Last updated: Wednesday, 15, December, 2010
Review clinical findings, FBC, blood film; see Anaemia - hypochromic, microcytic.
Iron deficiency can be present before the development of anaemia; the red cell indices and blood film are more sensitive indicators than is the Hb.
Ferritin provides the most sensitive measure of iron stores; low ferritin is diagnostic of iron deficiency, however normal levels may occur when iron deficiency is associated with inflammation or neoplasia.
Iron/iron binding capacity and transferrin saturation may distinguish iron deficiency from the anaemia of chronic disease, but as they may co-exist, a more specific test for iron deficiency is the ratio of plasma soluble transferrin receptor to serum ferritin.
Alternatively, a trial of oral iron therapy offers a more practical approach.
Chronic blood loss, especially
|This is the commonest cause of iron deficiency anaemia and may be occult; uterine and gastrointestinal blood loss, in particular, should be considered.|
|See under Vaginal bleeding|
Parasitic infection, especially
See Worm infection
Intravascular haemolysis e.g. mechanical heart valves
Increased iron requirements, especially
|An uncommon cause in developed countries, but may be seen in the elderly and may be a contributing factor in pregnancy, debilitating illness and alcoholism.|