Causes of Iron Deficiency - Differential Diagnosis Algorithm

 • Blood loss: GI (cancer, ulcer, IBD), GU (cancer), GYN (cancer, menses), Epistaxis, Surgery, Hemodialysis

 • Iron loss: Intravascular hemolysis, (PNH, sickle-cell, prosthatic valve), Intensive athletic training, Pulmonary hemosiderosis

 • Inadequate intake for needs: Infancy, Adolescence, Pregnancy, Lactation, Low iron diet

MALABSORPTION

 • Decreased ferrous iron from achlorhydria: PPI or H2-blocker, H.pylori, Atrophic gastritis, Gastrectomy

 • Increased hepcidin: Chronic kidney disease, Heart failure, Cancer/Waldenstroms, Rheumatoid arthritis and other chronic inflammatory conditions, Obesity, Polycythemia vera

 • Competitive inhibition with DMT1: Zinc, Manganese, Calcium, Cadmium, Lead

 • Structural problem (loss of sites of absorption): Celiac disease, Bypass surgery, Bacterila overgrowth, Hookworm, whipworm



- Dr. Tony Breu @tony_breu



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