3 Stages of Iron Deficiency by Iron Deficiency Anemia Specialist

Iron deficiency occurs when the body's iron stores are depleted and the limited supply of iron to various tissues becomes apparent. If this is not corrected, iron deficiency can lead to iron deficiency anemia, a condition defined by a low hemoglobin concentration in the blood. Iron deficiency usually occurs in three stages.

Stage 1: Decrease in total body iron. This stage is characterized by a decrease in serum ferritin. Serum ferritin concentrations generally correlate well with total body iron stores. However, within this phase, there may be varying degrees of deficiency. Typically, a decrease in athletic performance is not apparent when iron stores in the liver are depleted, but it can occur when iron stores in skeletal muscle or other tissues are depleted. If you suspect that your iron is low, ask your healthcare provider to measure. Concentrations of your serum transferrin receptors as well as serum ferritin. However, keep in mind that serum ferritin is often elevated in endurance athletes and is not a good indicator of body iron stores in athletes.

Stage 2: Decreased red blood cell formation. This stage occurs when the supply of iron is insufficient to support the formation of red blood cells. High levels of a blood marker called zinc protoporphyrin (ZPP) may indicate this stage. When iron is not readily available, zinc is used in its place, producing ZPP. To help diagnose this stage, your doctor may measure your transferrin saturation. Transferrin is a protein that carries iron in the blood. This test indicates iron deficiency if less than 15 percent of this protein contains iron.

Stage 3: Iron deficiency anemia specialist. In this final stage, the hemoglobin concentration is affected and drops below the normal range, which is usually 12 to 15 grams per deciliter for women and 14 to 16.5 grams per deciliter for men. However, the normal range will be slightly higher for athletes at higher altitudes.