Around one in eight people worldwide suffers from <a href="http://www.world-today-news.com/dont-ignore-it-6-signs-that-reveal-iron-deficiency-in-the-body/" title="Don't ignore it .. 6 signs that reveal iron deficiency in the body”>iron deficiency anemia. Most often, women of childbearing age, children or patients with various chronic diseases are affected.
The ferritin concentration in the blood is suitable for diagnosis because it correlates with the amount of iron stored. However, the reference value for ferritin may influence the number of cases diagnosed. In an in JAMA Network Open In the published study, researchers therefore examined how different reference values affect the diagnosis of iron deficiency [1].
Researchers are analyzing data from 255,000 primary care patients
The study was based on data from 255,351 adult primary care patients from Switzerland. The evaluation showed that ferritin cutoff values of 15, 30 and 45 ng/ml were associated with an incidence of iron deficiency diagnoses of 10.9, 29.9 and 48.3 cases per 1,000 patient-years, respectively. In other words: the higher the ferritin value, the more often the diagnosis was made.
“This study should be of particular concern to physicians because of the number of patients it includes,” explained Dr. Miguel Turégano-Yedro. He is a general practitioner at the Casar de Cáceres Health Center in Casar de Cáceres, Spain, and coordinator of the Hematology Working Group of the Spanish Society of General Practitioners. Turégano-Yedro emphasizes that the work could be groundbreaking for general practitioners. “As expected, as the reference value for ferritin increases, the incidence of iron deficiency and iron deficiency anemia also increases.”
Ferritin is the most sensitive parameter for diagnosing iron deficiency and iron deficiency anemia, says Turégano-Yedro. “If a patient needs to be supplied with iron, other parameters such as hemoglobin are also recorded to determine whether anemia is present.”
Who needs iron substitution?
The ferritin level, which is associated with iron deficiency, is usually 15 ng/ml, says Turégano-Yedro. “When we assess patients with a ferritin level of 15 or less, we know that many of them have symptoms such as fatigue, fatigue or loss of appetite and therefore require iron supplementation.” However, the ferritin cutoff level is set to 30 ng/ml or 45 ng/ml, the incidence is higher, although in many cases there are no symptoms and no iron administration is necessary.
Turégano-Yedro also noted that he does not believe it is necessary to increase the reference value to 45 ng/ml. “However, setting the cutoff value at 30 ng/ml could be of interest in people at increased risk of iron deficiency or iron deficiency anemia, for example women of childbearing age, women with very heavy menstruation, children, frail elderly, people with Gastrointestinal bleeding or people who do a lot of exercise.”
Iron deficiency or anemia?
Iron deficiency must be differentiated from anemia. “If the ferritin level is below 15 ng/ml, there is iron deficiency, which may or may not be accompanied by symptoms, although most patients usually have symptoms,” says Turégano-Yedro. “To diagnose a patient with iron deficiency anemia, they must have low hemoglobin, indicating anemia, and low ferritin, indicating iron deficiency.”
This is exactly what the expert is wondering about. “I noticed that for many of the patients in the study, doctors requested ferritin analysis without including hemoglobin, even though hemoglobin is part of the basic analysis carried out in Spain,” said Turégano-Yedro.
When should iron be supplemented?
The study examines the frequency of diagnosis of non-anaemic iron deficiency in conjunction with the choice of ferritin cutoff value. As Turégano-Yedro explains, the percentage of patients with iron deficiency but without anemia is not particularly high. This is not particularly relevant for general practitioners. “If a patient suffers from iron deficiency with or without anemia and shows symptoms, he or she should receive iron supplements,” says the expert.
What does he advise if there is no deficiency but anemia? “In principle, iron supplementation is not necessary in this situation, as the anemia can be due to chronic diseases or hemolytic anemia,” says Turégano-Yedro. Further investigations are then required.
This article was originally published on Univadis.es. As part of the translation process, our editorial team may also use text editing software including AI.
