From the Guidelines
This laboratory pattern suggests iron deficiency without anemia, and I strongly recommend starting oral iron supplementation to replenish iron stores and prevent progression to iron deficiency anemia. Despite having normal hemoglobin (Hb) levels and a borderline low-normal MCV of 80, the ferritin level of 7µg/L is significantly below the normal range, indicating depleted iron stores 1. According to the British Society of Gastroenterology guidelines, a serum ferritin level of <15 μg/L is indicative of absent iron stores, and levels of less than 30 μg/L are generally indicative of low body iron stores 1. I recommend starting oral iron supplementation, such as ferrous sulfate 325mg once or twice daily, taken on an empty stomach with vitamin C to enhance absorption, as suggested by various studies 1. Alternatively, ferrous gluconate or ferrous fumarate may be better tolerated if side effects occur. Continue supplementation for 3-6 months to replenish iron stores, with follow-up ferritin testing after 3 months. This represents early iron deficiency where the body has depleted iron stores but still maintains normal red blood cell production. Without treatment, this condition will likely progress to iron deficiency anemia with decreasing MCV and hemoglobin levels. Additionally, investigation into the cause of iron deficiency is essential, considering potential sources such as menstrual blood loss, gastrointestinal bleeding, malabsorption, or dietary insufficiency 1. It is also important to note that iron from meat (heme iron) is better absorbed than plant-based iron (non-heme) 1, and athletes with restrictive diets that make adequate consumption of iron difficult should consult a sports dietitian to optimize their daily nutrition plans for iron intake 1.
From the Research
Interpreting Normal Hb Results and MCV of 80 with a Ferritin Level of 7µg/L
- A ferritin level of 7µg/L is considered low, indicating depleted iron stores 2.
- A Mean Corpuscular Volume (MCV) of 80 is within the normal range, suggesting that the red blood cells are of normal size.
- Normal Hemoglobin (Hb) results in this context may indicate that the individual is not yet experiencing iron-deficiency anemia, but the low ferritin level suggests that iron stores are depleted 3.
- Iron deficiency can progress from low iron stores to iron-deficiency anemia, and individuals may be asymptomatic or experience symptoms such as fatigue, irritability, and difficulty concentrating 2.
Potential Causes and Treatment
- The most common causes of iron deficiency are bleeding, impaired iron absorption, inadequate dietary iron intake, and pregnancy 2.
- Treatment for iron deficiency typically involves oral iron supplementation, such as ferrous sulfate, to replenish iron stores 2, 4.
- Other forms of iron supplementation, such as lactoferrin, may also be effective in improving iron parameters and hemoglobin levels 5.
- It is essential to identify and treat the underlying cause of iron deficiency to prevent further depletion of iron stores 2.