Iron deficiency, cognition, mental health and fatigue in women of childbearing age: a systematic review

Abstract

It is known that Fe deficiency has a negative impact on cognitive function in children by altering brain energy metabolism and neurotransmitter function. It is unclear whether Fe deficiency has detrimental effects on cognition, mental health and fatigue in women of childbearing age. Our aim was to systematically review the literature to determine whether Fe deficiency in women of childbearing age affects cognition, mental health and fatigue, and whether a change in Fe status results in improvements in cognition, mental health and fatigue. Studies using Fe supplement interventions were reviewed to examine the effect of Fe deficiency in women of childbearing age (13–45 years) on their cognition, mental health and fatigue. English-language articles ranging from the earliest record to the year 2011 were sourced. The quality of retrieved articles was assessed and the Fe pathology, cognitive, mental health and fatigue data were extracted. Means and standard deviations from cognitive test data were included in meta-analyses of combined effects. Of the 1348 studies identified, ten were included in the review. Three studies showed poorer cognition and mental health scores and increased fatigue with Fe deficiency at baseline. Seven studies reported an improvement in cognitive test scores after Fe treatment. Results of three of these studies were included in meta-analyses of the effect of Fe supplement intervention on cognition. The results of the meta-analyses showed a significant improvement in Arithmetic scores after treatment (P < 0·01), but no effect on Digit Symbol, Digit Span or Block Design. While an improvement in cognition after Fe treatment was seen in seven out of ten studies, the evidence base is limited by poor study quality and heterogeneity across studies. Additional high-quality studies using consistent measures are warranted.

Diet quality and 10‐year healthcare costs by BMI categories in the mid‐age cohort of the Australian Longitudinal Study on Women's Health

“…Meat is the richest dietary source of high biologically available iron (haem-iron) and is considered to have a major role in the prevention of iron deficiency (37) . Although iron deficiency is most common among young women, iron deficiency is relatively prevalent across the life cycle of women and is associated with poor immunity, reduced capacity for physical activity, increased fatigue and reduced cognitive function (38,39) .…”

A Study of the Effects of Latent Iron Deficiency on Measures of Cognition: A Pilot Randomised Controlled Trial of Iron Supplementation in Young Women

“…A recently conducted systematic review [23] reports on eight studies that included both iron-deficient and iron-sufficient participants at baseline [15,16,17,18,19,20,39,40]. Of these, four reported higher cognitive scores for iron-sufficient than iron-deficient participants at baseline, as well as improved scores after iron treatment [15,16,17,20].…”

Running on empty: a review of nutrition and physicians' well-being

“…Among women of reproductive age, iron deficiency is a common but under-recognised cause of fatigue that can be easily addressed and corrected 29. Vitamin B 12 deficiency, which can also cause fatigue, is common among vegans, strict vegetarians, people with malabsorption syndromes, those over 50 years of age and those who take proton-pump inhibitors, H2 blockers or metformin 30…”