A common issue with multiple etiologies, the following test results will help to confirm your clinical suspicion:
- ↓ Ferritin (If low, virtually diagnostic, but cannot rule out if low/normal)
- ↓ MCV (typically <80fL)
- ↓ Hematocrit (Hct) and RBC count
- ↓ Serum iron (*note this value can vary on a daily basis and with any iron supplementation)
- ↓ TSAT (Transferrin saturation)
- ↑ TIBC, Transferrin, RDW
- Peripheral blood smear that shows microcytic, hypochromic RBCs [could also have anisocytosis and
target cells] - NOTE: There is commonly a mild thrombocytosis associated with Iron deficiency anemia
*Bone marrow iron stores is the gold standard for the diagnosis of Iron deficiency anemia (rarely done)
REFERENCES
- Camaschella C. Iron-deficiency anemia. N Engl J Med. 2015 May;372(19):1832-43.
- Lynch EC. Peripheral Blood Smear. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 155.
- Short MW, Domagalski JE. Iron deficiency anemia: evaluation and management. Am Fam Physician. 2013 Jan 15;87(2):98-104.
Dr. C HumphreysInternal Medicine
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