Client: Female, 38, menstruating · Reports: fatigue, hair shedding, slow recovery after exercise
| Marker | Result | Lab range | Twigged | Trend |
|---|---|---|---|---|
| Ferritin | 22 µg/L | 15–200 | Below functional | ↓ from 41 (2024) |
| Transferrin saturation | 17% | 10–45 | Below functional | ↓ from 24% (2024) |
| Haemoglobin | 128 g/L | 115–165 | Within functional | Stable |
| MCV | 86 fL | 80–100 | Within functional | Stable |
Every result sits inside its lab range. On a standard report, nothing is flagged.
Pattern identified
Low iron stores with reduced iron availability
Ferritin and transferrin saturation are both low and falling since 2024, while haemoglobin is still holding. This is consistent with reduced iron stores and availability before anaemia is present, and may help explain her fatigue, hair shedding and slow recovery.
Next steps
- Add hs-CRP. Ferritin rises with inflammation, so hs-CRP shows whether her ferritin may be overstating her stores.
- Add active B12 and folate. Both are needed for healthy red cells, and low levels can add to fatigue alongside low iron.
- Retest iron studies after you’ve addressed intake and absorption, to confirm the trend has turned.
The main takeaway
Your iron stores are running low
Every result sits inside the lab’s range, but your iron stores are lower than we’d like and have been dropping since your last test. This can happen well before anaemia shows up, and it may help explain your tiredness, hair shedding and slower recovery after exercise.
Your next steps
- A few extra tests. An inflammation marker, plus active B12 and folate, will give us the full picture.
- Rebuilding your iron. We’ll talk through how to improve your intake and absorption at your next appointment.
- A follow-up test to make sure your levels are heading back up.
3 cited references · Practitioner brief and client report, written for each reader