Identifying and Treating Iron Deficiency

Why is Iron Deficiency Important?

Iron is required for good mental and physical health, to maintain energy levels and to ensure a healthy immune system. Without sufficient iron, patients may feel exhausted, lethargic and apathetic, and can exhibit a range of other symptoms which highlight the various systemic effects of low iron levels. Clinical studies have also shown that low iron levels can have a negative impact on an individual’s quality of life, both socially and economically. Iron deficiency can be diagnosed as a comorbidity with underlying chronic conditions and can be an indicator of a negative future outlook for the patient’s health.

Fatigue, Exhaustion and Tiredness

Fatigue is a common complaint made to primary care providers by both the general population and by individuals with certain chronic conditions including chronic heart failure, chronic kidney disease, coeliac disease and inflammatory bowel disease (IBD). Iron deficiency is one cause of fatigue that can be treated. It is important to recognise fatigue since it can affect the patient’s physical, emotional, social and economic wellbeing. The use of clinically verified fatigue questionnaire tools such as the FACIT-F scale, the Brief Fatigue Inventory and the Daily Fatigue Impact Scale can enable doctors to determine the level of a patient’s fatigue.

Other Signs and Symptoms of ID

Iron deficiency has multiple symptoms that may be observed on their own, or in combination with other symptoms. Symptoms may appear gradually, meaning that patients may not initially recognise the symptom and may have accepted it as part of their life. Fatigue is often associated with iron deficiency, however other symptoms include looking pale, dyspnoea and heart palpitations, a sore tongue, craving to eat non-food items, restless leg syndrome or spoon-shaped nails. In addition, patients may appear irritable and lose concentration easily. Follow this link to find detailed descriptions of the signs of iron deficiency.

Testing for Anaemia and Iron Deficiency

When iron deficiency, with or without anaemia, is suspected, a combination of physical examination, medical history and diagnostic tests should be used to advance diagnosis. It can be useful to know the patient’s menstruation and pregnancy history, whether they have any chronic conditions, and their medication use. A complete blood count (CBC) will indicate whether or not the patient is anaemic and iron deficiency can be identified through TSAT, serum ferritin, serum iron and TIBC readings. The cut-off values that indicate iron deficiency are included in this section.

Treatment Options

Once blood tests have confirmed that a patient is iron deficient, the most suitable method for the patient to improve their iron levels can be identified. Treatments may include educating the patient to improve the amount of iron in their diet, or by prescribing supplemental iron in the form of oral iron tablets, or intravenous iron. Different treatments may be more suitable for individual patients depending on their level of iron deficiency and co-morbidities.