Iron deficiency can take months to develop, until it shows in blood test results

An iron deficiency occurs in stages, as the attached infographic shows. But you might not see these stages developing, as people don't often get regular blood tests, so we more likely see that they are well into anaemia and iron deficiency symptoms when they see us and we analyse their results.

However these stages and resulting changes in iron studies biomarkers are not always the same as in the infographic, as there are other factors which can affect the iron-related markers, especially of Ferritin. As a result, Ferritin isn't always the first biomarker to show the signs of a possible iron deficiency.

Hence the 4 stage progression, assuming no infection or inflammation or tissue damage, should be:

Stage 1 – the iron stores as Ferritin, starts showing as low
Stage 2 - the iron being available to be transported, being the Transferrin Saturation %, starts showing as low
Stage 3 – Haemoglobin, the oxygen transport protein in the red blood cells, starts showing as low due to the reduced iron
Stage 4 – MCV is usually the last of these biomarkers to show low iron, in our experience.

More often we would actually see that Transferrin Saturation starts showing as low first, and before low ferritin shows as low!

Also, a reminder to never just test for Ferritin on its own, or interpret iron levels from this one biomarker! In so many cases, we have seen low Ferritin in early to advanced stages of iron overload conditions (such as Haemochromatosis)! We have seen doctors and other practitioners recommending iron infusions and/or iron supplements in these cases of low Ferritin, when all other iron-related biomarkers are showing as very high iron overload situation.

Pathology analysis is an art and a science!

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