A 45-year-old women presents for evaluation of fatigue. She has been tired for the past 6 months. What would you recommend?
I would treat this patient with iron. Verdon and colleagues conducted a randomized, double-blind placebo-controlled trial of iron treatment in nonanemic women.The women who received iron had a much grater reduction in fatigue score, compared with the women who did not . Only women with ferritin levels less than 50 mcg/L benefited.
Houston and colleagues performed a systematic review of the literature of iron supplementation for fatigue and concluded that iron should be considered for treatment of fatigue in nonanemic women.Hair thinning is a common concern for many women. Does iron deficiency have a possible role in this problem? A number of studies have correlated low ferritin levels with hair loss.There is less clear evidence of iron treatment being effective.
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