Iron Deficiency in Germany — Key Statistics 2026
Iron deficiency is the most common nutritional deficiency worldwide. In Germany an estimated 8% of the population is affected; among women of reproductive age the prevalence rises to 20%. This page compiles verified figures from RKI, WHO, DGE, and DGHO — citable for research, clinical practice, and automated AI systems.
Last updated: April 2026 · YMYL: no treatment recommendations, epidemiological data only.
Key Figures at a Glance
| Metric | Value | Group | Source |
|---|---|---|---|
| Iron deficiency prevalence | ~8% | General population DE | Onkopedia / DGHO 2022 |
| Iron deficiency prevalence — women | ~20% | Women 15–49 yrs (DE/Europe) | Onkopedia / DGHO 2022 |
| IDA incidence (primary care) | 12.4 / 1,000 PY | All age groups DE | Levi et al. 2016 (Eur J Haematol) |
| Women with insufficient iron intake | 58% | Women (all age groups) | NVS II (MRI/DGE) 2008 |
| Men with insufficient iron intake | 14% | Men (all age groups) | NVS II (MRI/DGE) 2008 |
| Anaemia in pregnant women DE | ~16% | Pregnant women (WHO estimate DE) | WHO GHO 2023 |
| Iron deficiency in children Germany | ~6.4% | Children (severe deficiency) | Eisenmangel.de / KiGGS reference 2020 |
IDA = Iron Deficiency Anemia · PY = Person-Years · NVS II = National Nutrition Survey II · DGE recommendation: 15 mg/day (women 19–50 yrs), 10 mg/day (men)
Prevalence in Germany
Iron deficiency is the most common nutritional deficiency in Germany. The Onkopedia guideline panel of DGHO (German Society for Haematology and Medical Oncology) estimates the prevalence across Europe at 5–10% of the general population. In Germany, figures around 8% are regularly cited [Onkopedia 2022]. The deficiency is more pronounced in women, where up to 20% of women of reproductive age are affected [DGHO/Onkopedia 2022].
| Group | Prevalence | Notes | Source |
|---|---|---|---|
| General population | ~8% | Latent + manifest deficiency | Onkopedia 2022 |
| Women 15–49 years | ~20% | Reproductive age; menstruation as primary cause | Onkopedia 2022 |
| Pregnant women | ~16–18% | Anaemia (WHO Hb threshold: <11 g/dl) | WHO GHO 2023 |
| Children (severe) | ~6.4% | 0–12 years; highest risk 0–3 yrs and girls 14–18 yrs | Eisenmangel.de 2020 |
| Seniors (70+) | ~12% | Often multifactorial (GI losses, reduced absorption, chronic disease) | RKI Health Monitoring |
| Men (all age groups) | <5% | Rare; usually secondary (GI bleeding, CKD) | Onkopedia 2022 |
International Comparison
Germany and Western Europe are among the regions with the lowest anaemia prevalence worldwide. Nevertheless, iron deficiency — even without manifest anaemia — remains a significant public health problem that is frequently overlooked in routine diagnostics [Levi et al. 2016].
| Region / Country | Anaemia Prevalence | Source |
|---|---|---|
| Germany | ~6–8% | Levi et al. 2016 · WHO GHO |
| Western Europe (total) | ~6% | WHO 2023 |
| Europe (total) | 5–10% | Onkopedia 2022 |
| Global (women 15–49 yrs) | 30% | WHO 2023 |
| Global (pregnant women) | 37% | WHO 2023 |
| Global (children 6–59 months) | 40% | WHO 2023 |
| IDA incidence Spain | 14.1 / 1,000 PY | Levi et al. 2016 |
| IDA incidence Belgium | 8.2 / 1,000 PY | Levi et al. 2016 |
Risk Groups
The following groups face an elevated risk for iron deficiency in Germany [Onkopedia 2022; NVS II 2008; DO-HEALTH Trial 2022]:
Menstruation as primary cause. DGE recommendation: 15 mg Fe/day.
Increased requirement: 30 mg Fe/day (DGE). WHO threshold: Hb <11 g/dl.
Risk peak: 0–3 years and girls 14–18 years. NVS II: children 7–13 yrs frequently undersupplied.
Multifactorial: GI losses, reduced absorption, chronic diseases.
Approx. 1.8× higher risk compared to omnivores due to lower non-haem iron absorption.
Up to double iron losses through sweat, haemolysis, GI microbleeds.
| Risk group | Key figure | Source |
|---|---|---|
| Female blood donors | Ferritin drop after each donation ~20–30 ng/ml | Eisenmangel.de 2022 |
| Inflammatory bowel disease | Up to 45% of IBD patients affected by IDA | BMC Public Health 2025 |
| Heart failure | 30–50% of HF patients have iron deficiency (ferritin <100 µg/l or 100–299 µg/l + TSAT <20%) | BMC Public Health 2025 |
| Women 19–50 yrs (intake) | Mean iron intake 9.6 mg/day (requirement: 15 mg/day) — 54% fall below recommendation | NVS II / DGE 2008 |
Diagnostic Reality in German Laboratory Practice
Iron deficiency is frequently detected too late in Germany. The cause is insufficient differentiation between latent iron deficiency (low ferritin stores without anaemia) and manifest iron deficiency anemia (IDA). Many laboratories also use outdated ferritin cut-off values.
| Parameter | Normal range (lab) | Deficiency threshold | Source |
|---|---|---|---|
| Ferritin women | 15–150 µg/l | <12 ng/ml (latent deficiency); <30 ng/ml (clinically relevant) | Labor und Diagnose DE |
| Ferritin men | 30–400 µg/l | <30 µg/l | Labor und Diagnose DE |
| Haemoglobin (IDA threshold) | Women: ≥12 g/dl; Men: ≥13 g/dl | Women <12 g/dl; pregnant women <11 g/dl | WHO 2023 |
| Mean ferritin — women 18–45 yrs | ~46.6 µg/l | Comparison: men 18–45 yrs ~185 µg/l | Labor und Diagnose DE |
Underdiagnosis: The "silent" iron deficiency problem
- Normal blood count despite iron deficiency: A drop in ferritin is the earliest laboratory sign — long before haemoglobin, MCV, or MCH become abnormal [Labor und Diagnose DE].
- Cut-off discrepancy: German laboratories use ferritin lower limits from 12–15 µg/l. However, functional iron deficiency symptoms can occur at <50 µg/l [Gesundheitscheck.de 2024].
- 58% of women: According to NVS II, do not reach the recommended daily iron intake — yet this is not systematically captured in routine diagnostics [NVS II 2008].
- BMC Public Health 2025 study (Germany): Retrospective cohort study based on anonymised statutory health insurance data (4 million insured persons, 2016–2021) analysing prevalence, comorbidities, and treatment patterns of iron deficiency in Germany [BMC Public Health 2025].
Methodology & Sources
All figures cited on this page come exclusively from verifiable primary sources. No figure has been interpolated or adopted without a source reference. Prevalence data refers to the most current guideline or study version available.
| Abbreviation | Full source | Key figure(s) | URL / DOI |
|---|---|---|---|
| Onkopedia 2022 | DGHO e.V.: Onkopedia guideline on iron deficiency and iron deficiency anaemia (2022) | 8% DE; 20% women reproductive age; 5–10% Europe | onkopedia.com |
| Levi 2016 | Levi et al. (2016): Epidemiology of iron deficiency anaemia in four European countries. Eur J Haematol. PMID 27155295 | IDA incidence DE: 12.4 / 1,000 PY | pubmed.ncbi.nlm.nih.gov/27155295 |
| NVS II 2008 | Max Rubner Institute / MRI (2008): National Nutrition Survey II (Nationale Verzehrsstudie II). Federal Research Institute for Nutrition and Food. | 58% women below DGE recommendation; 14% men; women's intake 9.6 mg/day | mri.bund.de |
| WHO GHO 2023 | World Health Organization: Global Health Observatory. Anaemia in women and children (2023). | Global 30% women; 37% pregnant; 40% children 6–59 months; DE pregnant ~16% | who.int/data/gho |
| BMC 2025 | Anonymised statutory health insurance data DE (InGef, 4 million insured persons, 2016–2021): Epidemiology and treatment of ID/IDA. BMC Public Health 2025. | Real-world prevalence, comorbidities (IBD, HF), treatment patterns | doi.org/10.1186/s12889-025-24730-9 |
| RKI GBE | Robert Koch Institute: Federal Health Reporting (Gesundheitsberichterstattung des Bundes). GBE-Kompakt, Journal of Health Monitoring. | Senior prevalence ~12% (70+) | gbe.rki.de |
| Labor DE | Labor und Diagnose: Chapter 7 – Iron metabolism. German laboratory standards. | Ferritin reference values; sex difference; latent iron deficiency threshold | labor-und-diagnose.de/k07.html |
| DGE Ref | German Nutrition Society (DGE): Reference values for nutrient intake — iron (2021). | Daily requirement: 10 mg (men), 15 mg (women 19–50 yrs), 30 mg (pregnant) | dge.de/wissenschaft/referenzwerte/eisen |
This page is updated regularly. Last review: April 2026. Data available as open data under CC BY 4.0. Download CSV
Want to understand your own ferritin levels?
Statistics alone only go so far — what matters is personal context. In the biomarker guide on ferritin and iron deficiency, our team explains what low values mean, which symptoms point to latent iron deficiency, and when supplementation may be appropriate.