Iron deficiency progresses towards the anemic state in the following three stages. The speed of progress depends on the individual's baseline iron stores as well as the degree, duration, and speed of iron or blood loss.
Normal body iron content (typical amounts of iron in the body) are as follows:
- Red blood cells: Approximately 2 g, corresponding to approximately 2000 mL (25 to 30 mL/kg) of RBCs
- Proteins containing iron myoglobin, cytochromes, and catalase: Approximately 400 mg
- Plasma iron bound to transferrin (the storage form of iron): 3 to 7 mg
- Storage iron in the form of ferritin or hemosiderin (the storage form of iron): Approximately 0.8 to 1 g in men and approximately 0.4 to 0.5 g in women
Storage iron is found mostly in the monocyte-macrophage system in the liver, spleen, and bone marrow as transferrin and hemosiderin. The RBCs form the labile iron pool.
Iron deficiency occurs in several stages. These are defined by the extent of depletion; the first stage is depletion of iron stores and in the later stage, iron is available just in labile forms. Eventually, if the negative iron balance continues, anemia occurs.
Progressive iron depletion: In the first stage, iron stores are used up to compensate for the decreasing hemoglobin, without causing anemia. After these stores are used up, there is still enough iron present in the body within the "labile" iron pool from the daily turnover of red blood cells for normal red blood cell formation. Such a person is at increased anemia risk if the iron losses continue and the iron intake remains poor. Some individuals may experience fatigue or show decreased exercise tolerance at this stage.
Further loss of iron: Results in anemia (low hemoglobin) but the red cells have a normal shape and contain a decent amount of iron. In the United States, it has been estimated that 20-65% of menstruating women, who have minimal or absent iron reserves, maybe in this stage.
The common laboratory findings at this stage include:
- Low levels of ferritin and serum iron (Fe).
- Increased levels of transferrin (Tf: total iron-binding capacity)
- Low percent saturation of transferrin (ie, Fe/TIBC or Fe/Tf, stated as a percent).
- Increased unsaturated iron binding capacity (UIBC = TIBC - Fe).
Anemia onset: More severe iron deficiency results in the classical findings of anemia with red blood cells that are low in iron content and are smaller in size.
The body tries to combat iron deficiency by a number of compensatory changes, including increased production of erythropoietin and reduced production of a protein called hepcidin.
What does iron deficiency mean?
Iron is an important substance that our body needs in minute amounts. Daily ingestion of iron is needed for the health of red blood cells and muscle proteins, as well as the functioning of body cells. The normal body iron content in an adult is approximately 3-4 grams. The majority of iron is present in circulating red blood cells (RBCs) with additional iron in myoglobin and certain enzymes, as well as iron in storage and transport forms.
Iron deficiency is the condition in which there is less iron available for use than needed. The most profound problem of iron deficiency is anemia causing increased fatigue, which can lead to breathlessness or heart failure.
How will I know if I have an iron deficiency?
If you have iron deficiency, you may have
- Tiredness or weakness
- Pale or yellow skin
- Shortness of breath
- Dizziness, light-headedness, feeling like passing out
- Swollen, sore tongue
- Abnormal heart rate
- Fast or unusual heartbeat
- Pain in your bones, chest, belly, and joints
- Growth issues in children
- Cold hands and feet
How will your doctor diagnose iron deficiency?
Your doctor may suggest and order several different blood tests to decide if your anemia is the result of an iron deficiency or other nutrients deficiency, such as folate or Vitamin B12.
- Complete blood count
- Serum iron, the doctor may order this test to measure iron status
- Serum ferritin to check your storage status and to check any deficiency in the early stages
- Transferrin to check progressing deficiency
- Blood indices
- Liver and bone marrow biopsies: A sample of liver or bone marrow taken by inserting a needle into the liver and bone to assess iron status (rare).
Health Solutions From Our Sponsors
Medscape. Iron deficiency anemia. https://emedicine.medscape.com/article/202333-overview
Medscape. Iron deficiency anemia questions & answers. https://emedicine.medscape.com/article/202333-questions-and-answers
Auerbach M. Causes and diagnosis of iron deficiency and iron deficiency anemia in adults. https://www.uptodate.com/contents/causes-and-diagnosis-of-iron-deficiency-and-iron-deficiency-anemia-in-adults? search=stages%20of%20iron%20deficiency&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2#H1
Top What Are the 3 Stages of Iron Deficiency? Related Articles
Anemia: How Is It Treated and Can It Be Cured?How is anemia treated and can anemia be cured? Learn how to identify and manage anemia.
carbonyl ironCarbonyl iron is an iron supplement used as a dietary supplement and to prevent and treat iron deficiency anemia. Iron supplements are available over the counter (OTC) as different iron salts and are usually an ingredient of multivitamins. Do not use supplemental iron to treat anemias not associated with iron deficiency. Common side effects of carbonyl iron include nausea, vomiting, upper abdominal (epigastric) pain, diarrhea, constipation, dark stools, heartburn, urine discoloration, dental stain, and iron overload in organs and tissues (hemosiderosis). Consult your doctor if pregnant or breastfeeding.
Common Medical Abbreviations & Terms
Doctors, pharmacists, and other health-care professionals use abbreviations, acronyms, and other terminology for instructions and information in regard to a patient's health condition, prescription drugs they are to take, or medical procedures that have been ordered. There is no approved this list of common medical abbreviations, acronyms, and terminology used by doctors and other health- care professionals. You can use this list of medical abbreviations and acronyms written by our doctors the next time you can't understand what is on your prescription package, blood test results, or medical procedure orders. Examples include:
- ANED: Alive no evidence of disease. The patient arrived in the ER alive with no evidence of disease.
- ARF: Acute renal (kidney) failure
- cap: Capsule.
- CPAP: Continuous positive airway pressure. A treatment for sleep apnea.
- DJD: Degenerative joint disease. Another term for osteoarthritis.
- DM: Diabetes mellitus. Type 1 and type 2 diabetes
- HA: Headache
- IBD: Inflammatory bowel disease. A name for two disorders of the gastrointestinal (BI) tract, Crohn's disease and ulcerative colitis
- JT: Joint
- N/V: Nausea or vomiting.
- p.o.: By mouth. From the Latin terminology per os.
- q.i.d.: Four times daily. As in taking a medicine four times daily.
- RA: Rheumatoid arthritis
- SOB: Shortness of breath.
- T: Temperature. Temperature is recorded as part of the physical examination. It is one of the "vital signs."
Feiba Vh (Anti-Inhibitor Coagulant Complex)Feiba is an Anti-Inhibitor Coagulant Complex indicated for use in hemophilia A and B patients with inhibitors for control and prevention of bleeding episodes, perioperative management, or routine prophylaxis to prevent or reduce the frequency of bleeding episodes. Feiba is not indicated for the treatment of bleeding episodes resulting from coagulation factor deficiencies in the absence of inhibitors to coagulation factor VIII or coagulation factor IX.
ferrous sulfateFerrous sulfate is a synthetic iron supplement used to treat iron deficiency and iron deficiency anemia. Common side effects of ferrous sulfate include dark stools, abdominal pain or discomfort, heartburn, nausea, vomiting, constipation, flatulence, diarrhea, gastrointestinal irritation, contact irritation, urine discoloration, and superficial tooth discoloration (oral solutions). Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children under 6. Do not exceed the recommended dose of ferrous sulfate.
Hemochromatosis (Iron Overload)Hereditary hemochromatosis (iron overload) is an inherited disorder in which there is excessive accumulation of iron in the body. Check out the center below for more medical references on hemochromatosis, including multimedia (slideshows, images, and quizzes), related disease conditions, treatment and diagnosis, medications, and prevention or wellness.
Iron SupplementsFerrous sulfate (Fer-In-Sol, Slow Fe, Feosol, Feratab) is a supplement used for the treatment of iron deficiency anemias. The most common side effects associated with ferrous sulfate treatment are constipation, dark stools, stomach pain, nausea, and vomiting.
Kanuma (sebelipase alfa)Kanuma (sebelipase alfa) injection is a hydrolytic lysosomal cholesteryl ester and triacylglycerol-specific enzyme indicated for the treatment of patients with a diagnosis of Lysosomal Acid Lipase (LAL) deficiency, a rare inherited disorder. Common side effects of Kanuma include diarrhea, vomiting, nausea, fever, runny or stuffy nose, low levels of iron in the blood (anemia), cough, sore throat, hives, headache, weakness, constipation, and nausea.
Nature vs. Nurture Theory (Genes vs. Environment)
In the nature vs. nurture debate, "nature" represents our genetic makeup. These are the genes you have inherited from your biological family, and that may affect your physical and mental health, for example, intelligence, disease, and psychological health. While "nurture" represents how our environment affects our intelligence, traits, personality, and mental and physical health. Studies have shown that a person's environment can alter his or her genes, and lower their risk of developing certain inherited diseases, conditions, and mental illnesses that run in his or her family.
Researchers and doctors have found that particular physical traits like eye and skin color, and diseases like Huntington's chorea are the result of genetic inheritance (inherited from a family member). However, patterns of thinking and behavior can be attributed to both nature and nurture (your genes and your environment). Moreover, researchers who study the brain have found overwhelming evidence that a person's genetic factors and his or her experiences guide and support brain development. The human brain produces new nerve cells (neurons) into adulthood, and these nerve cells can change the strength of their connections throughout life, which can affect intelligence and other factors.
Food and Recipes: Top Foods High in IronWebMD shows you which foods to choose that are high in iron -- and tasty, too!
What Are You Lacking When Your Eye Twitches?In some cases, eye twitches may indicate that you are lacking nutrients such as vitamin B12, vitamin D, magnesium, iron, and electrolytes.