Symptomatic Iron Deficiency Without Anemia

Allan S. Brett, MD


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In this study, low-dose iron improved fatigue in nonanemic, menstruating women whose iron stores were marginal (as assessed by serum ferritin levels). The findings suggest that clinicians should check both blood counts and serum ferritin levels when menstruating women present with fatigue. However, several caveats should be noted: The placebo effect was substantial, blinding might have been compromised (because iron can change stool color), we don't know whether the 4-point difference in fatigue scores is clinically important, and scores on several quality-of-life indicators were not significantly different between the iron and placebo groups.