Iron deficiency anaemia is common in those with undiagnosed Coeliac disease. The part of the small intestine that is damaged in response to gluten in those with Coeliac disease, is the same part that is responsible for the absorption of iron. Iron deficiency may be the presenting clinical feature in the absence of diarrhoea or weight loss.

Things to consider when investigating iron deficiency –

  • A serum ferritin level <30 µg/L for an adult is diagnostic of iron deficiency.
  • Serum ferritin levels of 30-100 µg/L in an anaemic adult may represent iron deficiency if there is coexisting inflammatory disease. In these cases the ratio of ferritin to soluble transferrin receptors gives better discrimination.
  • If CRP is elevated, a ferritin above 30 could still represent iron deficiency