Iron deficiency affects as many as 40% of women of reproductive age, yet the problem often goes undetected—even when patients have symptoms and complications. On this episode, Dr. Blair Bigham and Dr. Mojola Omole speak with hematologists Dr. Michelle Sholzberg and Dr. Rita Selby about their structural solution to this pervasive problem: a province-wide change to how laboratories flag ferritin results. Their article, “Diagnosis and management of iron deficiency in females”, is published in CMAJ.
Dr. Michelle Scholzberg, a hematologist and clinician scientist at St. Michael’s Hospital and division director of Hematology at the University of Toronto, explains why iron deficiency without anemia is clinically important, how flawed reference standards and stigma around menstruation have contributed to underdiagnosis, why screening based on hemoglobin alone misses many patients and how structural barriers within medicine have long impeded timely detection and treatment. She outlines the evidence that drove a change to the clinical decision threshold for ferritin in Ontario laboratories and describes the movement that led to the change
Dr. Rita Selby, an academic hematologist and medical director of the Ontario Laboratory Medicine Program at Ontario Health, describes how change was implemented across Ontario’s major private labs. She clarifies the distinction between reference ranges and clinical decision limits, and how the shift helps clinicians identify subclinical iron deficiency earlier. She also discusses anticipated challenges, such as increased demand for treatment and the need for accessible knowledge translation tools.
This episode exemplifies how making structural change in Canadian medicine can be difficult, but is possible with grassroots advocacy and inter-institutional collaboration.
For more information from our sponsor, go to MedicusPensionPlan.com
Comments or questions? Text us.
Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.
You can find Blair and Mojola on X @BlairBigham and @Drmojolaomole
X (in English): @CMAJ
X (en français): @JAMC
Facebook
Instagram: @CMAJ.ca
The CMAJ Podcast is produced by PodCraft Productions
Popular Podcasts
CrimeLess: Hillbilly Heist
It’s 1996 in rural North Carolina, and an oddball crew makes history when they pull off America’s third largest cash heist. But it’s all downhill from there. Join host Johnny Knoxville as he unspools a wild and woolly tale about a group of regular ‘ol folks who risked it all for a chance at a better life. CrimeLess: Hillbilly Heist answers the question: what would you do with 17.3 million dollars? The answer includes diamond rings, mansions, velvet Elvis paintings, plus a run for the border, murder-for-hire-plots, and FBI busts.
Crime Junkie
Does hearing about a true crime case always leave you scouring the internet for the truth behind the story? Dive into your next mystery with Crime Junkie. Every Monday, join your host Ashley Flowers as she unravels all the details of infamous and underreported true crime cases with her best friend Brit Prawat. From cold cases to missing persons and heroes in our community who seek justice, Crime Junkie is your destination for theories and stories you won’t hear anywhere else. Whether you're a seasoned true crime enthusiast or new to the genre, you'll find yourself on the edge of your seat awaiting a new episode every Monday. If you can never get enough true crime... Congratulations, you’ve found your people. Follow to join a community of Crime Junkies! Crime Junkie is presented by audiochuck Media Company.
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.