Iron deficiency may be going unnoticed: New guidance could expand who gets diagnosed

Millions of Americans live with iron deficiency, but many never realize they have it. Updated guidance from the American Society of Hematology (ASH) could help clinicians spot more people with this common, treatable condition. From symptoms that are easy to miss to revised diagnostic standards, here is what to know.

We Are Austin spoke with Dr. Jacqueline Powers about the updated guidance, why iron deficiency is frequently missed, and how a basic blood test can provide answers.

Watch the full video above to hear Dr. Powers explain the new guidelines, symptoms to watch for, and when to talk with your healthcare provider about testing.

Why does iron deficiency get overlooked so often?

Iron deficiency is more widespread than many people realize. Dr. Powers estimates that about one in three people worldwide are affected, including roughly 10 million adults in the United States.

Even so, diagnosing it is not always simple.

"Some of the symptoms can be subtle, and sometimes they're dismissed as being related to stress or lack of sleep," Powers explained.

She added that older diagnostic cutoffs may also have played a role in missed diagnoses, with some patients being told their iron levels were normal when treatment could still have helped them.

Signs that may not seem obvious

Fatigue is one of the best-known symptoms of iron deficiency, but it is not the only one.

Other possible signs include trouble concentrating, dizziness, headaches, pale skin, shortness of breath, and a fast heartbeat.

One especially surprising symptom is pica, or a craving for nonfood items such as ice.

"If you or someone you know is craving ice constantly, you might be iron deficient and may benefit from doing testing," Powers said.

What is different under the new guidance?

According to Powers, the updated ASH guidance increases the ferritin thresholds used to help diagnose iron deficiency.

Ferritin is a protein that stores iron in the body, and checking its level helps healthcare providers assess a person's iron reserves.

The revised recommendations are intended to help clinicians identify iron deficiency sooner and decide whether a patient may need dietary changes, iron supplements, or further evaluation.

Who faces the highest risk?

Powers pointed to several groups that may be more vulnerable to iron deficiency, including young children, pregnant people, individuals with chronic blood loss, and those with limited diets or chronic inflammatory conditions.

She urges patients who have symptoms or risk factors to ask their healthcare providers about ferritin testing.

"It's not always checked, so it is specifically recommended that you talk to your clinician about checking your ferritin level in addition to any other regular blood work," Powers said.

For more information about iron deficiency and the American Society of Hematology's guidance, visit Hematology.org/IDA.

This information is for educational purposes and is not a substitute for medical advice. Symptoms can have multiple causes, and ferritin results require clinical interpretation. Consult a healthcare professional before beginning iron supplementation or other treatment.