Before moving on to the reasons that can lead to impaired iron and absorption, we first touch on another cause of iron loss – blood loss caused by exercise.
Yes, there may be latent blood loss due to sports. This is, first of all, gastrointestinal bleeding.
Fortunately, this does not apply to everyone, and should not become an obstacle to going in for sports, but only marathon runners and athletes who train very intensively.
✔️ Between 8% and 28% of marathon runners have occult gastrointestinal bleeding, and up to 84% of ultramarathon runners. In any sport, you need a measure, as you know. This is due to ischemia (circulatory disorders, lack of blood flow), and tissue damage as a result.
✔️ Therefore, it must be borne in mind that iron deficiency in runners and athletes can develop, and it makes sense to periodically monitor this.
❗️📛 Another very important point, I ask you to pay attention to it. Don’t panic, just remember. And draw the attention of colleagues to this.
✅If we find iron deficiency in women of childbearing age (before menopause), as well as in children and adolescents, this is normal, as a rule, this is not an alarming sign, but simply a common situation.
📛❗️ If we find iron deficiency in men of any age (not children or adolescents!) And in postmenopausal women, this may be a predictor (harbinger) of gastrointestinal cancer! Or a sign of an existing tumor! This does not mean that you need to panic about “oh God, this is cancer”, it means that you need to check it out !! Having done a colonoscopy and FGDS.
But we’ll talk about finding sources of blood loss later.
✅Let’s move on to impaired iron absorption.
Contrary to current trends, impaired iron absorption is a rare cause of iron deficiency.
However, there are several problems that hinder absorption.
🔹 Celiac disease
🔹Atrophic gastritis
🔹H. Pylori infection
🔹 History of bariatric surgery
Regarding N.rulogi. This is a common problem, but that doesn’t mean everyone with this infection will have iron deficiency. It’s just a risk factor. But if we have an unexplained iron deficiency, or the iron isn’t rising, it’s worth checking out.
Why are we analyzing all this, all these risk factors? In order to, firstly, their
eliminate if necessary, or the problem will not be solved, and, secondly, understand what to do if iron does not rise when using drugs. Another important cause of iron deficiency that is important to mention is IRIDA, a congenital disorder in which iron is not absorbed due to the TMPRSS6 mutation. In this case, the person will have anemia, low iron levels, and ferritin is usually normal. Diagnosis
placed only when all other possible causes of deficiency are excluded.

What are the symptoms of deficiency?
-Pika. Cravings for inedible foods. From the Latin word “magpie”, a bird that
loves to collect non-food items. A person may be drawn to eat such
things like ice, clay, dirt, paper, chalk, starch, raw rice or pasta, coal,
paints, old wallpaper, baby powder.
-Bituria. When, urine turns red after a person has eaten beets. It may
be without a deficiency, iron, but with a deficiency is especially common.
– Restless legs syndrome. When, at rest, a person feels significant discomfort in
legs and the desire to move them, after which the discomfort decreases.
-Fatigue, weakness
-Episodes of depression
-Poor exercise tolerance
-Dry skin, roughness, roughness
-Angular cheilitis (inflammation in the corners of the mouth)
-Koilonychia (spoon-shaped nails)
-Hair loss
Who should we screen for iron deficiency?
Anyone who has unexplained anemia (decreased hemoglobin). Remember that not every anemia is iron deficient!
-Anyone who has symptoms of iron deficiency,
-All pregnant women
-All with chronic kidney disease with anemia or those on hemodialysis.
If we have identified an iron deficiency, then we should think about the cause, and try to
to reveal, I already wrote about this, above.
What is important to remember for diagnosis?
-Ferritin may be falsely elevated in the presence of inflammation
-Iron may be low against the background of anemia of chronic disease, ferritin for us
more important.
-Normal ferritin does not exclude iron deficiency, if there are clinical manifestations.
And this is again about the fact that we always evaluate everything in aggregate, and examination, and analyzes, and complaints.
We treat patients, not their analyzes!
You can donate with ferritin C-reactive protein to see if there is a false increase. This may give us some information.
Here are the average correlation between ferritin and CRP:
-CRP <10 mg / L – ferritin 85 mcg / L,
– CRP 10% to mg / L, – ferritin 195 mcg / L
-CRP> 80 mg / L, – ferritin 548 mcg / L,
That is, if we divide the ferritin figure by about 8, if the CRP is from 5 to 10, by 5, if
CRP from 10 to 80, and by 8 if CRP is above 80.