The diagnosis of iron deficiency anemia ultimately rests on laboratory studies. Both the hemoglobin and hematocrit are depressed, usually to a moderate degree, in association with hypochromia, microcytosis, and modest poikilocytosis. The serum iron and ferritin are low The total plasma iron-binding capacity (reflecting elevated transferrin levels) is high. Low serum iron with increased iron binding capacity results in a reduction of transferrin saturation to below 15%. Reduced iron stores inhibit hepcidin synthesis, and its serum levels fall. In uncomplicated iron deficiency, oral iron supplementation produces an increase in reticulocytes in about 5 to 7 days that is followed by a steady increase in blood counts and the normalization of red cell indices Earliest parameter to be affected in the Iron deficiency anemia patient - Serum ferritin. Gold standard for making the diagnosis of Iron deficiency anemia - Bone marrow examination (storage iron in the form of ferritin or protein hemosiderin can be detected with the help of stain Prussian blue.)
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