Iron stores and menstruation in healthy adolescent girls – pilot study

Tissue iron stores are commonly assessed by measuring serum ferritin. Adolescent girls are more prone to develop iron deficiency due to menstrual blood loss. Menstruation is an inflammatory process and we hypothesized that serum ferritin levels may be elevated during menstruation as it is an acute phase protein and hence serum ferritin measurement alone may not be truly reflective of iron status in menstruating girls. The present study was conducted to compare Iron stores in healthy adolescent girls who have attained menarche with age matched healthy adolescent girls who have not attained menarche. Consecutive healthy adolescent girls who have attained menarche and with no illness in the preceding one month were enrolled as cases and consecutive healthy age matched adolescent girls who had not attained menarche served as controls. Hemoglobin, serum Iron and Ferritin were measured in both groups and compared. Serum ferritin levels were significantly high in girls who had attained menarche compared to girls who have not attained menarche (37.2 vs. 8.61 p value 0.0373). There was no significant difference in the hemoglobin and serum iron levels between the two groups. Serum ferritin levels are elevated in healthy menstruating adolescent girls and care should be exercised in relying on ferritin alone for determination of iron status in these girls.