Feature Article

Iron deficiency: how to detect it, how to correct it

JOCK SIMPSON, BRYONY ROSS, Jillian de Malmanche



Iron deficiency and iron deficiency anaemia are common. The serum ferritin level is the most useful indicator of iron deficiency but interpretation can be complex. Identifying the cause of iron deficiency is crucial. Oral iron supplements are effective first-line treatment. Intravenous iron infusions, if required, are safe, effective and practical.

Key Points

  • Measurement of the serum ferritin level is the most useful diagnostic assay for detecting iron deficiency, but interpretation may be difficult in patients with comorbidities.
  • Identifying the cause of iron deficiency is crucial; referral to a gastroenterologist is often required.
  • Faecal occult blood testing is not recommended in the evaluation of iron deficiency; a negative result does not impact on the diagnostic evaluation.
  • Oral iron is an effective first-line treatment, and simple strategies can facilitate patient tolerance.
  • For patients who cannot tolerate oral therapy or require more rapid correction of iron deficiency, intravenous iron infusions are safe, effective and practical, given the short infusion times of available formulations.
  • Intramuscular iron is no longer recommended for patients of any age.

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