Is it time to offer routine screening for iron deficiency in healthy adolescent females?

Abstract

Iron deficiency (ID), with or without anaemia, remains a significant global health issue among adolescents. Despite its high prevalence and impact on physical and cognitive function, ID is often underrecognized and undertreated. Adolescent females are particularly at risk due to dietary patterns and menstrual blood loss. Serum ferritin is the most reliable marker of iron status. However, its interpretation and the effect of inflammation should be acknowledged. Current screening practices often focus only on individuals with symptoms or known risk factors. This paper challenges that approach and supports universal screening using haemoglobin and ferritin testing in female adolescents around the age of 14-15, approximately 3 years post-menarche. Improving detection requires making screening more accessible, adolescent-friendly and connected to timely follow-up care. The end result is to build a healthier adolescent female population, preparing them to become healthier adult women facing the challenges of women's manifold roles in the modern world. It is important to clarify that the value of eliminating ID extends beyond future pregnancy readiness; it is equally critical for supporting the cognitive, physical and social demands of everyday life faced by adolescent girls and young women.