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What are the implications of low blood ferritin?

Q: My wife has a problem of low haemoglobin. Presently her value is 8.3. Her blood Ferritin value is very low. The doctors say that she has no problem. But they have recommended a bone marrow test. Please advise.

A:A low serum iron and ferritin with an elevated total iron binding capacity (TIBC) are diagnostic of iron deficiency. While a low serum ferritin is virtually diagnostic of iron deficiency, a normal serum ferritin can be seen in patients who are deficient in iron and have coexistent diseases. A marrow examination is not indicated to confirm iron deficiency but may be done if some other primary hematologic disease is being considered.

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