If the source of a woman’s chronic cough has you puzzled, try checking for iron deficiency.

All 16 healthy female nonsmokers who participated in a recent Italian study had normal lung function tests and no history of atopy, asthma or other bronchopulmonary diseases. They showed no symptoms or ENT evidence of gastroesophageal reflux.

Yet all of the women suffered from chronic idiopathic cough. The backs of their mouth were swollen, their mucous membranes were inflamed, and their vocal cords were hypersensitive.

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All of them were also iron-deficient (serum ferritin 9.4 ± 0.9 ng/mL). After two months of iron supplementation, the cough and inflammation either subsided or disappeared in every case.“Iron regulates the production of pro-inflammatory cytokines,” the study notes, “and its deficiency might favor upper-airway inflammation and dysfunction.”

Women are generally more prone to cough than men, and 20% of women in industrialized countries are iron-deficient. About one third of American women have “virtually no iron stores,” the study points out in its background data.The unpublished research, by physicians at the University of Turin, was presented at the American College of Chest Physicians scientific meeting in October.