Abdul Muqtadir Abbasi: Iron Deficiency Beyond Anemia and the Importance of Finding the Cause
Abdul Muqtadir Abbasi, Assistant Consultant at King Faisal Specialist Hospital and Research Center, shared a post on LinkedIn:
“2 to 2 Iron deficiency..
7 Don’t forget the underlying cause!
Diagnosing iron deficiency is only the first step.
Always investigate WHY the patient is iron deficient.
Consider:
- Heavy menstrual bleeding.
- Gastrointestinal blood loss.
- Peptic ulcer disease.
- Celiac disease.
- Inflammatory bowel disease.
- Previous bariatric surgery.
- Dietary deficiency.
- Blood donation.
- Malabsorption.
- Chronic inflammatory conditions.
In adult men and postmenopausal women, unexplained iron deficiency deserves particular attention to gastrointestinal blood loss and possible malignancy.
8 A few clinical pearls
- Normal hemoglobin does not exclude iron deficiency.
- Ferritin low 30 ngmL is the recommended diagnostic threshold in most healthy adult populations.
- Ferritin between 30 and 50 should not automatically reassure you in symptomatic or high risk patients.
- Never interpret ferritin in isolation when inflammation is present.
- Heavy menstrual bleeding needs proper assessment and management.
- Treating iron deficiency without addressing its underlying cause is incomplete management.
9 The take home message
Iron deficiency is common, frequently underdiagnosed and treatable.
We should diagnose it before it progresses to anemia, rather than waiting for hemoglobin to fall.
As physicians, we need to look beyond the CBC.”
Title: American Society of Hematology 2026 guidelines for diagnosis of iron deficiency
Authors: Jacquelyn M. Powers, Ming Y. Lim, Maureen Okam Achebe, Imo J. Akpan, Michael Auerbach, Megan C. Brown, Maria Paula Cardenas, Caroline Cromwell, Thomas DeLoughery, Robert E. Fleming, Martina Fraga, George Goshua, Paula James, Adam Lewkowitz, Jori May, Grace Nnadozie, Frances Ogunnaya, Guillermo J. Ruiz-Arguelles, Michelle Sholzberg, Layla Van Doren, Angela C. Weyand, Michelle P. Zeller, Muayad Azzam, Ali Choaib, Qais Hamarsha, Hassan Kawtharany, Jana Khawandi, Reem A. Mustafa
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