Iron deficiency anemia is diminished red blood cell production due to low iron stores in the body. BMID is found in patients with a ferritin range between 30 and 200 g/dL and TSAT between 10% and 20%. Once iron deficiency anemia is identified, the goal is to determine the underlying etiology. Fe, elemental iron; LR, label recommendation. Further evaluation should be based on risk factors (Figure 2).10,15,1721, Excessive menstruation is a common cause of iron deficiency anemia in premenopausal women in developed countries; however, a GI source (particularly erosive lesions in the stomach or esophagus) is present in 6 to 30 percent of cases.20,22,23 If the gynecologic workup is negative and the patient does not respond to iron therapy, endoscopy should be performed to exclude an occult GI source.20,22,23, Excessive or irregular menstrual bleeding affects 9 to 14 percent of all women and can lead to varying degrees of iron deficiency anemia.24 Etiologies include thyroid disease, uncontrolled diabetes mellitus, polycystic ovary syndrome, coagulopathies, uterine fibroids, endometrial hyperplasia, hyperprolactinemia, and use of antipsychotics or antiepileptics. It may reflect delayed release of iron from reticuloendothelial stores in active disease. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Studies that reported only ferritin levels are represented by red lines beneath the x-axis that encompass the range, and means are represented by diamonds situated on the lines. 1Department of Gastroenterology, University Hospital Birmingham, Vincent Drive, Birmingham, B15 2TH UK, 2Interdisciplinary Crohn Colitis Centre Rhein-Main, Schifferstrasse 59, 60594 Frankfurt am Main, Germany, 3Department of Gastroenterology, Heartlands Hospital, Birmingham, B9 5SS UK, 4Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Whringer Grtel 18-20, 1090 Vienna, Austria, 5Vifor Pharma Ltd., Flughofstrasse 61, 8152 Glattbrugg, Switzerland. The median baseline CRP value of the study population was applied as the cutoff value. Iron deficiency anemia . Correspondence Kleber Yotsumoto Fertrin, University of Washington, 825 Eastlake Ave, E MS CE3-300, Seattle, WA 98109; e-mail: kleber@uw.edu. They found 1023 people with confirmed BMID with mean ferritin between 33.6 and 158.3 g/L, whereas individuals with detectable BM iron had a mean ferritin >171.6 g/dL. TSAT 20% to 25% is still associated with BMID in CKD, and TSAT <20% may still predict BMID in patients with ferritin up to 500 g/L with HF or CKD treated with ESAs, with or without hemodialysis. Hepcidin-mediated ferroportin blockade traps iron inside cells, such as hepatocytes and macrophages, which in turn produce ferritin to store iron safely. The patient underwent an upper endoscopy and colonoscopy, and a bleeding gastric ulcer was detected, for which omeprazole was prescribed. iron: n=136). Erichsen K, Hausken T, Ulvik RJ, Svardal A, Berstad A, Berge RK. Iron Deficiency Anemia: Symptoms, Causes, Diagnosis, Treatment and More Guidelines often specify certain hemoglobin values as indications to transfuse, but the patient's clinical condition and symptoms are an essential part of deciding whether to transfuse.35 Transfusion is recommended in pregnant women with hemoglobin levels of less than 6 g per dL because of potentially abnormal fetal oxygenation resulting in non-reassuring fetal heart tracings, low amniotic fluid volumes, fetal cerebral vasodilation, and fetal death.15 If transfusion is performed, two units of packed red blood cells should be given, then the clinical situation should be reassessed to guide further treatment.35.