Iron Deficiency Symptoms: Why Doctors Now Watch Ferritin

New international guidance is changing how doctors read a common blood test, and it matters for anyone who trains. The American Society of Hematology has lowered the bar for diagnosing iron deficiency, and UAE doctors say the number to watch is ferritin, not just haemoglobin. If your energy has dropped or your training has stalled, iron deficiency symptoms can appear long before a standard anaemia result does.

In this article

1. Why ferritin matters more than haemoglobin alone
2. The new numbers to know
3. Who is most at risk in the UAE
4. Symptoms worth checking
5. Testing and food that helps
6. Train with more in the tank

Why ferritin matters more than haemoglobin alone

Ferritin is the protein that stores iron. It can fall before haemoglobin drops to anaemia levels, so a normal haemoglobin result does not always mean your iron is fine. Dr Malaz Yabrodi, a specialist in internal medicine at Medcare Shaikh Saqr Al Qasimi Hospital in Sharjah, told Khaleej Times that ferritin should not be read on its own. Inflammation or a recent infection can push it up for a while, so a single number is read alongside your symptoms and the rest of a blood panel.

The new numbers to know

The society now recommends diagnosing iron deficiency even without anaemia, and it has raised the ferritin cut-off it uses. The thresholds are:

• Most adults, including menstruating and pregnant individuals: 30 ng/mL or lower, up from the older 15 ng/mL.
• Higher-risk groups, such as heavy menstrual bleeding or a planned pregnancy: 50 ng/mL or lower.
• Children aged 9 months to 4 years: 20 ng/mL or lower.
• Adults with inflammation: under 100 ng/mL, or transferrin saturation under 20%.

The society estimates iron deficiency affects about 1 in 3 people globally, and that up to 70 percent of cases are missed in high-risk groups. Its president, Dr Robert S. Negrin, noted that many patients live with fatigue, weakness or difficulty concentrating for months, even years, before iron deficiency is recognised, which is part of why the threshold was raised.

Who is most at risk in the UAE

The common threads are blood loss, higher demand and lower intake. Women with heavy periods and anyone who is pregnant top the list. Endurance trainees lose small amounts of iron through heavy sweating and repeated foot strike, and their needs run higher. Residents on a vegetarian diet, common in the UAE's large South Asian community, absorb iron less efficiently from plants than from meat. If two or three of these apply to you, a normal haemoglobin result is worth a second look.

Symptoms worth checking

Low iron stores can show up as:

• Ongoing tiredness and low energy
• Reduced exercise tolerance, or a workout that suddenly feels harder
• Difficulty concentrating, headaches or dizziness
• Feeling cold, hair shedding and nail changes

None of these proves iron deficiency on its own, but together they are a reason to ask about a ferritin test rather than push through.

Testing and food that helps

The practical step is a blood test that includes ferritin, not haemoglobin alone, and a talk with your doctor about the number in context. On the plate, iron-rich foods include red meat, liver, legumes such as lentils and chickpeas, and dark leafy greens. Pairing plant iron with a source of vitamin C, a squeeze of lemon or a glass of orange juice, improves absorption, while tea and coffee with a meal reduce it. One caution from the guidance is worth repeating: the goal is a healthy level, not the highest possible one, because too much iron carries its own risks.

Train with more in the tank

Energy on the gym floor starts with the basics, and iron is one worth getting right. If you are ready to build a routine that matches how you want to feel, the GymNation team can help you get started. Fill in the enquiry form and we will take it from there.

Sources:
khaleejtimes.com
hematology.org

The opinions shared in the GymNation blog articles are solely those of the respective authors and may not represent the perspectives of GymNation or any member of the GymNation team.