Iron deficiency in New Zealand1

Iron deficiency is the most common nutritional deficiency worldwide, with as many as 80% of the world’s population iron deficient, while 30% may have iron deficiency anaemia.

Iron deficiency and depletion of iron stores can occur across all age groups. Groups which are commonly susceptible include children, women after the onset of menstruation, elderly people, vegetarians (especially vegans).

The terms ‘iron deficiency’ and ‘anaemia’ are often used interchangeably, however these are not interchangeable terms. Iron deficiency is only one cause of anaemia, and in the early stages of iron deficiency, anaemia is not present. Anaemia indicates more severe and longer duration of iron deficiency.

Iron deficiency results when iron requirements are not met by iron absorption from the diet and can develop gradually. Symptoms may be minimal until anaemia develops.

The three common situations leading to this imbalance are:

  • Excess iron loss (bleeding)
  • Inadequate dietary iron intake
  • Malabsorption of iron due to disease of the small intestine

'Iron deficiency anaemia' and 'anaemia' are often used
interchangeably but they are not the same.

  • Iron deficiency is common in the community
  • Iron deficiency may be present with or without anaemia
  • Anaemia indicates more severe and usually longer duration of iron deficiency
  • Iron deficiency may indicate serious disease
  • Iron deficiency is never a final diagnosis in itself
  • A cause of iron deficiency should always be sought
  • While seeking a cause, the iron deficiency itself should be corrected

Those most at risk of iron deficiency include:

  • Pregnant women due to rapid foetal growth.
  • Adolescent girls and women of childbearing age due to menstrual blood loss.
  • Young children due to rapid growth and inadequate iron intake.
  • Children with chronic disease or restricted diets.
  • People on restricted diets, such as vegetarians and vegans.
  • People with chronic renal failure on haemodialysis due to regular loss of blood (iron) in establishing dialysis through the lines.
  • People with chronic gastrointestinal blood loss due to NSAID use, angioectatic lesions, peptic ulcer disease, ulcerative oesophagitis, undiagnosed colorectal, oesophageal or gastric cancer, or inflammatory bowel disease.
  • Athletes (elite level).
  • People who have had weight loss surgery, especially where bypass of normal anatomy has been undertaken – as iron is only absorbed in the very proximal small bowel.

Reference: 1. Gastroenterological Society of Australia (GESA). Iron Deficiency. Clinical Update. October 2015. Available at [Accessed September 2019].


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