Time to talk: Iron Deficiency Anemia and Mental Illness
The 1st of February is National Time to Talk Day here in the UK. The event, aimed at removing the cultural taboo that has been associated with discussing mental health and its effects on daily life, relationships, and employment, has been embraced by leading members in almost every imaginable sector, with Prince Harry launching the event nationally during at a visit to London Ambulance Service which was holding its own Time To Talk Day event for staff.
People often hide their mental illness
Open dialogue can be instrumental in helping those with mental illness mange their well being. According to the Mental Health Foundation, “Nearly nine out of ten people with mental health problems say that stigma and discrimination have a negative effect on their lives”, with said stigmas delaying or impeding their getting help or treatment, and therefore delaying any potential for management or recovery. People with mental illness often feel isolated, and many have difficulties forming long standing personal relationships or having successful, fulfilling careers, often due to the latent, paralyzing fear that disclosure of their illness will push people or opportunities away, all the while trapping themselves in a cycle of illness that feels to them like quicksand (Corrigan, Watson). Openness, understanding and acceptance of the seriousness and struggle of mental health issues can help create an environment in which people with mental illness can take steps necessary to manage their mental and emotional well being, and do their best to enjoy and lead a more normal life.
Causes of mental health are not always known, with known causes including genetics, infection,, substance abuse, prenatal damage, physical and emotional trauma to name a few. A study published by BMC Psychiatry in 2013 points to a link between adult mental illness in people who also had a diagnosis of iron deficiency anaemia during either childhood or adolescence (ages 0-18).
Could there be other hidden factors involved?
In the research article published by BMC Psychiatry, the researchers, after reviewing close to three thousand patients who had iron deficiency anemia whilst under the age of eighteen, concluded that “Iron deficiency increased the risk of psychiatric disorders, including mood disorders, autism spectrum disorder, attention deficit hyperactivity disorder, and developmental disorders.” Although further study is required to clarify the mechanism in the association between IDA and psychiatric disorder (Chen) dietary intake of iron in childhood may be a worthwhile consideration in assessing the cause and contributing factors in mental illness. Iron, which is most prevalent in meat but can also be found in legumes, grains, nuts, and some vegetables, serves as an important cofactor in a number of reactions, including “the synthesis of tyrosine, a precursor to the neurotransmitters dopamine and norepinephrine; and tryptophan, a precursor to the neurotransmitter serotonin.” (Richardson) The link association the researchers observed seems to suggest that there are potentially some pathways that develop, or fail to develop, during childhood and adolescence based in part of the availability of iron stores in the body.
An estimated 4 million people in the UK have anaemia, with “50% of the anaemia ... assumed to be attributable to iron deficiency” (Stoltzfus). Iron Deficiency Anaemia has been recognised as one of the most prevalent micronutrient deficiencies worldwide (Gibson). Globally, 2 billion people, or 1 in 4, are anemic, with iron deficiency ranking as number 9 among 26 risk factors included in the Global Burden of Disease (GBD) 2000 project, and accounted for 841,000 deaths and 35,057,000 disability-adjusted life years lost. Symptoms associated with anaemia are lethargy, reduced cognitive function, and some instances may carry wider reaching implications for people with iron deficiency anaemia.
Iron deficiency anaemia during infancy and childhood may cause irreversible damage to neurological development and increase the risk of mood disorders, autism spectrum disorder, and developmental disorders. Proactive treatment, specifically through a haemoglob
in and haematocrit measurements and subsequent dietary adjustments (at the recommendation of a medical professional) are important to prevent any mental illness that may have been caused by low iron levels. Mental illness may still occur, through one of the listed known pathways above or potentially through something yet undiscovered.
At Entia, we think that a world where mental illness (as well as its prevention, treatment, and the acceptance of the struggles it brings) is acknowledged and openly discussed is not only achievable but morally just. It is certainly something worth taking the time to talk about today.
Gibson, R.S. Principles of Nutritional Assessment, 2nd ed.; Oxford University Press: New York, NY, USA, 2005.
Stoltzfus, RJ. Iron deficiency: global prevalence and consequences. Food Nutr Bull. 2003 Dec;24(4 Suppl):S99-103
Chen et al.: Association between psychiatric disorders and iron deficiency anemia among children and adolescents: a nationwide population-based study. BMC Psychiatry 2013 13:161.
Richardson, et al.: Higher Body Iron Is Associated with Greater Depression Symptoms among Young Adult Men but not Women: Observational Data from the Daily Life Study. Nutrients: Basel, Switzerland, 2015
Corrigan, PW. Watson, AC. Understanding the impact of stigma on people with mental illness: World Psychiatry. 2002 Feb; 1(1): 16–20.