinstagram iconpintrest iconrss icon

 Get The Latest By Email

Weekly Magazine Daily Inspiration

AVAILABLE LANGUAGES

enafarzh-CNzh-TWdanltlfifrdeeliwhihuiditjakomsnofaplptroruesswsvthtrukurvi

New Attitudes - New Possibilities

InnerSelf.comClimateImpactNews.com | InnerPower.net
MightyNatural.com | WholisticPolitics.com | InnerSelf Market
Copyright ©1985 - 2021 InnerSelf Publications. All Rights Reserved.