Screening teenage girls for anemia at their annual well visit.

      We have traditionally checked teenage girls for anemia every year at their check-up once their menstrual periods have started. Although we have found some teens with anemia (for that age, a hemoglobin under 12.0), overall more than 90% of the teenagers have not been anemic. And most of those young women with anemia have had other signs, symptoms, or history that would make us suspicious: they are pale, they do not eat red meat, they are vegetarians, they are tired, they have heavy periods, or they have thalassemia minor.
      We have discussed at our office whether it was appropriate to continue checking those teen girls without any worrisome sign, symptom, or history for anemia each year. We have decided to start (as of know, Dec. 3, 2013) routinely checking teen girls at 15 years of age for anemia (with the finger prick that we do in the office and get the results in less than a minute) at their check-up. We will always want to check it annually if there is a history of anemia, heavy periods, tiredness, pale complexion, or a vegetarian diet. If you would like your child checked at their check-up at a different age or without any of these warning signs, please discuss it with the doctor.