Iron Deficiency: Why It's So Common—and What You Can Do About It

Feeling tired, foggy, irritable, or just “off” is common in many of the children and teens we see. But sometimes, what looks like a psychiatric concern—fatigue, inattention, depression, or anxiety—can actually be rooted in something more basic: iron deficiency. At Philadelphia Integrative Psychiatry, Dr. Danish and his team routinely assess for underlying contributors to mental health symptoms, and iron deficiency anemia (IDA) is one of the most common and often overlooked. Left untreated, it can impact mood, attention, immunity, and even increase the risk of falls due to dizziness and poor coordination. Staying updated on how to best address IDA is key to our integrative approach, and a new study offers some valuable guidance.

A recent systematic review and meta-analysis, Optimal Dose and Duration of Iron Supplementation for Treating Iron Deficiency Anaemia in Children and Adolescents (PLOS ONE, 2025), provides much-needed clarity on what dosing strategies work best for improving hemoglobin (Hb) levels in otherwise healthy youth. With over 8,800 participants from 16 countries, this analysis offers powerful insights that we can apply in real-world care.

What This New Study Reveals About Treating Iron Deficiency Anemia

The study found that iron supplementation led to an average improvement of 2.01 gm/dL in hemoglobin levels, confirming its strong efficacy. Interestingly, the duration of treatment had a significant impact. Children and teens who received iron for less than three months had the greatest improvement, with an average Hb increase of 2.39 gm/dL. Those who were treated for over six months also saw a meaningful gain of 1.93 gm/dL, while intermediate durations (three to six months) were associated with more modest improvements of 1.58 gm/dL. This suggests a U-shaped relationship, where very short or extended treatments may be more effective than moderate ones.

Another important takeaway is that lower doses of iron—specifically less than 5 mg/kg/day—showed favorable trends in hemoglobin improvement, particularly for patients starting with lower baseline levels. While not statistically definitive, this finding aligns with emerging clinical thinking: that lower doses may be safer, better tolerated, and still highly effective. That’s especially relevant when managing iron alongside psychiatric symptoms, where adding a high-dose supplement with gastrointestinal side effects could compromise overall treatment adherence.

The type of iron used also matters. Oral ferrous sulfate emerged as the most effective and widely studied form, leading to an average hemoglobin increase of 2.03 gm/dL. Although other forms like ferrous ascorbate or intravenous iron (e.g., ferric carboxymaltose) also performed well, ferrous sulfate remains a reliable, accessible, and cost-effective option—particularly in outpatient or integrative settings like ours.

One of the more nuanced findings was that patients with lower baseline hemoglobin experienced the greatest improvements. For every unit increase in starting Hb, the overall treatment effect declined slightly, suggesting that supplementation should be tailored to the severity of deficiency—not just applied in a one-size-fits-all way.

Why This Matters in a Psychiatry Practice

At Philadelphia Integrative Psychiatry, we don’t just treat symptoms—we investigate their root causes. Iron deficiency, even before it reaches the level of anemia, can contribute to a wide range of issues we see every day: low energy, poor concentration, low mood, irritability, frequent infections, sleep disturbances, and more. It can mimic or worsen depression, ADHD, and anxiety, and it may compromise treatment outcomes if left unaddressed. Additionally, dizziness and orthostatic symptoms linked to IDA can increase fall risk—an often-overlooked safety concern in children and teens with mental health conditions.

This research strengthens the clinical case for early, individualized screening and treatment of iron deficiency in psychiatric settings. Knowing that low-dose, short-course iron supplementation can be highly effective gives us a powerful, safe intervention to support not just physical health, but mental clarity, mood stability, and overall resilience.

Getting in Touch with Dr. Danish and His Team

If your child or teen is struggling with mood issues, focus problems, fatigue, or chronic illness, it may be time to explore whether low iron is part of the picture. At Philadelphia Integrative Psychiatry, Dr. Danish and his team offer comprehensive evaluations that include targeted lab testing, individualized treatment planning, and a whole-person approach to care. Whether your child needs guidance on diet, supplementation, or an in-depth psychiatric assessment, we’re here to help.

For More on This Topic and Related Subjects, Check Out These Blogs by Dr. Danish:

https://phillyintegrative.com/blog/boosting-your-immune-system-with-zinc-and-vitamin-c-what-you-need-to-know