Iron Deficiency in Female State Fair Attendees

Iron deficiency affects nearly 2 billion people globally, and it is among the most common
risk factors for disability and death. In its most extreme presentation, it results in
anemia, where the RBC count of the individual is markedly low, hindering oxygen transport.
Anemia has a remarkable global presence, affecting approximately one third of the world's
population. Though there are multiple causes for anemia, the World Health Organization (WHO)
estimates that the most common cause for anemia on the planet is iron deficiency. Although
findings from the US indicate that iron deficiency is less prevalent than in many other
nations, iron deficiency is still a pervasive national public health concern. A study that
analyzed the National Health and Nutrition Examination Survey (NHANES) data from 2007-2010
indicated that US children 5 years of age and younger have an anemia incidence of 3.2
percent.

Incidence of depression varies based on diagnostic tools used and categories included, as
well as the country, gender, age, and socioeconomic status of individuals. Globally, it is
estimated that between 4 and 10 percent of people experience major depressive disorder (MDD)
while between 2.5 and 5 percent experience dysthymia, a depression that involves less severe
symptoms but has a chronic manifestation. On average, the first onset of depression is 20
years old, though this figure is highly variable. It has consistently been demonstrated that
females experience a much higher incidence of depression than males. MDD has repeatedly been
reported in females at rates 1.5 to 3 times that of males, and female dysthymia has been
reported at 2 times that of males.

The current state of the literature on the connection between mental health and iron status
is further muddled by subjective, self-reported assessments and a lack of randomized
controlled trials, but the evidence certainly suggests an association. Affective
characteristics studied in relation to iron deficiency include irritability, anger, or mood;
depression, both as postpartum depression (PPD) or depression independently; and perceived
QOL. Differences in assessment tools as well as length and dosage of iron treatment likely
play a pivotal role in discordant results. Most studies also include fatigue as a primary
outcome as it is closely tied to these affective characteristics.

The aim of this study is to further investigate iron status and iron deficiency symptoms in
menstruating females. It builds on the existing research for use of cutoff values for various
biochemical assessments of iron as well as for stages of deficiency in which symptoms are
experienced. In addition, the association between iron status, measured either biochemically
or by self-reported iron deficiency symptoms, and depression was examined.

Inclusion Criteria:

- non-pregnant

- female

- 18-45 years of age

Exclusion Criteria:

- pregnancy

- male

- outside age range

- post-menopausal

- experiencing one of the following inflammatory or iron metabolism disorders: active
treatment for cancer, irritable bowel syndrome, colitis, Chron's disease, chronic
heart failure, chronic kidney disease, chronic parasitic infection, hemochromatosis,
human immunodeficiency virus, polycystic ovarian syndrome, respiratory illness, sickle
cell anemia, and thalassemia