An NHS surgeon is urging individuals experiencing persistent, unexplained tiredness and forgetfulness to request specific blood tests from their general practitioner. This proactive approach could help identify potential health issues before more severe symptoms manifest.
Early Detection Through Blood Panels
Dr Karan Rajan, an NHS surgeon, emphasised the importance of comprehensive blood testing. He stated: "If you've been informed that your iron levels are normal, yet you continue to feel exhausted, forgetful, and experience low mood, this is precisely what you should ask your doctor to examine on your blood panels. The initial indicator to decline isn't the iron circulating in your blood; it's the 'storage iron'."
The medical professional suggested that assessing ferritin levels might offer the "earliest and most sensitive" sign of diminishing iron reserves. Such testing could detect a deficiency "even before anaemia develops," providing a crucial window for early intervention.
Understanding Iron Deficiency and Anaemia
Typically, insufficient iron levels can progress to iron deficiency anaemia. According to NHS guidance, this condition often results from inadequate iron intake, frequently due to blood loss or during pregnancy. Fortunately, it generally responds well to appropriate treatment.
A complete blood analysis can identify which specific levels are suboptimal. Dr Rajan elaborated that transferrin saturation (TSAT) "demonstrates how much iron is being transported and is actually usable," while measuring total iron-binding capacity (TIBC) assists in determining whether the body is "desperately attempting to acquire more iron."
The NHS Ferritin Blood Test Explained
The NHS ferritin blood test evaluates the body's iron stores and is commonly employed to diagnose iron deficiency anaemia or conditions involving excess iron storage, such as haemochromatosis. A small blood sample is usually taken from the arm, often in conjunction with a full blood count (FBC).
Patients are typically advised to fast for approximately twelve hours prior to the test. Ferritin levels ranging from 12 to 30 ug/L are considered low. However, symptoms like a pale complexion, brittle nails, and hair thinning can emerge when levels fall below 70 ug/L.
Test results are generally returned promptly after the procedure. These findings enable GPs to investigate underlying causes and formulate the most suitable treatment plan for each individual patient.
Interpreting Test Results Accurately
Dr Rajan cautioned: "Ferritin levels can be falsely elevated if inflammation is present. For accuracy, you require a combination of CRP and ferritin measurements. Haemoglobin and MCV are late-stage markers and often the last parameters to decrease."
Symptoms of Low Iron Levels
Symptoms associated with low iron, which may lead to iron deficiency anaemia, can include:
- Persistent tiredness and lack of energy
- Shortness of breath
- Noticeable heartbeats (heart palpitations)
- Paler than usual skin
- Frequent headaches
Less common symptoms of iron deficiency anaemia, typically not associated with pregnancy, may encompass:
- Hearing ringing, buzzing, or hissing noises internally (tinnitus)
- Altered taste perception of food
- Generalised itching sensations
- A sore tongue
- Hair loss – noticing increased hair shedding during brushing or washing
- Cravings to consume non-food items, such as paper or ice (pica)
- Difficulty swallowing (dysphagia)
- Painful open sores (ulcers) at the corners of the mouth
- Nail changes, including spoon-shaped nails
- Restless legs syndrome
Treatment for Low Ferritin and Iron Levels
After determining the root cause, doctors usually prescribe iron tablets to supplement what the body isn't obtaining naturally. Dr Rajan warned: "In addition to examining the correct panels, avoid supplementing blindly because excessive iron can be harmful; a proper diagnosis is essential first."
Overconsumption of iron can provoke common digestive issues, including constipation, nausea, abdominal discomfort, diarrhoea, or dark and bloody stools. Significant overdoses might lead to serious complications such as liver damage, cardiac failure, and seizures.
Dietary Recommendations and Supplement Timing
NHS guidance indicates that individuals should obtain between 8.7mg (for men and post-menopausal women) and 14.8mg (for women under fifty or menstruating regularly) of iron daily. Most of this requirement can be met through a balanced, nutritious diet incorporating foods like red meat, pulses, nuts, dried fruit, and fortified breakfast cereals.
Dr Rajan also highlighted the importance of timing for supplement effectiveness, noting that iron supplements are "best absorbed on an empty stomach." This typically means early morning, upon waking, is optimal as individuals have usually fasted for several hours.
He concluded: "Low iron exists on a spectrum. You can experience a constellation of symptoms that appear before the classic signs of low energy and dizziness become prominent."
