Risk factors for iron deficiency in adolescents

Major risk factors

Heavy menstrual blood loss (>80 mL/month)

Underweight or malnourished

Alternative diets with low iron intake (eg, vegetarian or vegan)*

History of iron deficiency anemia

Bariatric surgery

Blood donation

Minor or conditional risk factors

Female sex

Chronic inflammatory conditions^¶

Athletes participating in endurance training

Obesity^Δ

Use of acid-suppressing medications (PPI or H2 blockers)

Periods of rapid growth

PPI: proton pump inhibitor; H2: histamine 2 receptor.

* Iron-rich foods include meats, eggs, iron-fortified cereals, and some legumes.

¶ Eg, inflammatory bowel disease or rheumatologic conditions.

Δ In the United States, obesity is a risk factor for iron deficiency in adolescents in both sexes but especially in females^[1].

References:

Nead KG, Halterman JS, Kaczorowski JM, et al. Overweight children and adolescents: a risk group for iron deficiency. Pediatrics 2004; 114:104.
American Academy of Pediatrics Committee on Nutrition. Iron. In: Pediatric Nutrition, 8th ed, Kleinman RE, Greer FR (Eds), American Academy of Pediatrics 2019. p.561.

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