Iron deficiency

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Unit 601

February 2023

Iron deficiency

The purpose of the activity is to consider the investigation and management of iron deficiency in general practice.

Iron deficiency is a common health issue in Australia, with anaemia affecting approximately 8% of children aged <5 years, 15% of non-pregnant premenopausal women and 12% of pregnant women. Consequently, iron deficiency is an important diagnosis to consider for patients presenting to general practitioners with symptoms such as fatigue and pallor. 

Although there are no Australian prevalence estimates for iron deficiency in infants and toddlers, a 2022 study found that approximately 90% of infants aged 6–11.9 months and 25% of toddlers aged 1–2 years had inadequate iron intake.

Iron requirements increase during adolescence, and women are particularly susceptible to iron deficiency because of menstrual blood loss. The Australian Bureau of Statistics has reported that 40% of girls aged 14–18 years have inadequate iron intake to meet physiological demands.

Iron demand increases three-fold during pregnancy, reaching a peak in the third trimester. In total, 1000–1200 mg of iron is required. Iron deficiency rates of almost 20% during pregnancy have been reported in some Australian studies.

Heavy menstrual bleeding (HMB) is the most common presentation of abnormal uterine bleeding in premenopausal women in the general practice setting, affecting 25–30% of women of reproductive age. Continued HMB results in a high risk of developing iron deficiency anaemia.

Inflammatory bowel disease (IBD) affects >80,000 Australians, and it is predicted that one in 200 Australians will develop IBD. Patients with IBD often have iron deficiency anaemia due to both chronic blood loss and impaired iron absorption.

Learning outcomes

At the end of this activity, participants will be able to:

  • list the factors that increase the risk of iron deficiency in infancy and adolescence 
  • outline the potential causes of abnormal uterine bleeding in premenopausal women 
  • discuss iron demand in pregnancy, highlighting major routes of loss and gain
  • describe the additional factors that must be considered when considering ferritin levels in a patient with inflammatory bowel disease.

Case studies

Below is a list of the case studies found in this month's edition of check. To see how these case studies unfold and gain valuable insights into this months topic, log into gplearning to complete the course.

Jack is a previously healthy boy, aged 18 months, who is brought in by his mother, Annie. Annie is upset and worried something is wrong after her sister commented on how pale Jack is.

Jeongyeon, aged 15 years, is a student who presents with persistent tiredness for the past six months. She finds classes after lunch challenging and feels increasingly anxious about underperforming at school. She no longer plays sport, and her mother feels that she is becoming increasingly withdrawn. Jeongyeon admits she has been feeling emotionally low; however, she has not had any thoughts or acts of self-harm.

Virginia, aged 40 years, works full time as a manager at a retail firm. She reports that her periods have become noticeably heavier over the past six months, with frequent flooding that causes her significant embarrassment. Prior to this, she had been well with normal, regular periods. She reports that over the past few months she has been feeling tired most of the time and occasionally feeling breathless. Virginia has three teenage children, with her youngest child delivered 12 years ago by elective caesarean section for placenta praevia, at which time she underwent tubal occlusion with clips. 

Olivia, aged 27 years, is a mother who presents to you with complaints of worsening tiredness, shortness of breath and feeling generally exhausted. She is currently 29 weeks pregnant with her third child; her older children are two and seven years of age. Olivia’s previous pregnancies were uncomplicated. She has just moved to the area and is seeking shared antenatal care.

Gustav, aged 30 years, presents with a background of ulcerative colitis, for which he takes mesalazine tablets. He presents to you with increasing fatigue and increased bowel frequency with occasional episodes of blood in the stool over the past few months. He looks notably pale and unwell.

CPD

This unit of check is approved for 10 hours of CPD activity (two hours per case). The 10 hours, when completed, including the online questions, comprise five hours’ 鲍鱼视频al Activities and five hours’ Reviewing Performance.


 
鲍鱼视频al
Activities
5
hours
Measuring
Outcomes
0
hours
Reviewing
Performance
5
hours

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TOPICS

Child and youth healthHaematological presentationsPregnancy and reproductive health

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