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Meta-analysis links lower Fe, Zn, Mg and higher Cu levels to iron deficiency anemia in childrenChildren with iron deficiency anemia often have different levels of other minerals in their blood

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Key Takeaway
Note association of altered trace element levels with pediatric IDA; high heterogeneity limits certainty.

A systematic review and meta-analysis examined the association between serum trace elements and iron deficiency anemia (IDA) in children and adolescents, pooling data from 1105 participants. The analysis compared serum levels of iron (Fe), zinc (Zn), copper (Cu), and magnesium (Mg) between IDA patients and non-IDA controls. The study setting and specific follow-up duration were not reported.

Results showed IDA patients had significantly lower serum levels of Fe (WMD: -13.07 µmol/L; 95% CI: -16.09 to -10.05), Zn (WMD: -4.33 µmol/L; 95% CI: -5.30 to -3.35), and Mg (WMD: -18.17 µmol/L; 95% CI: -21.00 to -15.33). In contrast, serum Cu levels were significantly higher in the IDA group (WMD: 4.33 µmol/L; 95% CI: 2.21 to 6.46). Absolute numbers for these measurements were not reported.

Safety and tolerability data were not reported. A key limitation is the high statistical heterogeneity (I² > 95%) noted for the analyses of Fe, Zn, and Cu, which suggests considerable variation between the included studies. The practice relevance is restrained; the authors suggest these findings may inform comprehensive nutritional strategies for managing IDA, but clinicians should interpret them cautiously as they represent observational associations, not evidence of causation or therapeutic benefit from supplementation.

Researchers reviewed and combined data from several existing studies to look at the connection between iron deficiency anemia and other minerals in children and teens. They analyzed information from over 1,100 participants, comparing blood levels of iron, zinc, copper, and magnesium in those with anemia to those without it.

The main finding was that children with iron deficiency anemia had significantly lower average levels of iron, zinc, and magnesium in their blood. Interestingly, they had higher average levels of copper compared to children without anemia. The study did not report on any safety concerns related to these mineral levels.

It is important to be careful with these results for a few reasons. First, this type of analysis can only show that these mineral levels are associated with anemia—it cannot prove that low zinc or magnesium causes anemia, or that high copper is a problem. Second, the individual studies included in the review were quite different from each other, which makes the overall result less certain.

Readers should realistically take away that a child's nutritional status is complex. If a child has iron deficiency anemia, their doctor might consider checking other minerals as part of a complete picture, but this research does not yet support changing standard care or taking new supplements.

What this means for you:
Anemia in kids is linked to other mineral imbalances, but this doesn't prove cause and effect.

Study Details

Study typeMeta analysis
Sample sizen = 1,105
EvidenceLevel 1
PublishedDec 2026
View Original Abstract ↓
OBJECTIVES: Iron deficiency anemia (IDA) remains the most prevalent form of anemia in children and adolescents globally. In addition to iron (Fe), other trace elements, such as zinc (Zn), copper (Cu), and magnesium (Mg), may influence hematopoiesis, yet the extent of their dysregulation in IDA remains unclear. METHODS: We conducted a systematic review and meta-analysis of observational studies assessing the serum levels of Fe, Zn, Cu, and Mg in pediatric IDA populations. The literature was searched in PubMed, Scopus, Embase, and Web of Science up to January 2025. The data were standardized to consistent units (μmol/L), and pooled weighted mean differences (WMD) with 95% confidence intervals (CI) were calculated. Subgroup, sensitivity, and publication bias analyses were performed. The study protocol was registered online (PROSPERO number: CRD42024578704). RESULTS: Eight articles encompassing twelve datasets and 1105 participants were included. Compared to controls, IDA patients had significantly lower levels of Fe (WMD: -13.07 μmol/L, 95% CI: -16.09 to -10.05), Zn (WMD: -4.33 μmol/L, 95% CI: -5.30 to -3.35), and Mg (WMD: -18.17 μmol/L, 95% CI: -21.00 to -15.33) but higher levels of Cu (WMD: 4.33 μmol/L, 95% CI: 2.21-6.46). High heterogeneity (² > 95%) was noted for Fe, Zn, and Cu. Subgroup analyses confirmed consistent trends across age, gender, and geography. CONCLUSION: Pediatric IDA is associated with broad alterations in trace elements, highlighting potential roles for Fe, Zn, Cu, and Mg in the pathophysiology of anemia. These findings may inform comprehensive nutritional strategies in managing IDA.
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