An examination of nationally representative data indicates that nonpregnant women of reproductive age with iron deficiency have higher prevalence of depressive symptom scores than those with iron sufficiency, particularly among women of low income.

Iron deficiency is the most common diet-related nutrient deficiency worldwide and disproportionately affects women of reproductive age. Although the physical symptomatic impact of iron deficiency is widely known, studies are inconclusive regarding the effect of iron deficiency on psychosocial health consequences such as depression.  To investigate the association between iron status and depressive symptoms, Murray-Kolb (Purdue University, formerly of The Pennsylvania State University) and colleagues analyzed data from the National Health and Nutrition Examination Survey (NHANES; 2005-2010), a nationally representative survey conducted to assess the health and nutritional status of Americans.  Nonpregnant women of reproductive age (20-44 years of age) with completed data on iron biomarkers, depressive symptoms, and sociodemographic variables were included.

Among 2516 females, nearly 10% had depressive symptom status. Respondents with depressive symptoms were more likely to be older, of non-Hispanic Black race/ethnicity, of separated marital status, of low poverty income ratio, to not have health insurance, to be on antidepressants, to have less than high school education, to have more household members, and to have an obese body mass index, compared with females without depressive symptoms.

After accounting for sociodemographic and health characteristics, females with iron deficiency had higher scores for depressive symptoms than females with iron sufficiency, especially those in the low-income category. 

These findings contribute to the existing literature reporting a significant association between impaired iron status and depressive symptoms. Should causality be established, efforts could focus on advocation enhanced screening for iron deficiency among women of reproductive age as iron supplementation could offer an effective intervention to alleviate the deficiency, prevent it from progressing to anemia, and decrease the rate of depressive symptoms in nonpregnant women of reproductive age.


Ciulei MA, Ahluwalia N, McCormick BJJ, Teti DM, Murray-Kolb LE. Iron Deficiency is Related to Depressive Symptoms in United States Nonpregnant Women of Reproductive Age: A Cross-Sectional Analysis of NHANES 2005-2010. The Journal of Nutrition, Volume 153, Issue 12, December 2023, Pages 3521-3528,

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