Iron Deficiency Anemia in the Western World – Ignorance vs Action

Dr. Shariq Khoja

Although, Iron deficiency anemia shows high burden of illness around the world, there is a clear imbalance in prevalence among low- and middle-income countries (LMICs) versus the western world. Does this mean that the health systems in high income countries should not worry about this problem?

Difference in the prevalence of Iron Deficiency Anemia

The prevalence of iron deficiency anemia in the western regions, including North America and Western Europe, is generally lower compared to other parts of the world, with rates typically ranging from 5% to 7%. This is way lower than many LMICs, where the prevalence is in the range of 30-40% in the overall population. In general, Western countries have higher rates of food security, better access to healthcare, and more widespread use of iron supplementation and fortification, all of which contribute to lower prevalence of iron deficiency anemia. However, even within the high-income countries, specific populations like young females and certain ethnic groups may experience higher rates.

Severity of Iron Deficiency Anemia in Certain groups:

High-risk patients can also benefit from Telemedicine Solutions for remote consultations and continuous monitoring.

• 1.In the US, a study found that almost 40% of 12- to 21-year-old females experienced iron deficiency, with 6% having iron deficiency anemia.
• 2.Another study in the US found that 14% of adults had absolute iron deficiency and 15% had functional iron deficiency.
• 3.Women who are pregnant or breastfeeding or those who have recently given birth.
• 4.Women who menstruate, particularly if menstrual periods are heavy.
• 5.People who have undergone major surgery or physical trauma.
• 6.People with gastrointestinal diseases such as celiac disease (sprue), inflammatory bowel diseases such as ulcerative colitis, or Crohn disease.
• 7.People with peptic ulcer disease.
• 8.People who have undergone bariatric procedures, especially gastric bypass operations.
• 9.Vegetarians, vegans, and other people whose diets do not include iron-rich foods (Iron from vegetables, even those that are iron-rich, is not absorbed as well as iron from meat, poultry, and fish.)
• 10.Children who drink more than 16 to 24 ounces a day of cow’s milk (Cow’s milk not only contains little iron, but it can also decrease absorption of iron and irritate the intestinal lining causing chronic blood loss.)
  
  

Other less common causes of iron deficiency include:

1.Blood loss from the gastrointestinal tract due to gastritis (inflammation of the stomach), esophagitis (inflammation of the esophagus), ulcers in the stomach or bowel, hemorrhoids etc.

2.Blood loss from chronic nosebleeds

3.Blood loss from the kidneys or bladder

4.Frequent blood donations

5.Intravascular hemolysis, a condition in which red blood cells break down in the blood stream, releasing iron that is then lost in the urine.

Critical Actions:

The above evidence shows that the prevalence of iron deficiency anemia in certain groups of the society merits regular monitoring of hemoglobin and hematocrit in these populations, depending on the severity of anemia. While regular laboratory tests remain the gold standard, modern Telemedicine Solutions and Point-of-Care Diagnostic Devices can improve anemia screening in outpatient clinics, community settings, and at home through minimally invasive or non-invasive technologies.
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https://www.hematology.org/education/patients/anemia/iron-deficiency.