Latest / Morning Medical with Dr. Chow / Iron Deficiency Screening, Sober-Curious Movement, and Youth Sports Health Concerns

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Iron Deficiency Screening, Sober-Curious Movement, and Youth Sports Health Concerns · Morning Medical with Dr. Chow

0:00
Good morning, everyone.
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Welcome to another episode of Morning Medical with Dr.
0:04
Chow.
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I'm your host, Dr.
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Chi-Ming Chow.
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Today is episode seventy-five, and we have an important topic to discuss that affects many,
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yet often goes undiagnosed: iron deficiency.
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Iron deficiency may affect many women, and it can lead to anemia, a condition that results in
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the body having too few healthy red blood cells.
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Around a third of women of reproductive age in the United States might not get enough iron.
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Despite these high numbers, doctors don’t routinely screen for the condition during
0:40
annual health examinations.
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About three years ago, Soumya Rangarajan, a front-line hospital doctor, struggled day after
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day with exhaustion, headaches, and heart palpitations.
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Initially, she thought these symptoms were due to the demands of working during the COVID-19
0:58
pandemic.
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However, a social media post made her consider that she might have an iron deficiency.
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She requested a blood test from her doctor, and the results showed she had anemia, caused by
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lower-than-normal iron levels in her blood.
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Rangarajan, who is a geriatrician at the University of Michigan, recalled that her
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symptoms made it difficult for her to get through a full week at work.
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After her diagnosis, she started taking iron supplements and noticed significant
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improvements in her energy levels and overall wellbeing.
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Research suggests that iron deficiency isn’t routinely screened for unless women present
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symptoms to their healthcare provider.
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Angela Weyand, a pediatric hematologist at the University of Michigan Medical School,
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mentioned that while the American College of Obstetricians and Gynecologists recommends
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routine screening for anemia in pregnant women, many non-pregnant women who are iron deficient
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but not anemic are often missed.
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The U.S.
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Preventive Services Task Force recently reviewed studies on iron deficiency screening
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for asymptomatic pregnant women.
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They concluded that there is insufficient evidence to recommend routine screenings, as
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the existing data was unclear about whether screening for iron deficiency in the absence of
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symptoms made a significant difference.
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Iron is a vital component of hemoglobin, a protein in red blood cells that helps carry
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oxygen to every part of the body.
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It’s also essential for various other cellular functions, including energy production and
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maintenance of healthy skin, hair, and nails.
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If iron levels dip too low for too long, hemoglobin levels also drop, resulting in
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anemia.
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Even before anemia sets in, low iron levels can cause health problems.
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Women with iron deficiency can experience lightheadedness, shortness of breath, anxiety,
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depression, and restless leg syndrome.
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Iron deficiency has also been linked to heart failure, hearing loss, and pica — a craving for
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substances like ice, dirt, or clay.
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Pregnancy increases the need for iron, making pregnant women especially vulnerable to anemia.
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Michael Georgieff, a pediatrics professor at the University of Minnesota, noted that iron
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requirements for pregnant women go up dramatically.
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If not screened and supplemented, it’s very hard to keep up with a pregnant woman’s iron
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status, potentially leading to difficult pregnancies and low birth weight babies.
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Margaret Ragni, an emeritus professor of clinical translation research at the University
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of Pittsburgh, emphasized the poor quality of life associated with iron deficiency.
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She advocated for annual screenings, noting that many of her female patients reported
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significant improvements in their quality of life after starting iron supplements.
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Iron supplements can come with side effects like stomach cramps, nausea, and constipation.
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However, intravenous iron treatments can offer relief.
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Rangarajan, for instance, switched to intravenous iron supplements and noticed a
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significant improvement in her symptoms within a week.
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The World Health Organization has estimated that, worldwide, about thirty percent of women
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between fifteen and forty-nine years old were anemic in 2019, with iron deficiency being
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responsible for about half of these cases.
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Some research even suggests that the vulnerability to iron deficiency can start at a
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young age.
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Angela Weyand co-authored a study in 2023 that found the overall prevalence of iron deficiency
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among women and girls aged twelve to twenty-two was more than thirty-eight percent.
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The prevalence of anemia was about six percent.
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These statistics highlight the importance of screening for iron deficiency, especially in
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younger women.
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Labs determine iron levels by looking at the concentration of ferritin, a protein that
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stores iron, in the blood.
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The World Health Organization says that anything under fifteen micrograms of ferritin
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per liter of blood is iron deficient.
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However, some researchers argue that this threshold should be higher to avoid false
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negatives.
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Weyand and other researchers advocate for raising the ferritin threshold to fifty
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micrograms per liter for women.
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They believe that this would help capture patients who might otherwise be ignored and
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dismissed or told their symptoms were due to some other issue.
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Iron deficiency is an easily treatable condition once diagnosed.
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Weyand noted that women in low-income communities are at higher risk of iron
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deficiency due to a lack of access to healthcare and iron-rich foods like meat, dark
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leafy vegetables, salmon, and tofu.
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After her anemia diagnosis, Rangarajan initially took iron tablets daily but cut back
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to three times a week due to side effects like stomach cramps and nausea.
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Eventually, she switched to intravenous iron supplements and experienced significant
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improvement in her symptoms.
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Weyand often uses her social media platforms to advocate for more attention to iron deficiency.
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She hears from many working women about how diagnosis and treatment significantly improved
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their quality of life.
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She believes that we are vastly undertreating iron deficiency currently.
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Iron deficiency is rare in men, affecting about two percent of men in the United States.
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When it does develop, it can signal underlying conditions like an ulcer or cancer.
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As Weyand put it, “It’s more of a red flag in terms of figuring out why they’re iron
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deficient.”
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The International Federation of Gynecology and Obstetrics issued recommendations in 2023 to
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regularly screen all menstruating women and girls for iron deficiency.
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Weyand hopes that these recommendations and more research will help increase awareness
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among U.S.
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healthcare providers about the need for regular screening.
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The U.S.
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Preventive Services Task Force’s recent findings did not sit well with some
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researchers.
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Michael Georgieff, whose research focuses on the effect of iron on fetal brain development,
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believes that more studies are needed to assess the potential health impact of iron screening
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and supplementation for asymptomatic pregnant women.
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Esa Davis, a task force member and associate vice president for community health at the
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University of Maryland, noted that the task force needs more studies to show the benefits
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or harms of screening and supplementation in pregnant women who show no signs or symptoms of
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iron deficiency.
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Weyand hopes that ongoing research on iron deficiency in women will encourage
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organizations like the U.S.
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Preventive Services Task Force to reconsider their stance on regular screening.
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Regular screening could lead to meaningful changes in how we diagnose and treat iron
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deficiency, improving the quality of life for many women.
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Having experienced the debilitating effects of iron deficiency and anemia, Rangarajan
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emphasized the importance of screening for diagnosis and effective treatment.
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She noted that her energy levels and performance at work have improved tremendously
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since starting intravenous iron treatments.
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Engaging in creative activities can significantly boost well-being by providing
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meaningful spaces for expression and achievement, according to a new study.
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Walking into my grandmother’s house, I watch her hands move in a fast-weaving motion as
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stitches extend from her knitting needles.
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Beside her are layered stacks of knit blankets, scarves, and ponchos stitched with carefully
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selected color schemes and patterns made of wool yarn.
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She donates these blankets to children’s hospitals and foster homes.
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Her favorite pastime is creating.
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She is always crafting, whether it’s knitting, coloring, scratch art, or most recently,
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dabbling in gem art.
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These activities provide her satisfaction and purpose in ways more fulfilling than work.
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She infused her love for arts and crafts into the rest of my family.
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My mom joined community theater groups when she became an empty nester and learned pour
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painting.
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My younger cousin photographs nature, and his father (my uncle) has a comedic podcast with
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voice actors.
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My twin brother and I sang in college — it kept us sane while balancing our heavy academic
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workloads.
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Creating art reduces levels of cortisol, the body’s stress hormone, past research has shown.
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Dr.
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Helen Keyes, cognitive psychologist and head of the school of psychology and sport science at
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Anglia Ruskin University, said that engaging with arts and crafts is accessible and
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affordable.
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Options such as knitting and drawing require very few tools and can be engaging and
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creatively fulfilling activities.
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Now, a new study by Keyes and fellow researchers has found that engaging in creative
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activities can significantly boost well-being by providing meaningful spaces for expression
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and achievement.
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Although prior studies have shown that creating arts and crafting is therapeutic for people
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with mental health conditions, the general population has been understudied, according to
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the study, which was recently published in Frontiers in Public Health.
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That’s why they sampled members of the general population without diagnosed illnesses to see
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how arts and crafts might contribute to well-being and may reduce loneliness outcomes
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in everyday life.
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The team used data from a major national survey in the United Kingdom between 2019 and 2020 to
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investigate how creative activities could impact life satisfaction, controlling for
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variables known to affect well-being such as gender, age group, health, employment status,
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and deprivation.
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The researchers analyzed a sample of 7,182 participants living in England (age sixteen and
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over) from the annual Taking Part survey conducted by the United Kingdom’s Department
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for Culture, Media, and Sport, which explores how the public engages with these activities.
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Dr.
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Keyes said, “We kept our analysis to arts and crafting at a broad level, rather than focusing
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on specific hobbies, as we know that people’s preferences vary and they will find the craft
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or creative activity that works best for them.”
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More than 37 percent of survey respondents confirmed they had taken part in at least one
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craft activity over the last year.
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They were also asked about their employment status, their health, their sense of life being
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worth living, how frequently they feel lonely, and their levels of sensed happiness, anxiety,
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and life satisfaction.
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Participants’ reported happiness, life satisfaction, and sense of lives being
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worthwhile were positively correlated to participating in arts and crafts, but arts and
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crafts were not associated with decreased anxiety or loneliness, which requires further
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investigation.
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Additional study is needed to examine the social aspects of creative activities,
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researchers said.
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Dr.
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Frank Clark, a psychiatrist with Prisma Health and a poet, said that all forms of art can be
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beneficial in boosting mental health.
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Benefits include an increase in self-esteem, reduction in anxiety and stress, improving
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communication, and fostering creativity.
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Dr.
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Clark was not involved in the study.
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The researchers suggested that arts and crafts could improve public health.
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Dr.
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Keyes said, “Governments and national health services might consider funding and promoting
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crafting, or even socially prescribing these activities for at-risk populations as part of a
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promotion and prevention approach to well-being and mental health.
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Engaging with crafting is something that is relatively easy to introduce into your life.”
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Crafting provides an opportunity for a sense of achievement and expression through creation.
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Dr.
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Keyes said, “A sense of mastery is important for well-being, and there is inherently a sense
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of mastery associated with crafting and creating art; that is, people can see their
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progress and be proud of what they are producing.”
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If you don’t think of yourself as artistic or creative, Dr.
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Clark has four suggestions to tap into your creative side: reframe your thinking to be
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optimistic about your creative potential; do not be afraid to take risks to try a new
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activity; foster relationships with people who are in a creative space that’s interesting to
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you; and think about what you did creatively as a child and do it again.
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A cheap option for indulging in creativity is coloring.
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Although some may perceive coloring as an activity for kids, Dr.
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Clark said, “I love adult coloring books and encourage everyone to embrace their inner
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child.
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Coloring is an example of a mindfulness activity that has a multitude of health
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benefits.
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It can help foster social connection, improve concentration, and spur creativity.”
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Dr.
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Clark added, “Creativity has the power to foster resilience, restoration, and
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reconciliation.
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It is a cathartic antidote that can help provide a sense of meaning and purpose for
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humanity.”
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Excessive alcohol use leads to around one hundred seventy-eight thousand deaths each year
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in the United States, according to the Centers for Disease Control and Prevention.
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Such an alarming statistic might make anyone rethink their drinking habits, and Generation Z
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is already leading this shift.
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With the sober-curious movement offering a new approach to lifestyle and wellness, it's
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reshaping long-standing traditions and beliefs—specifically attitudes about alcohol's
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role in our personal lives and dating preferences.
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But what is sober curious, and can adopting this lifestyle really enhance your overall
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well-being?
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Introduced by author Ruby Warrington, the concept of sober curiosity encourages people to
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examine their drinking habits and explore life with less alcohol.
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Drinking has traditionally been used to unwind, celebrate, or cope with stress, but the
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sober-curious movement challenges these ancient associations with alcohol.
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"Sober curious means you are not one hundred percent alcohol-free, but you are interested in
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exploring a lifestyle where alcohol is not the center of attention," said Hilary Sheinbaum, a
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dry lifestyle expert and author of The Dry Challenge and Going Dry: A Workbook.
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"You might drink on occasion, but you're drinking less."
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Sheinbaum's dry journey began with a bet in two thousand seventeen when she and a close friend
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challenged each other to complete Dry January.
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The winner would get to choose a lavish dinner spot in New York.
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Initially skeptical due to alcohol's deep roots in her journalism career and social life, she
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found that the month-long experiment transformed her life dramatically.
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Since realizing how abstaining from alcohol can boost well-being, personal growth, and
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perspective, Sheinbaum has been guiding others, including Generation Z, toward a life with less
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alcohol.
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Generation Z approaches life with more of a focus on health and well-being compared to
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previous generations, and drinking less aligns with their values of maintaining physical and
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mental wellness while seeking a more balanced and intentional lifestyle.
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Like millennials, who, according to a two thousand twenty American Heart Association and
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American Diabetes Association survey, are worried about the impact their health may have
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on their ability to experience life fully, Generation Z also shares this concern.
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In fact, the survey found that Generation Z participants—specifically, seventy-five percent
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of them—were most concerned about their health preventing them from living life to the
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fullest.
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A two thousand twenty-four survey from NCSolutions reinforces Generation Z's
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prioritization of their health, reporting that they are cutting back on drinking primarily to
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enhance their physical and mental health, make lifestyle changes, lose weight, and save money.
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Overall, forty-one percent of participants from all generations stated they are trying to drink
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less in two thousand twenty-four.
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This percentage was much higher for Generation Z, as sixty percent of respondents from this
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generation said they plan to drink less this year.
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Being sober curious may also affect how a person approaches dating by influencing their
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choice of partner and the types of dates they prefer, as they seek connections with those who
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respect their lifestyle and enjoy activities that do not revolve around alcohol.
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In a two thousand twenty-three press release, Mark Van Ryswyk, chief product officer at
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Tinder, explained that a suite of new features on the dating app was a result of the new
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generation of daters who seek "authentic connections formed through shared interests and
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common causes and have no time for the 'game-playing' of previous generations.
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They want to portray their true authentic selves and expect the same in return."
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This Tinder update included basic info tags, which allow users to include important
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information about themselves, including drinking habits.
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A Bumble study also found that since the pandemic, many users have altered their
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drinking habits, with twenty-five percent of United States adults drinking less than before,
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leading to a shift in dating preferences.
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As a result, thirty-four percent of Bumble users now prefer "dry dates," or dates that do
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not involve alcohol.
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This may require some creativity, depending on where you live.
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"Think outside the box and plan things that are not going to a bar.
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Eventually, that person is going to be involved in parts of your life that do not involve
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drinking, so I think it is about incorporating things that you enjoy and bringing that person
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in," said Sheinbaum.
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"And if you're going to the bar, check the menus in advance." She recommends that
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sober-curious daters use the app Better Without, which lists bars and restaurants that
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offer nonalcoholic options.
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The growing popularity of drinks marketed as alcohol alternatives reflects a growing shift
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towards mindful drinking and wellness.
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A recent NIQ generational consumer study also revealed that Generation Z has greatly
20:05
contributed to the rise of nonalcoholic drinks.
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These alcohol-free options offer diverse flavors and benefits without intoxication,
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helping Generation Z navigate social pressures and avoid feeling left out while maintaining
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their commitment to a healthy lifestyle.
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Mocktails, or alcohol-free cocktails, mimic the creativity, flavors, and presentation of
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traditional cocktails.
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Sometimes, they contain nonalcoholic spirits and juice, soda, bitters, and other
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ingredients.
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Nonalcoholic wine can replicate the aromas and flavors of regular wine, providing
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similar-tasting experiences without the alcohol.
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Nonalcoholic beer tastes similar to regular beer but contains significantly less alcohol,
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often marketed as zero point zero percent alcohol by volume.
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In the United States, it can legally contain up to zero point five percent alcohol by volume.
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Kombucha is a fermented green or black tea that contains probiotics for potential digestive
21:10
health benefits.
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It's available in various flavors and can be a refreshing, low-calorie alternative to sugary,
21:17
alcoholic drinks for those who do not mind its tanginess and mild sweetness.
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CBD drinks are infused with cannabidiol, a nonpsychoactive compound derived from cannabis.
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They come in various forms, such as teas and sparkling waters, targeting wellness and
21:34
calmness.
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Choosing not to drink alcohol can lead to numerous benefits across various aspects of
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your life.
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From better physical and mental health to financial savings, the advantages are
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significant.
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Improved physical health includes a reduced risk of liver disease, heart problems, and
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certain cancers.
21:55
Better mental health includes a decreased risk of depression and anxiety and improves overall
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mood stability.
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Enhanced sleep quality, increased energy and productivity, weight management, and financial
22:09
savings are also notable benefits.
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Sheinbaum can attest to the positive impact of consuming less alcohol.
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"I felt amazing.
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My skin was clearer, my bank account was fuller, my sleep was better.
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I just felt healthier," she said, recalling how she felt after her first Dry January.
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The sober-curious movement is likely to gain momentum if more people seek healthier
22:36
lifestyles and reevaluate their relationship with alcohol.
22:41
As of this year, forty-one percent of Americans are making the effort to drink less, with
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Generation Z and millennials making up a large portion of that percentage.
22:52
"Alcohol is not going anywhere, but as time goes on, I think people will be more open to
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trying nonalcoholic beverages if they have not already, and I think they will be more open to
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not drinking at functions and celebrations," Sheinbaum said.
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She encourages anyone considering this lifestyle to start by taking on a challenge
23:14
with a friend, much like her own experience.
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"I always say there is strength in numbers.
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Recruit a friend.
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Even taking it a step further and making a bet if that motivates you," Sheinbaum said.
23:30
Since making the shift to drink less can be challenging, as alcohol is deeply ingrained in
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many aspects of daily life, it's important to approach the process with patience and
23:40
self-compassion.
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"Be kind to yourself during the whole process," Sheinbaum said.
23:45
"We've become accustomed to alcohol being present everywhere, so you start to realize how
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often you're offered a drink or how often it's available.
23:52
If you have a drink, that's OK.
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Continue on your sober-curious journey the next day."
23:58
Chris Nowinski, PhD, from the Concussion Legacy Foundation in Boston, raised a provocative
24:04
question this week: 'Is it safe to hit a kid in the head 200 times?' This question highlights
24:10
the ongoing concerns about head trauma in youth football.
24:14
With increasing awareness about the long-term effects of concussions, Nowinski's words serve
24:19
as a stark reminder of the risks involved in contact sports for children.
24:25
Daniel Grossman, MD, of Advancing New Standards in Reproductive Health, voiced his concerns
24:31
about the elimination of federal abortion protections.
24:34
He stated, 'These laws are just incompatible with evidence-based medical care, and the bans
24:40
need to be repealed.' Grossman's comments reflect the ongoing debate and tension in
24:45
obstetric care, especially as it pertains to reproductive rights and access to safe medical
24:52
procedures.
24:54
Trisha Pasricha, MD, MPH, from Beth Israel Deaconess Medical Center in Boston, shared an
25:01
intriguing insight about Parkinson's disease.
25:04
'At least for some patients, Parkinson's disease may originate in the gut,' she said.
25:10
This statement points to emerging research linking upper gastrointestinal damage to
25:14
subsequent diagnoses of Parkinson's, opening new avenues for understanding and potentially
25:20
treating this debilitating condition.
25:23
James Lawler, MD, MPH, from the University of Nebraska Medical Center's Global Center for
25:30
Health Security in Omaha, commented on the H5 bird flu.
25:34
He remarked, 'That would indicate a step up in the virus' game,' if the flu were to be passed
25:40
by human-to-human transmission.
25:43
Lawler's words underscore the potential for a significant public health threat if the virus
25:48
evolves to spread more easily among humans.
25:52
Rachel Aaron, PhD, of Johns Hopkins University School of Medicine in Baltimore, made an
25:56
important distinction about chronic pain in children.
26:00
'It tells us that chronic pain, in and of itself, is not depressing,' she said.
26:05
Aaron's research suggests that while kids with chronic pain may have anxiety and depression,
26:10
the pain itself is not the direct cause of their mental health issues.
26:14
This finding could influence future treatment approaches for young patients struggling with
26:18
chronic pain and associated mental health challenges.
26:22
Neil Tanna, MD, from the Katz Women's Surgical Center at Northwell Health in New York,
26:27
discussed the art of body contouring through liposuction.
26:32
'You do liposuction in a way that accentuates the desirable contours of the body,' he said.
26:39
Tanna's comment highlights the precision and skill involved in modern cosmetic surgery,
26:44
particularly in creating aesthetically pleasing results such as surgically created six-pack
26:50
abs.
26:52
Michael Green, MD, MPH, from the UPMC Children's Hospital of Pittsburgh and an
26:58
advisor to the FDA, raised alarms about antibiotic resistance.
27:04
'Carbapenem resistance is a thing and it's far worse now than it was 10 years ago,' he stated.
27:10
Green's comment stresses the growing challenge of antibiotic-resistant infections, which
27:15
complicate treatment options and pose a serious threat to public health.
27:20
Kai Rejeski, MD, from Memorial Sloan Kettering Cancer Center in New York City, spoke about the
27:26
risks associated with CAR T-cell therapy for cancer.
27:30
'A patient has to be alive to develop a second malignancy,' he said.
27:35
Rejeski's words remind us of the delicate balance between the benefits and risks of
27:40
advanced cancer treatments, emphasizing that the primary goal is to extend life, even if
27:46
there are potential long-term risks.
27:49
Luis-Emilio García-Pérez, MD, PhD, from Eli Lilly in Indianapolis, discussed sex
27:58
differences in weight loss from tirzepatide, also known as Zepbound.
28:03
'There seems to be similar effects with semaglutide,' he noted.
28:07
García-Pérez's observation may inform future research and treatment protocols, particularly
28:13
in understanding how different sexes respond to weight loss medications.
28:18
That's all for today's episode of Morning Medical with Dr.
28:21
Chow.
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I'm Dr.
28:23
Chi-Ming Chow, and I hope you found our discussions insightful and thought-provoking.
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Join us tomorrow for another update on the latest in medical and health news.
28:32
Have a great day and stay healthy!