Persistent fatigue and dizziness? Neurologist Dr Priyanka Sehrawat shares 4 blood indicators of iron deficiency to check

Iron deficiency can often go undetected if you don't opt for the correct blood tests. Dr Sehrawat shares 4 main indicators and what they mean.

Iron deficiency can often show up through everyday symptoms such as persistent fatigue, dizziness, exhaustion, pale skin or shortness of breath. But identifying low iron is not always as simple as checking a single blood marker. The test you get done can provide different insights into your iron status, and overlooking the body’s iron stores while focusing only on circulating iron may leave a deficiency undetected.

Dr Priyanka Sehrawat, a general physician and neurologist trained at AIIMS, New Delhi, and currently associated with The Neuromed Clinic in Gurugram, is breaking down the different aspects of iron deficiency, including how to identify it and the common mistakes people can make while trying to correct it. In an Instagram video shared on August 26, the neurologist highlights, “You also misinterpret your iron reports and take iron tablets the wrong way, which is why you always remain iron deficient. Let me tell you that there are four indicators that show iron deficiency in your blood.”

Indicators of iron deficiency

1. Haemoglobin: This is a rough indicator because a deficiency in haemoglobin can occur not only due to iron deficiency, but also due to vitamin B12 deficiency, excessive blood loss, and many other causes.
2. MCV and MCH: Mean Corpuscular Volume (MCV) and Mean Corpuscular Haemoglobin (MCH) are part of your Complete Blood Count (CBC). When they decrease, it is usually due to iron deficiency.
3. Serum Iron: This tells you the total iron in your blood, and it is a very good indicator.
4. Serum Ferritin: This is the one you miss. Ferritin is the body's iron store.

The role of iron stores

The human body stores iron mainly in the form of the protein complex ferritin, primarily in the liver, spleen and bone marrow. Ferritin is the body’s main soluble and readily accessible form of iron storage within cells. When iron levels become excessively high, some ferritin can break down and form haemosiderin, an insoluble form of stored iron that accumulates in tissues.

According to Dr Sehrawat, the body draws on its stored iron reserves when there is an increased demand for oxygen. She explains, “You will need these iron stores whenever you require excessive oxygen consumption – for example, if you suddenly start moderate-to-high intensity exercise. The need for iron also increases during pregnancy, and for breastfeeding or lactating mothers.”

Serum iron vs. serum ferritin

Serum ferritin reflects the amount of iron stored in the body, while serum iron indicates the amount of iron circulating in the bloodstream at a given moment. Therefore, having normal serum iron levels does not necessarily mean that your body has adequate iron reserves to meet increased demands or support higher oxygen consumption. Ignoring serum ferritin levels is a common mistake.

Dr Sehrawat highlights, “If your serum iron is normal but your ferritin is low, it means you do not have that store. Whenever you need excessive iron or oxygen, your body won't be able to manage or correct it. So, if ferritin is also low, whatever iron medicines you need to take or iron replenishment you need to do, do not forget about it.”

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. It is based on user-generated content from social media. HT.com has not independently verified the claims and does not endorse them.

Dr Priyanka Sehrawat is a neurologist based in Gurugram. She completed her MBBS from Lady Hardinge Medical College, Delhi, followed by an MD in Medicine. She later pursued a DM in Neurology from the All India Institute of Medical Sciences (AIIMS), Delhi. Dr Sehrawat currently practices at The Neuromed Clinic in Gurugram, where she diagnoses and treats a range of neurological conditions.