Iron deficiency assessment in Reading
If you are worried about low iron, low ferritin or iron deficiency anaemia, you can book a careful GP-led assessment with me, Dr Asim Naqvi, to help you understand your symptoms, blood results and next steps.
Worried your symptoms could be linked to low iron?
I often see people who feel exhausted, breathless, light-headed, weak, restless or unable to exercise as they normally would.
Some have been told their ferritin is low. Others have been told they are anaemic. Some have symptoms but their haemoglobin is still within range, so they have been reassured even though they still feel unwell.
My role is to look at the whole picture – your symptoms, ferritin, iron studies, full blood count, medical history, possible causes and response to any previous treatment – before advising on the most sensible next step.
Iron deficiency can be important, but it does not explain every symptom. If low iron looks relevant, I will explain why. If another deficiency, medical condition or referral seems more appropriate, I will say so clearly.
What is iron deficiency?
Iron is needed to make haemoglobin, the protein in red blood cells that helps carry oxygen around the body. When iron is low, the body may struggle to make enough healthy red blood cells, which can lead to iron deficiency anaemia. NHS Inform describes common symptoms of iron deficiency anaemia including tiredness, lack of energy, shortness of breath and heart palpitations.
Iron deficiency and iron deficiency anaemia are closely related, but they are not exactly the same thing.
You can have low iron stores before anaemia is obvious on a full blood count. This is one reason I pay attention to ferritin, iron studies, symptoms and the wider clinical picture, rather than only looking at haemoglobin.
A low ferritin result can be a sign that iron stores are depleted, but interpretation is not always simple. The British Society of Gastroenterology describes serum ferritin as the most useful marker of iron deficiency anaemia, while also recognising that other iron tests can help when ferritin may be falsely normal, such as in inflammation.
Symptoms I often review
Iron deficiency can affect people in different ways. Symptoms can also overlap with B12 deficiency, thyroid disease, folate problems, vitamin D deficiency, inflammation, sleep problems, stress and other medical conditions.
I do not treat a number on a screen. I look at the person in front of me, the pattern of symptoms, the risk factors, the blood results, the possible causes and the response to any previous treatment.
I also look for other contributors, because B12 is not always the whole story.
Tiredness, weakness and low stamina
You may feel drained, physically weaker than usual or unable to manage normal daily tasks without becoming exhausted.Breathlessness or reduced exercise tolerance
Some people notice they become breathless on stairs, during exercise or with activity they previously managed well.Dizziness, light-headedness or palpitations
Low iron or anaemia can sometimes be associated with feeling faint, light-headed or aware of the heartbeat. These symptoms should always be interpreted carefully, as they can have other causes too.Restless legs, headaches or poor sleep
Some patients describe restless legs, headaches, poor sleep or a general sense that their body is not recovering properly.Brain fog, low mood or poor concentration
Low iron can sit alongside symptoms such as poor focus, low motivation, irritability or feeling mentally slower than usual.Symptoms despite treatment or reassurance
Some people come to me because they still feel unwell despite oral iron, previous treatment, “borderline” results or being told that no action is needed.
Pernicious anaemia and B12 absorption
Pernicious anaemia is one important cause of B12 deficiency. It is linked to autoimmune changes affecting the stomach, which can make it harder for the body to absorb B12 from food.
This matters because the cause of B12 deficiency can affect treatment, monitoring and whether the problem is likely to return.
If pernicious anaemia or autoimmune gastritis may be part of your picture, I can help you understand what your results suggest, whether further testing may be useful and what the next step should be.
Why iron can become low
Heavy periods or menstrual blood loss
Pregnancy, recent birth or increased iron need
Gut blood loss or digestive causes
Diet or restricted intake
Absorption problems or medication effects
More than one contributor
Low ferritin, iron deficiency and anaemia
Ferritin is often described as a marker of iron stores. Haemoglobin tells us whether anaemia is present. Iron studies can help show how iron is being transported and used.
These results need to be interpreted together.
Someone may have:
- Low ferritin without anaemia
- Iron deficiency anaemia
- Borderline results with significant symptoms
- Iron deficiency alongside inflammation
- Recurrent low iron despite treatment
- Symptoms that are not fully explained by iron alone
I often see patients who have focused only on one number, such as ferritin or haemoglobin. My approach is to look at the pattern rather than one isolated result.
If your ferritin is low, I will consider why it is low. If your haemoglobin is low, I will consider whether iron deficiency is the likely cause or whether another type of anaemia needs to be considered. If your results do not fit your symptoms, I will say so clearly.
Iron infusions and when they may be considered
I often see people who have been told they may have pernicious anaemia, but have not had a clear explanation of what it means.
Some have low or borderline B12 results. Others have symptoms that fit possible B12 deficiency, but their results have been described as “normal”. Some have already started B12 injections or tablets and want to understand whether the underlying cause has been properly considered.
My role is to look at the whole picture – your symptoms, medical history, risk factors, blood results, possible absorption problems and response to any previous treatment – before advising on the most sensible next step.
My role is to look at the whole picture – your symptoms, medical history, risk factors, blood results, possible absorption problems and response to any previous treatment – before advising on the most sensible next step.
My approach to iron deficiency assessment
Your symptom pattern
Your medical history and risk factors
Your blood results in context
Possible pernicious anaemia or absorption problems
Cofactors and alternative diagnoses
A practical plan
B12 does not work in isolation
If someone has persistent tiredness, brain fog, dizziness, nerve symptoms or low exercise tolerance, it is often sensible to look at related areas too. This does not mean testing everything without purpose. It means choosing tests that fit the clinical picture.
B12 and folate
Vitamin D and thyroid function
Inflammation and chronic illness
Gut and autoimmune background
What happens when you book a consultation
You tell me what has been happening
I start by listening. I want to understand what has changed, how long your symptoms have been present and how they are affecting your work, family life, exercise, mood and confidence.
I review your background carefully
I look at your medical history, medication, diet, gut symptoms, menstrual history, family history, previous diagnoses and any past investigations.
I assess your risk factors
This may include autoimmune disease, gut problems, medication effects, vegan or restricted diet, nitrous oxide exposure, bariatric surgery, heavy periods or a family history of related conditions.
I interpret your results in context
I review relevant results such as B12, folate, ferritin, iron studies, vitamin D, thyroid markers and other tests where available.
I explain my clinical opinion clearly
I will explain what I think may be going on, what the results support, what they do not prove and whether B12, iron or another issue seems most relevant.
We agree a practical plan
Your plan may include further testing, B12 treatment, iron treatment, monitoring, symptom tracking, lifestyle advice, a GP letter or referral where appropriate.
B12 Metabolic Clinic is not an emergency service
Please seek urgent help through NHS 111, 999 or A&E if you have severe chest pain, sudden shortness of breath, fainting, weakness on one side of the body, new confusion, black stools, heavy bleeding, rapidly worsening symptoms or anything that feels severe, sudden or unsafe to wait.
If you have new or rapidly worsening neurological symptoms, severe weakness, problems walking or symptoms that feel unsafe to wait, please seek urgent medical advice.
Book an iron deficiency assessment with me
If you are worried about low ferritin, iron deficiency, iron deficiency anaemia or symptoms that have not been fully explained, you do not need to work it out alone.
I will take time to listen, review your symptoms and results carefully and help you understand the most sensible next step.
Frequently asked questions
If you are considering an appointment, you may have questions about blood tests, B12 injections, iron infusions or whether this clinic is right for your symptoms. I have answered some of the most common questions below, but if you are unsure, you are welcome to get in touch before booking.
- Can I have an iron infusion privately?
An iron infusion may be considered privately if it is clinically appropriate. I will review your symptoms, blood results, medical history and previous response to oral iron before advising whether this is suitable.
- Why does my iron keep dropping?
Recurring low iron may be linked to heavy periods, blood loss, diet, gut absorption problems, medication, inflammation, pregnancy, blood donation or another medical issue. I would review the pattern carefully rather than only replacing iron repeatedly.
- What is the difference between iron deficiency and anaemia?
Iron deficiency means your iron stores or available iron are low. Anaemia means your haemoglobin is below the expected range. Iron deficiency can lead to anaemia, but the two do not always appear at the same time.
- What is ferritin?
Ferritin is commonly used as a marker of iron stores. A low ferritin result can suggest depleted iron stores, but interpretation may be more complex if inflammation or other medical conditions are present.
- What symptoms can iron deficiency cause?
Iron deficiency anaemia can cause tiredness, lack of energy, shortness of breath and palpitations. Some people also describe dizziness, reduced exercise tolerance, restless legs, headaches, brain fog or feeling generally drained. These symptoms can have other causes too, so assessment matters.
- Can low iron cause symptoms even if I am not anaemic?
Yes, some people can have low iron stores before anaemia is obvious. I look at ferritin, iron studies, full blood count, symptoms and risk factors together rather than relying on haemoglobin alone.
- How is this different from a standard iron infusion service?
This is a GP-led assessment, not just an iron infusion service. I look at your symptoms, medical history, ferritin, iron studies, full blood count, possible causes, cofactors and response to previous treatment before advising on the next step.
If an iron infusion is appropriate, I will explain why. If iron does not look like the main issue, I will say so and consider other possible causes such as B12 deficiency, folate problems, thyroid disease, inflammation, vitamin D deficiency or another medical condition.
- Do I need to try iron tablets first?
Often, oral iron is the first treatment considered. However, some people do not tolerate it, do not absorb it well or do not respond adequately. In those situations, other options may need to be discussed.
- Will iron treatment fix all my symptoms?
Not always. Iron deficiency can be important, but not every symptom is caused by low iron. If your symptoms suggest another cause or your response to treatment does not fit, I will explain what else should be considered.
- Where is B12 Metabolic Clinic based?
B12 Metabolic Clinic is located at The Forbury Clinic in Reading, Berkshire.
Remote consultations may also be available where clinically appropriate. If blood tests, B12 injections or iron infusions are needed, I will explain what can be arranged safely and practically.