Dr. Nicole Cain breaks down iron deficiency into three stages: storage depletion (low ferritin), marginal deficiency (falling ferritin and transferrin), and anemia (low hemoglobin). Symptoms can show up before your blood count drops, which is why testing ferritin matters. The European Society of Cardiology defines iron deficiency as ferritin under 100 ng/mL.
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Here's how to tell what stage of iron depletion you're in before it gets to the point where you are severely anemic. According to the literature, there are three phases of iron depletion, which is pretty remarkable because most doctors were trained to just run a CBC to see if they're anemic, and if they're not, they stop there. This is what I mean by cbc. That's the test that looks at red blood cells, white blood cells, immune system cells. Stage 1. This is mild DEF deficiency or storage iron deficiency. Storage iron will show up on your test as ferritin. Stage 2. This is called marginal deficiency, where your ferritin is dropping, but it's getting worse. Now your transferrin is starting to decline, by the way, in both of these stages. So far, your CBC is normal. Stage three. Now you have iron deficiency anemia. Iron stores are exhausted, ferritin goes down even more. Hematocrit and hemoglobin are dropping. Here's why it matters. Iron deficiency symptoms can start way before anemia develops. Are you ready for this next part? The European Society of Cardiology guidelines define iron deficiency as ferritin under 100. So many of my patients are deficient. Ferritin 30, ferritin 10, ferritin 53. Ask your doctor to test your ferritin.