Iron Deficiency Diagnosis and Treatment Strategies

Iron deficiency arises from inadequate supply, absorption or utilisation of iron and is the most common nutritional disorder worldwide. Diagnosis relies on a combination of haematological and biochemical markers, notably haemoglobin concentration, serum ferritin and transferrin saturation. Inflammatory states elevate hepcidin and ferritin as an acute-phase response, which can mask true iron depletion and necessitates parallel assessment of transferrin saturation to confirm deficiency. First-line treatment comprises oral iron salts, with choice of compound, dose and release profile tailored to maximise absorption and minimise gastrointestinal intolerance. Intravenous iron formulations offer rapid repletion of iron stores in cases of severe deficiency, malabsorption or poor oral tolerance but require clinical monitoring for infusion-related reactions. Emerging strategies include novel iron chelates designed for improved tolerability, and hepcidin-modulating agents to enhance bioavailability. Effective management combines early detection, individualised supplementation, routine monitoring of iron indices and identification of underlying causes of loss or malabsorption. Public health measures address dietary fortification, targeted prophylaxis in high-risk populations and education to improve adherence. Ongoing research seeks to refine diagnostic thresholds and develop therapies that balance efficacy, safety and patient acceptability, thereby reducing the global burden of iron deficiency and its complications.

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Iron Deficiency Diagnosis and Treatment Strategies publication trend

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Technical terms

Ferritin: Intracellular protein complex that stores iron and serves as a marker of body iron reserves.

Transferrin saturation (TSAT): The ratio of serum iron to total iron-binding capacity, indicating the proportion of iron available for erythropoiesis.

Hepcidin: Liver-derived peptide hormone that regulates systemic iron homeostasis by inhibiting intestinal iron absorption and macrophage iron release.

Acute-phase reactant: A plasma protein whose concentration changes in response to inflammation, affecting the reliability of certain biomarkers.

Methanogenesis: A microbial process in the gastrointestinal tract that produces methane, implicated in the gastrointestinal side effects of oral iron therapy.

References

1. Limitations of Serum Ferritin in Diagnosing Iron Deficiency in Inflammatory Conditions. International Journal of Chronic Diseases (2018).
2. Oral Iron Supplementation—Gastrointestinal Side Effects and the Impact on the Gut Microbiota. Microbiology Research (2021).
3. Efficacy and safety of ferric citrate hydrate compared with sodium ferrous citrate in Japanese patients with iron deficiency anemia: a randomized, double-blind, phase 3 non-inferiority study. International Journal of Hematology (2021).