The most common nutrient deficiency is low iron. It is especially common among women because iron is lost by menstrual bleeding and pregnancies. As a result, women are expected to have a lower hemoglobin, on average, than men.
It has been estimated that 25% of women aged 18-50 have low iron. This causes fatigue, impaired concentration, decreased exercise tolerance, and poor sleep quality. A recent editorial by hematologist Dr. Angela Weyand, published in The Lancet medical journal, suggests that iron deficiency accounts for a major source of gender inequality.
For many years, it has been assumed that anemia during pregnancy was due normal. Recently it has become clear that iron deficiency is the main problem, occurring in as many as 25% of all pregnancies. Children born to iron deficient mothers have been shown to have impaired cognitive, motor, social, and emotional development.
The way to solve this is to identify and treat all women who have iron deficiency. This public health mission has been challenging because of lack of awareness among women and their physicians and poor understanding of the iron tests.
Another problem has been the difficulty women face when trying to find a hematologist to provide iron treatment. Historically, the practice of hematology has been combined with oncology. Because iron deficiency is a “benign” blood condition, it has been viewed as low priority for oncology doctors.
A third problem has been coverage by health insurance plans. The safest and most effective iron treatments are somewhat expensive. The health care system makes it hard for physicians to create a sustainable system to do outpatient infusions. This has led many to refer their iron-deficient women to hospitals for iron infusions.
Finally, iron infusions have been challenging because the old formulations caused allergic reactions. Physicians were afraid to prescribe iron infusions, instead relying on oral iron supplements. Many studies show these supplements are usually not effective, and they are not well tolerated.
Recently, Heme Onc Call, the country’s first telemedicine-based hematology practice, was created to reform the way women’s health hematology is practiced. Women no longer need to visit an oncologist for low iron. Instead, they schedule a next-day online appointment as the “digital entry” into the women’s health practice.
After a careful assessment of the woman’s situation and review of iron testing, this telemedicine hematology sets up iron infusions and obtains confirmation of coverage from the health insurance plan. The iron infusion is promptly completed in a safe and comfortable outpatient clinic.
The mission of Heme Onc Call is to identify and treat every woman who has iron deficiency: pregnant women, those who have heavy menstrual bleeding, and those who do not absorb iron well (e.g. after weight-loss surgery). Ask your doctor about testing your iron level, and contact Heme Onc Call for a televisit appointment.
