Iron Deficiency

Overview

Iron deficiency means the body’s iron stores are low, as shown by a low ferritin, even when the haemoglobin is still in the normal range. It is an earlier stage than iron deficiency anaemia — the stores are running down, but haemoglobin has not yet fallen. Identifying iron deficiency at this stage allows the cause to be addressed and anaemia prevented, rather than waiting for the count to drop. This page focuses on low iron stores; the anaemia that results when stores are depleted is covered on the Iron Deficiency Anaemia page.

Why low stores matter even without anaemia

Low iron stores can still cause symptoms in some people — tiredness, poor concentration, hair shedding, restless legs and reduced exercise tolerance — even with a normal haemoglobin. They also signal that the body is losing or using more iron than it is taking in, so the underlying cause (diet, menstrual loss, digestive bleeding, poor absorption) needs the same attention as for established anaemia.

Common causes

• Inadequate dietary iron, especially in vegetarian or restricted diets.
• Heavy menstrual periods.
• Digestive blood loss — piles, ulcers, inflammation or small-bowel causes (see Digestive Problems).
• Poor absorption — coeliac disease, stomach surgery, certain medicines.
• Increased need — pregnancy, breastfeeding, growth spurts, regular intense exercise.
• Regular blood donation.

Evaluation and investigations

Diagnosis rests on iron studies — a low ferritin is the most sensitive marker, with a low serum iron and low transferrin saturation supporting it. Because ferritin rises with inflammation, a normal or high ferritin does not exclude iron deficiency when inflammation is present, and newer markers may be used in that setting. The cause is sought in parallel. See Elevated Ferritin for the opposite pattern.

Management overview

Treatment replaces iron and addresses the cause — dietary improvement with absorbable iron and vitamin C, oral iron supplements where needed, and investigation of any source of loss. Stores are rechecked to confirm they have refilled, and treatment is continued for a few months after the ferritin normalises. See Iron Deficiency Anaemia and Nutritional Anaemia.

Warning signs — seek prompt care

• Ferritin that is falling despite supplementation, or hidden blood in the stool.
• Development of anaemia (low haemoglobin) on follow-up testing.

How we help

Dr. Nayak identifies low iron stores with iron studies, finds and addresses the cause, and builds a replacement plan with monitoring to refill stores and prevent anaemia. Consultations are available in-clinic in Bhubaneswar and over teleconsultation.

Related conditions and patient concerns

• Iron Deficiency Anaemia
• Anaemia
• Nutritional Anaemia
• Elevated Ferritin
• Digestive Problems
• Fatigue, Weakness & General Symptoms