Teenage Girls and Anaemia: Iron-Rich Eating

Being tired all the time is easy to blame on school, phones or late nights. In teenage girls it is often something measurable: anaemia. It is common, it is checkable with one blood test, and it responds to treatment.

What is anaemia?

WHO defines anaemia as a condition in which the number of red blood cells, or the amount of haemoglobin inside them, is lower than normal. Haemoglobin carries oxygen around the body, so when it drops, everything feels harder. WHO says anaemia is diagnosed when blood haemoglobin falls below thresholds set for a person's age, sex and physiological status, for example pregnancy.

Why are teenage girls at higher risk?

WHO says iron deficiency, mostly from not getting enough iron in food, is the most common nutritional cause of anaemia, and lists heavy menstrual bleeding among the causes. The NHS is more direct: heavy periods and pregnancy are very common causes of iron deficiency anaemia. A girl who is growing quickly and losing blood monthly needs more iron than she did as a child.

WHO reports that globally 30% of women aged 15 to 49 are affected by anaemia. In Pakistan, the National Nutrition Survey 2018, reported by UNICEF, found that over half of adolescent girls are anaemic. The same survey found one in eight adolescent girls and one in five adolescent boys are underweight.

What are the symptoms?

WHO lists tiredness, dizziness or feeling light-headed, cold hands and feet, headache, and shortness of breath, especially on exertion. The NHS lists tiredness and lack of energy, shortness of breath, noticeable heartbeats, skin that is paler than usual, and headaches. The NHS also names less common signs including a sore tongue, mouth ulcers, hair loss, changes to the nails, altered taste, difficulty swallowing, restless legs, and craving non-food items such as ice or soil.

Many girls have no obvious symptoms at all, which is why testing matters.

How is it diagnosed?

The NHS says a doctor arranges a blood test to check whether the number of red blood cells is normal, called a full blood count. Do not guess from symptoms, and do not start iron on your own. Anaemia has other causes, including infections, chronic disease and inherited red blood cell disorders, and these need different treatment. If a doctor does find iron deficiency, the NHS says iron tablets are usually recommended and are taken for about six months, under medical supervision.

Which foods are rich in iron?

WHO lists lean red meat, fish, poultry, legumes and leafy greens. The NHS adds:

• Dark-green leafy vegetables such as kale and watercress; palak and saag are everyday equivalents.
• Pulses: beans, peas and lentils, so daal, chana and lobia all count.
• Meat.
• Dried fruit such as apricots, prunes and raisins.
• Cereals and bread fortified with extra iron.

How can she absorb more of that iron?

WHO advises eating foods rich in vitamin C alongside iron-rich meals, because they help the body take up more iron. Orange, guava, lemon juice, tomato and amla all do this job, so squeezing lemon over daal is not just for flavour.

WHO also says some foods slow iron absorption, naming tea, coffee and bran. The NHS adds milk and dairy and foods high in phytic acid such as wholegrain cereals. The practical fix is timing: keep tea away from mealtimes rather than giving it up.

When to see a doctor

Book a check-up and ask about a blood test if a girl:

• Is tired all the time, breathless climbing stairs, or unusually pale.
• Has heavy periods, soaking through pads quickly or bleeding for many days.
• Has headaches, dizziness or a pounding heartbeat.
• Has a sore tongue, mouth ulcers, hair loss or nail changes.
• Craves and eats non-food items such as ice, chalk or soil.
• Is losing weight, not gaining weight, or has stopped eating properly.

Never start iron tablets or other supplements without testing and medical advice. If she has chest pain, faints, is breathless while sitting still, or is bleeding very heavily, call Rescue 1122 where available, or go to the nearest hospital emergency department.