https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5028806/
See Fig. 3:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5028806/figure/F3/
Argue that you are clearly iron-deficient (especially in the setting of your other medical conditions), and that you are symptomatic. Or find another hematologist who understands iron deficiency in bariatric patients.
See Fig. 3:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5028806/figure/F3/
Suggested approach for the assessment and treatment of iron deficiency/iron deficiency anemia in clinical practice. 1In patients with inflammation, ferritin levels < 100 ng/mL should be considered as iron-deficient; 2Hb increase < 2 g/dL in 4 wk. Stein et al[6]. CHr: Hemoglobin content of reticulocytes; CRP: C-reactive protein; ESA: Erythropoiesis-stimulating agent; Hb: Hemoglobin; %HYPO: Percent hypochromic red blood cells; ID: Iron deficiency; IDA: Iron deficiency anemia; TSAT: Transferrin saturation.
***In clinical practice, iron status is mainly assessed on the basis of serum ferritin levels[182]. However, serum ferritin is subject to gender differences and falsely elevated levels in populations with inflammatory reactions since it is also an acute-phase reactant[181]. Therefore, the diagnostic workup of anemic patients (i.e., men with Hb < 13 g/dL or non-pregnant women with Hb < 12 g/dL) should include CRP, to detect underlying inflammatory reactions (suggested cut-off 5 mg/L), and TSAT (suggested cut-off 20%), a marker of low iron availability that is less affected by inflammatory reactions[181,182].
Argue that you are clearly iron-deficient (especially in the setting of your other medical conditions), and that you are symptomatic. Or find another hematologist who understands iron deficiency in bariatric patients.
