Quick answers
Low ferritin, low iron and iron deficiency anemia are among the most common reasons patients attend Dr Pranab Gyawali’s clinic. He has assessed and treated this problem for over 25 years, both in London and Dubai.
If your blood results show that your ferritin or iron stores are low, Dr Gyawali will assess why this has happened, whether your current treatment is working and whether the cause needs further investigation.
What will Dr Gyawali assess? Your blood results, symptoms, diet, medications, menstrual or other blood loss, digestive symptoms and response to previous iron treatment will be reviewed.
What results should I bring? Please bring your recent full blood count and ferritin result. Previous iron studies, coeliac tests, stool tests and reports from earlier investigations are also helpful.
Will I need more tests? This depends on the likely cause. Further blood tests, stool tests, gastroscopy or colonoscopy may be recommended. Capsule endoscopy is reserved for selected cases.
Does everyone with low iron need an endoscopy? No. The decision depends on your age, symptoms, medical history and whether the iron deficiency is unexplained, persistent or keeps returning.
What treatment may be recommended? Treatment may include iron tablets, intravenous iron or treatment of the underlying cause. Iron replacement and investigation can often proceed alongside each other.
Where will I be assessed? Your consultation and any required procedures will take place in a JCI-accredited facility in Dubai.
What might happen after your assessment?
The next step will depend on your blood results, symptoms and medical history. Not every patient requires every investigation.
Treatment options
Treatment depends on the severity of the deficiency, the likely cause and how you have responded to treatment previously.
- Oral iron is often used first.
- Intravenous iron may be considered when tablets are ineffective, poorly tolerated or unsuitable.
- An identified cause, such as gastrointestinal blood loss, inflammation or impaired absorption, should also be treated.
- Follow-up blood testing may be recommended to check the response.
Frequently asked questions
When does iron deficiency need a gastroenterology work-up?
A gastroenterology assessment is particularly important in men with confirmed iron deficiency anemia, women after the menopause, and people with unexplained, persistent or recurrent anemia.
Assessment may also be appropriate when iron levels do not improve as expected, or when there is rectal bleeding, persistent bowel symptoms, unexplained diarrhoea, weight loss or a relevant family history.
Younger women do not automatically need an endoscopy. Further investigation may be considered when the deficiency is severe, recurrent or appears disproportionate to menstrual losses.
What are the common causes of low iron?
Common explanations include heavy menstrual bleeding, pregnancy, insufficient dietary iron and increased iron requirements.
Gastrointestinal causes include reduced absorption, coeliac disease, inflammation, ulcers and slow blood loss from the digestive tract. More than one factor can be present.
Why is my iron still low after taking iron tablets?
Iron can remain low if tablets are not tolerated, are not absorbed adequately, have not been taken for long enough or cannot keep up with continuing blood loss. The diagnosis and response to treatment should be reviewed before simply continuing the same treatment.
Do I always need a gastroscopy or colonoscopy?
No. These procedures are recommended according to the individual pattern of iron deficiency and the likelihood of an underlying gastrointestinal cause.
When is capsule endoscopy used?
Capsule endoscopy is not normally the first investigation. It may be useful when appropriate gastroscopy and colonoscopy have not found the cause, but iron deficiency anemia persists or returns.
Helpful guides about low iron
Request a low-iron assessment
If your recent blood tests show low ferritin, low iron or iron deficiency anemia, you can request an assessment to review the results, consider the likely cause and decide what should happen next.
Please use the appointment form below or contact the Admin Team on WhatsApp.