Iron Deficiency (without anemia)


In iron deficiency, the amount of iron stored away for later use is reduced but has no effect on functional iron– the iron needed to meet the daily needs of an individual. If the body requires increased iron (due to a rapid growth spurt, for example), a person with inadequate stored iron has no reserves to use. Iron deficiency is 2.5 times as common as iron deficiency anemia.


Institutionalized children are at particular risk for iron-deficiency due to the possibilities of poor maternal prenatal care, poor maternal health, low birth weight, bottle-feeding with formula that is not iron-fortified, tea drinking, a diet low in iron-containing foods, and intestinal parasites.

International adoptees are at risk for iron deficiency because they often have diets low in iron prior to adoption. Even if they do not have an iron deficiency upon adoption, they may have low iron stores. Once adopted, their improved diet, along with added activity and love and attention from a family, usually leads to a growth spurt in the initial period at home. The body calls upon the inadequate stores and can then become iron deficient.


Symptoms of iron deficiency can range from no symptoms at all to the same symptoms seen in iron deficiency anemia:


Iron deficiency without anemia is identified by low ferritin, a high ZnPP, or a low MCV on the CBC.


Like Iron Deficiency Anemia, Iron Deficiency is a risk to the brain. It also raises the risk of progressing to Iron Deficiency Anemia, with its attendant risks to the brain (see section on Iron Deficiency Anemia). The risk for progressing to Iron Deficiency Anemia is greatest during an adopted child’s first six months home, during any rapid growth spurts.


Oral iron supplementation can be used for both prevention and treatment of iron deficiency anemia. The most common iron supplement is ferrous sulfate, which can be obtained over-the-counter. Oral iron supplements are usually best absorbed by an empty stomach. However, because iron can irritate your child’s stomach, he may need to take the supplements with food. Your doctor may also recommend that your child take iron supplements with orange juice or with a vitamin C tablet, as vitamin C increases iron absorption. It usually takes several months of iron supplementation to correct the iron deficiency. Increasing dietary intake of iron can help prevent iron deficiency anemia.

Food Sources

chicken liver, beef, turkey, chicken, pork loin, tuna, halibut, blue crab, oysters, clams, shrimp, fortified cereals, oatmeal, soybeans, lentils and other beans, molasses, tofu, spinach, chard, thyme, raisins, sesame seeds, pumpkin seeds. Pair with vitamin-c rich foods for optimal absorption.

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