What is the diagnosis for a 43-year-old female with hypoferritinemia (Iron: 37 mcg/dL), elevated Total Iron-Binding Capacity (TIBC: 417 mcg/dL), and low Iron Saturation (11%)?

From the Guidelines

The patient should be started on oral iron supplementation, specifically ferrous sulfate 325 mg once or twice daily, taken on an empty stomach with vitamin C to enhance absorption, as the lab results indicate iron deficiency with low iron saturation (11%) and borderline normal iron level (44 mcg/dL) 1. The lab results indicate iron deficiency, as shown by low iron saturation (11%, below the normal range of 20-55%) and borderline normal iron level (44 mcg/dL, just above the lower limit of 37 mcg/dL), with a high-normal total iron binding capacity (TIBC) of 417 mcg/dL.

• Key points to consider when initiating iron supplementation include:
  • Take iron supplements at least 2 hours apart from calcium supplements, antacids, coffee, tea, dairy products, and high-fiber foods, which can reduce absorption 1.
  • Common side effects include constipation, nausea, and black stools, and if these occur, try taking the supplement with food or reducing the dose 1.
  • Further evaluation is needed to determine the cause of iron deficiency, which could include menstrual blood loss, gastrointestinal bleeding, poor dietary intake, or malabsorption 1.
  • A complete blood count should be checked to assess for anemia, and follow-up iron studies should be performed after 2-3 months of supplementation to monitor response to treatment 1. The American Gastroenterological Association (AGA) recommends using a ferritin cut-off value of 45 mg/dL in individuals with anemia, and the patient's low iron saturation and borderline normal iron level support the initiation of iron supplementation 1.

From the Research

Iron Deficiency Anaemia

• The patient's iron level is 37 mcg/dL, which is below the normal range of 44-145 mcg/dL.
• The Total Iron Binding Capacity (TIBC) is 417 mcg/dL, which is above the normal range of 228-428 mcg/dL.
• The iron saturation is 11%, which is below the normal range of 20-55% 2.

Treatment Options

• Oral iron supplementation is a common treatment for iron deficiency anaemia, with ferrous and ferric formulations being the two main types 2.
• Ferrous sulphate preparations are considered the standard treatment due to their good bioavailability, efficacy, and acceptable tolerability 2.

Unrelated Studies

• There are studies available on unrelated topics, such as the total condylar knee prosthesis 3 and pre- and post-synaptic inhibition 4, which do not provide relevant information for this patient's condition.