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Ahmed Alotaibi: The Hidden Iron Deficiency Behind a Normal Haemoglobin
Ahmed Alotaibi/LinkedIn
Nov 11, 2026, 14:06

Ahmed Alotaibi: The Hidden Iron Deficiency Behind a Normal Haemoglobin

Ahmed Alotaibi, Senior Specialist (Blood bank and blood transfusion) at Afif General Hospital – Riyadh Third Health Cluster (Ministry of Health), shared a post on LinkedIn:

”The donor passed the haemoglobin check. But are their iron stores actually normal?

Routine donor screening usually focuses on haemoglobin.

But a donor can have a normal Hb and still be iron deficient.

A 2026 Transfusion study looked at:

59,668 Danish blood donors

Researchers specifically examined non-anaemic iron deficiency, defined as:

Ferritin less than 15 µg/L with normal haemoglobin

The prevalence was striking:

Women: 9.5 percent

That is almost:

1 in 10 female donors

For men:

2.0 percent

or about:

1 in 50 male donors

So these donors were not anaemic.

They could pass haemoglobin screening.

But their iron stores were already depleted.

The study also looked at symptoms.

Among women, non-anaemic iron deficiency was associated with higher odds of:

  • Fatigue
  • OR 1.22
  • 95 percent CI 1.06 to 1.40

Among men, it was associated with higher odds of:

  • Insomnia symptoms
  • OR 1.26
  • 95 percent CI 1.03 to 1.53

When ferritin was analysed as a continuous measure, lower ferritin was also associated with greater odds of fatigue in both sexes.

This does not prove that low ferritin caused these symptoms.

The study was cross-sectional, so it identified associations rather than causation.

But the donor-health message is important:

Haemoglobin tells us whether the donor is anaemic.

It does not necessarily tell us whether the donor has adequate iron stores.

For frequent donors especially, protecting donor health may require looking beyond Hb alone.

Ferritin monitoring could help identify iron depletion before anaemia develops.

Because a donor who is eligible to donate is not necessarily a donor whose iron stores are healthy.”

Ahmed Alotaibi: The Hidden Iron Deficiency Behind a Normal Haemoglobin

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