From the Guidelines
Yes, iron levels should be checked in a child with elevated lead levels. This is an important part of the comprehensive evaluation and management of lead toxicity. Iron deficiency can increase lead absorption from the gastrointestinal tract and may worsen the effects of lead exposure 1. When evaluating a child with elevated lead levels, healthcare providers should order a complete blood count with hemoglobin and hematocrit, serum iron, total iron binding capacity, and ferritin to assess iron status.
The most recent and highest quality study, published in 2016 by the American Academy of Pediatrics, recommends screening children for iron deficiency and insufficient dietary calcium intake, especially those with elevated blood lead concentrations 1. This is because iron deficiency can exacerbate the effects of lead exposure, and adequate iron stores can help reduce lead absorption.
Key points to consider when evaluating a child with elevated lead levels include:
- Assessing iron status through laboratory tests, such as complete blood count, ferritin, and serum iron
- Providing nutritional counseling related to calcium and iron
- Encouraging the consumption of iron-enriched foods, such as cereals and meats
- Considering multivitamin supplementation with iron, if necessary
- Monitoring children with elevated lead levels until environmental investigations and remediation are complete and blood lead concentrations decline
By prioritizing iron level checks in children with elevated lead levels, healthcare providers can help mitigate the effects of lead toxicity and promote better health outcomes for these children 1.
From the Research
Iron Levels and Elevated Lead in Children
- Checking iron levels in children with elevated lead levels is a relevant consideration, as several studies have investigated the relationship between iron deficiency and lead exposure in children 2, 3, 4, 5, 6.
- Research suggests that iron deficiency can increase the absorption of lead, leading to higher blood lead levels in children 2, 5.
- A study published in the World Journal of Pediatrics found that lead-exposed children with iron deficiency had significantly higher blood lead levels than those without iron deficiency 2.
- Another study published in The Journal of Pediatrics found that iron therapy decreased blood lead levels in infants with mildly elevated lead levels and varied iron status 3.
- A more recent study published in Biological Trace Element Research found a significant association between elevated blood lead levels and iron deficiency in children aged 1-6 years 4.
- The evidence suggests that iron deficiency is associated with higher blood lead levels in children living in contaminated environments, and that improving iron status may help reduce blood lead levels 5, 6.
- The use of iron supplements in children with lead poisoning should be individualized, and supplements should only be provided to patients who are iron deficient or who continue to live in lead-exposed housing 6.