I have seen prescriptions of iron supplement when CBC reveals low hemoglobin. Low hemoglobin does not always mean iron deficiency, it might be due to other causes where iron supplement is contraindicated. So, when a report reveals low hemoglobin we should go for hemoglobin electrophoresis and serum ferritin to find out the cause prior to taking measures.Even when hemoglobin is normal we should look for MCV, if it is low we should also go for hemoglobin electrophoresis and serum ferritin. What is your opinion?
Yes, in many countries it is standard practice to measure ferritin and some other additional markers like folic acid etc before prescribing iron supplements. I don't know why it is not standard where you live.
The MCV is a useful screening tool to detect iron deficiency and hemoglobinopathy . some times iron deficiency is present along with hemoglobinopathy . In cases of decreased MCV and normal haemoglobin .ferritin level along with hemoglobin (Hb) electrophoresis needed to determine if iron replacement therapy is indicated . However causes of other nutritional deficiences should also be investigated .
