BMJ 2001;322:1355-1357 ( 2 June )

Education and debate

Why should women have lower reference limits for haemoglobin and ferritin concentrations than men?

D Hugh Rushton, honorary senior lecturer ^a, Robin Dover, clinical research officer ^b, Anthony W Sainsbury, senior veterinary officer ^c, Michael J Norris, senior lecturer ^a, Jeremy J H Gilkes, consultant dermatologist ^d, Ian D Ramsay, consultant endocrinologist ^d. 

^a School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth PO1 2DT, ^b Imperial Cancer Research Fund, Lincoln's Inn Field, London WC2A 3PX, ^c Institute of Zoology, Zoological Society of London, Regents Park, London NW1 4RY, ^d Lister Hospital, London SW1W 8RH

Correspondence to: D Hugh Rushton rushton@btinternet.com

The first 150 words of the full text of this article appear below.

The need to transport oxygen and remove carbon dioxide from animal tissue is a fundamental requirement of life, independent of age or sex.¹ The role of iron in humans and many other mammals is central to this process. ^{2 3} Haemoglobin concentration and red blood cell count are important diagnostic indicators for anaemia in humans and animals.

In prepubertal humans no major differences can be found between the sexes in red blood cell count or haemoglobin and serum ferritin concentrations.⁴ Only after the onset of menstruation does a difference emerge.⁴ Not until 10 years after the menopause does this situation revert in women, when the haemoglobin concentration becomes similar to that of aged matched men. ^{4 5} This situation is compounded by the fact that modern women have a different reproductive history from those in the past. They reach sexual maturity at an earlier age, have fewer pregnancies, and breast feed for shorter periods; as . . . [Full text of this article]

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