Overview
Iron deficiency is the most common nutritional deficiency worldwide. Women between 20 and 45 are particularly affected, mainly due to regular blood loss during menstruation. Iron is needed to produce haemoglobin, the red blood pigment; once the body's stores are depleted, iron deficiency anaemia can develop. Common signs include persistent fatigue, difficulty concentrating, pale skin, hair loss and brittle nails. The most important laboratory value for assessing iron stores is ferritin; haemoglobin and transferrin saturation are usually considered as well. In a video consultation you can have existing laboratory results interpreted by a doctor and discuss your symptoms. Based on the doctor's assessment, a private prescription for an oral iron supplement may be issued and a plan for follow-up tests agreed. Billing is carried out as a private service according to the German GOÄ fee schedule and is therefore aimed at privately insured and self-paying patients. Blood cannot be drawn via telemedicine; the sample is taken at a local practice or laboratory.
Common causes
In women of childbearing age, the most common cause is increased iron loss through menstruation, especially with heavy or prolonged periods. Pregnancy and breastfeeding also significantly increase iron requirements. A vegetarian or vegan diet can contribute to lower iron intake, as plant-based iron is absorbed less efficiently than iron from meat. Other possible causes include chronic blood loss in the gastrointestinal tract, for example from mucosal inflammation or ulcers, and absorption disorders in coeliac disease or chronic inflammatory bowel disease. Certain medicines, such as acid-suppressing drugs, can also reduce iron absorption. Intensive endurance sport, frequent blood donation and restrictive diets are additional factors. Because iron deficiency can also be a sign of conditions that require treatment, addressing the cause is always part of the care – not just correcting the deficiency.
When to see a doctor
Have persistent fatigue, a drop in performance, noticeable pallor, increased hair loss or brittle nails medically assessed – especially if the symptoms last for several weeks. A previously measured low ferritin level is also a good reason for a medical consultation, so that the cause and possible supplementation can be clarified. Certain warning signs require a prompt in-person examination: blood in the stool or black-coloured stool, unintended weight loss, blood in the urine, very heavy or prolonged menstrual bleeding, and iron deficiency in men or after the menopause, as these situations more often involve a source of bleeding that needs investigation. In case of severe shortness of breath at rest, chest pain, a racing heart with dizziness or impending circulatory collapse, call the emergency number 112 immediately. Do not take iron supplements long-term without medical supervision, as excess iron can also be harmful.