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Iron Deficiency: Symptoms, Blood Values, and Iron Infusion in Vienna

Iron Deficiency: Symptoms, Blood Values, and Iron Infusion in Vienna

Detecting iron deficiency, correctly interpreting iron levels, and knowing when an iron infusion is medically indicated.

8 min.

Iron deficiency is one of the most common causes of fatigue, paleness, and reduced performance. It usually develops gradually and is reflected in typical iron levels in the blood count (ferritin, hemoglobin, transferrin saturation). Iron tablets are almost always sufficient – in certain situations, an iron infusion is the better solution.

✨ Key Information at a Glance

  • Iron deficiency is the most common nutritional deficiency and the leading cause of anaemia worldwide (Camaschella, NEJM 2015).

  • It progresses in 3 stages: first the stores are depleted, only then does the haemoglobin level drop.

  • Ferritin is usually the first, most sensitive parameter – but must always be assessed in conjunction with inflammatory markers.

  • Tablets are the 1st choice of therapy. Infusion is indicated if tablets are not tolerated, are ineffective, or if a concomitant disease (e.g. heart failure, dialysis, chronic inflammatory bowel disease [CED]) is present.

  • Intravenous iron is generally well tolerated; hypersensitivity is rare, and with repeated administration of certain preparations, phosphate levels may decrease.

What is Iron Deficiency?

Iron is involved in practically every cell of the body – especially in oxygen transport in the blood and in energy production. The body cannot produce iron itself; daily loss must be compensated for through food (Federal Health Portal [Gesundheitsportal des Bundes], "Iron").

If intake is insufficient or if more iron is lost than absorbed, the iron stores empty first – without this necessarily showing in the blood count (MSD Manual, Professional Version; Camaschella, NEJM 2015).

Iron Deficiency Symptoms: How does it manifest?

Iron deficiency and fatigue are closely linked – in addition, the following often occur:

  • Fatigue and reduced physical capacity

  • Difficulty concentrating

  • Paleness

  • Hair loss, brittle nails

  • Restless legs (restless legs symptoms)

  • Headaches, dizziness

Illustration: Woman with symbols for common symptoms of iron deficiency – fatigue, headaches, difficulty concentrating, shortness of breath during exertion, palpitations, as well as changes to hair, nails, and skin.

The Three Stages of Iron Deficiency

  • I · Iron depletion (Speichereisenmangel) — What happens: Stores empty, blood formation still supplied · Hemoglobin: normal

  • II · Iron-deficient erythropoiesis (Eisendefizitäre Erythropoese) — What happens: Blood formation no longer sufficiently supplied · Hemoglobin: still normal

  • III · Iron deficiency anemia (Eisenmangelanämie) — What happens: Hb drops below standard value (women < 12, men < 13 g/dl) · Hemoglobin: decreased

Source: MSD Manual (Professional Edition), Iron Deficiency Anemia, Camaschella, NEJM 2015

The three stages of iron deficiency with the respective affected laboratory values (ferritin, transferrin saturation, hemoglobin).

Which blood values indicate iron deficiency?

💡 Good to know
A normal Hb does not rule out iron deficiency — the stores may have been empty for a long time. The ferritin reference range depends on the laboratory; the values of the laboratory we use are listed in the table below. If ferritin is low, this indicates depleted iron stores.

⚠️ Caution with interpretation
Ferritin can be falsely elevated in cases of inflammation, infection, liver disease, hypothyroidism, or when taking the contraceptive pill. In unclear cases, TSAT or CHr as well as CRP are additionally used (the so-called "Thomas plot" approach).

Sources: MSD Manual (Professional Edition), Deutsches Ärzteblatt, New Parameters for Diagnostics

All figures apply to adults. Values for children and adolescents are deliberately not included. A reference range is not an iron deficiency threshold.

10 entries
Adult reference range — figures for adults
Laboratory valueAdult reference rangeMeaningSource
Haemoglobin (Hb)
Notable
Men 13–17 g/dl · Women 12.5–15.0 g/dloxygen transport in the blood
Ferritin
Notable
Women 15–150 ng/ml · Men 30–400 ng/mlfill level of the iron stores
Transferrin saturation (TSAT)
Notable
16–45 %iron loading in the blood
Transferrin
Borderline
Men 1.7–3.3 g/l (170–330 mg/dl) · Women 1.6–3.5 g/l (160–350 mg/dl)transport protein for iron
MCV
For information
85–101 flmean volume of the red blood cells
MCH
For information
26–34 pgmean haemoglobin content per blood cell
Reticulocytes
For information
0.5–1.5 %young, newly formed red blood cells
Reticulocyte haemoglobin (CHr/RetHb)
For information
no dedicated thresholdiron supply of current blood formation
CRP
For information
below 10 mg/linflammation value for context
Serum iron
For information
Men 60–160 µg/dl · Women 40–150 µg/dlsnapshot of the iron in the blood

Reference ranges can differ depending on the laboratory, measurement method, sex and clinical situation.

Iron Deficiency Calculator – Check Your Values

Enter your current laboratory values to get an initial assessment of whether iron deficiency is likely. The more values you enter, the more precise the assessment.

⚠️ Please note: This calculator provides an estimate for rough orientation and is not a medical diagnosis and not a medical device. It does not replace a medical examination. The final diagnosis can be made only by a doctor, based on the medical history, a physical examination and, where necessary, further laboratory tests.

Personal details

Sex (required)

Laboratory values

Values marked are required for an assessment. The remaining fields increase accuracy but are optional.

Thresholds based on:

This calculator serves exclusively for general information and self-assessment by healthy adults and patients of our practice. It is not a medical device, does not make a diagnosis and does not replace medical advice, examination or treatment. If you have health complaints, please contact your doctor.

⚠️ Important Notice
This calculator provides an estimate for rough guidance only and is neither a medical diagnosis nor a medical device. It is not a substitute for a medical examination. The final diagnosis can only be made by a physician based on medical history, physical examination, and, if necessary, further laboratory diagnostics.

Sources for the threshold values used: MSD Manual (Professional Edition), Camaschella, NEJM 2015, ESC/HFA 2023, KDIGO 2026, ECCO/Dignass 2015, OEGGG 2022, ESMO/Aapro 2018, AWMF S2k RLS

🧬 What does this mean for me?

"A ferritin value alone does not tell the whole story." The assessment takes into account:

  • Age and gender

  • Desire to have children or pregnancy

  • Potential sources of bleeding (e.g. menstrual bleeding, gastrointestinal tract)

  • Concomitant diseases (IBD, heart failure, renal insufficiency)

  • Previous tolerance of oral iron supplements

  • Other laboratory values (inflammation, renal function, phosphate)

"The assessment is carried out individually – tailored to your personal situation."

Who is particularly commonly affected?

  • Women of childbearing age: deficiency in approx. 20–35%

  • Pregnant women (third trimester): up to 85%

  • Chronic inflammatory bowel diseases: 35–90%

  • Heavy menstrual bleeding or gastrointestinal bleeding

  • Athletes, vegetarians/vegans, the elderly

Source: ebminfo.at

🤰 Iron Deficiency in Pregnancy and Family Planning

Iron requirements increase significantly during pregnancy; in the last trimester, up to 85% of pregnant women suffer from iron deficiency. When planning a pregnancy, a ferritin level of at least 30 ng/ml is targeted; in the second trimester, a drop below 30 ng/ml is considered the threshold for oral supplementation. Intravenous iron is only administered during pregnancy if clearly necessary, preferably in the second or third trimester.

Sources: ebminfo.at, OEGGG 2022, EMA

Illustration: Medical consultation regarding family planning and pregnancy, alongside symbols for cycle tracking, pregnancy, and a blood test.

👵 Iron Deficiency in Older Age

Fatigue and paleness are often attributed to other causes in older age. A newly occurring iron deficiency should therefore always be a reason to search for a possible source of bleeding, rather than solely substituting it.

Illustration: elderly couple in a medical consultation with their General Practitioner [Hausarzt], next to symbols representing exercise tolerance when climbing stairs, dizziness and fatigue, as well as nutrition, medication and check-up of medical findings.

Tablets or Iron Infusion?

  • Heart failure, dialysis, acute flare-up of chronic inflammatory bowel disease (CED), time pressure (surgery/pregnancy) — Recommendation: Infusion often preferred

  • Tablets poorly tolerated or insufficient absorption — Recommendation: Infusion appropriate

  • Mild/moderate deficiency, no urgency — Recommendation: Tablets (1st choice)

Sources: ebminfo.at, EMA

When is substitution beyond tablets appropriate?

✅ Conclusion
Iron substitution is a recognised therapeutic component in several chronic diseases — always based on a laboratory-confirmed diagnosis, never solely on the basis of symptoms. In inflammatory diseases, the ferritin threshold must be set higher because ferritin itself is an inflammatory marker.

Sources: ESC/HFA 2023, DGK Commentary, Journal für Kardiologie, KDIGO 2026, ECCO/Dignass 2015, OEGGG 2022, AWMF S2k RLS, ESMO/Aapro 2018

Risks and Side Effects of an Iron Infusion

  • Hypersensitivity reactions: possible but rare — therefore infusion under medical supervision.

  • Some preparations (especially iron(III) carboxymaltose) can lower phosphate levels with repeated administration.

  • Pregnancy: intravenous iron only when clearly necessary.

Sources: EMA, Zoller H et al., PHOSPHARE-IBD, Gut 2023;72(4):644–653, PMID 36343979, DOI 10.1136/gutjnl-2022-327897, ebminfo.at

You can find the practical procedure in our Medical Practice [Ordination] and appointment scheduling on the infusion therapy services page.

Whether the treatment can be billed via the health insurance fund depends on the medical indication. We will discuss this with you prior to the treatment.

View the procedure and appointment for the iron infusion →

⚠️ When should I consult a General Practitioner?

🚨 Please consult your General Practitioner (Hausarzt) promptly in the event of:
- Blood in the stool or black-coloured stool
- Unintentional weight loss
- Very heavy or prolonged menstrual bleeding
- Pronounced fatigue or shortness of breath on exertion
- During an infusion: skin rash, shortness of breath, dizziness — please report to the practice team immediately

Have unclear iron levels clinically assessed by a General Practitioner [Hausarzt]

Laboratory values are only one part of the picture. At our medical practice (Ordination) in Vienna-Floridsdorf, we discuss findings, symptoms, and medical history together and determine the next steps.

Iron Infusion Vienna – schedule an appointment now →

Frequently asked questions about iron deficiency and iron infusion

Sources (24)

💡 Take-home Message

Iron deficiency develops in stages and often remains undetected for a long time. Ferritin is the most sensitive early indicator, but it must be evaluated in connection with inflammatory markers. In cases of heart failure, renal insufficiency, chronic inflammatory bowel diseases, during pregnancy, and in restless legs syndrome, iron substitution is an established, guideline-supported treatment component. Tablets remain the first choice; an infusion is a well-tolerated alternative when medically justified by a doctor.

Medical Advice

The information on this website is intended for general guidance only and does not replace an individual medical consultation, examination, or diagnosis. In the event of symptoms or health-related questions, please consult your physician.

🧭 What are the next steps?

1

Understand medical report

2

Assess your personal risk

3

Set individual goals

4

Monitor progress

5

If needed, plan treatment together