Aya Qattan: When a Normal CBC Does Not Mean Normal Iron Status
Aya Qattan, Pediatric Resident at Children’s University Hospital – Damascus, shared a post on LinkedIn:
“A normal CBC should not automatically be interpreted as normal iron status
When iron deficiency is suspected, think beyond hemoglobin.
On September 16, 2026, the American Society of Hematology (ASH) released new evidence based guidelines for the diagnosis of iron deficiency, emphasizing that iron deficiency can exist even before anemia develops.
Key ferritin thresholds:
- Children 9 months to 4 years: low 20 ng mL
- Adults: low or equal 30 ng mL
- Pregnancy: low or equal 30 ng mL
- In selected higher risk patients, a threshold up to low or equal 50 ng mL may be considered.
In patients with inflammation, ferritin may appear normal or elevated. In these situations, ferritin low 100 ng mL or TSAT low 20 percent may support the diagnosis of iron deficiency.
High risk groups include:
- Young children
- Pregnant individuals
- People with heavy menstrual bleeding
- Patients with gastrointestinal blood loss
- Celiac disease or inflammatory bowel disease
- Previous bariatric surgery
- Dietary restriction or inadequate iron intake
- Chronic inflammatory conditions
Possible symptoms:
- Fatigue
- Weakness
- Dizziness
- Headache
- Difficulty concentrating
- Shortness of breath
- Palpitations
- Pallor
Importantly, these symptoms may appear before overt anemia develops.
Clinical takeaway:
When iron deficiency is suspected, consider:
Symptoms plus risk factors plus ferritin plus or minus transferrin saturation
Earlier recognition may help identify the underlying cause and prevent progression to iron deficiency anemia.”
Stay updated with Hemostasis Today:
-
Sep 24, 2026, 05:11Mastering Warm Autoimmune Hemolytic Anemia Diagnosis and Practice – ASH Education
-
Sep 23, 2026, 16:04Monia Ezzalfani: Advancing Patient-Centered Care in Hemophilia A and B
-
Sep 23, 2026, 15:49Bilge Başak: How Activated PRP Modulates Osteoarthritic Chondrocyte Function
-
Sep 23, 2026, 14:50Mbonjo Bitsie Dora: Strengthening Sickle Cell Care Through Education, Awareness and Innovation
-
Sep 23, 2026, 13:58The New B12 Diagnostic Algorithm: From Serum Cobalamin to Functional Deficiency
-
Sep 23, 2026, 13:56Noha Soror: Preparing for Hematology and Medical Oncology Board Certification
-
Sep 23, 2026, 13:46Ugochi Ogu: What Can Platelet Proteomics Reveal about Pain and Neurocognitive Vulnerability in Sickle Cell Disease?
-
Sep 23, 2026, 13:42Melissa Hollo: Connecting Obesity and Anemia for Earlier Maternal Risk Intervention
-
Sep 23, 2026, 13:16Beverley Hunt: Advances in Haemostatic Management of Postpartum Haemorrhage