EARLY DIAGNOSIS AND MODERN TREATMENT STRATEGIES IN IRON DEFICIENCY ANEMIA CLINICAL SIGNIFICANCE OF FERRITIN AND TRANSFERRIN SATURATION

Abstract

Iron deficiency anemia is the final hematological expression of a process that may begin with depletion of iron stores long before hemoglobin falls. Its recognition therefore requires more than identifying microcytosis. Ferritin describes stored iron, whereas transferrin saturation reflects the iron available for erythropoiesis; their diagnostic value depends on inflammation, renal function, recent treatment, and the probability of ongoing blood loss. This narrative review examines how these markers guide early diagnosis, investigation of the underlying cause, selection of oral or intravenous replacement, and assessment of response. Particular attention is given to apparently contradictory results, such as low transferrin saturation with preserved ferritin, and to the distinction between improved absorption with alternate-day dosing and proven clinical superiority. Durable treatment requires correction of both the iron deficit and its source. A structured follow-up plan is essential because normalization of hemoglobin alone does not establish that stores are replenished or that recurrent bleeding has been excluded.