Feeling drained dizzy or mentally foggy even after being told your iron levels are normal can be confusing and discouraging. However early iron deficiency often does not show up in routine blood tests. Symptoms can appear much earlier when iron stores begin to fall even though haemoglobin and serum iron remain within range. A UK-based surgeon has now highlighted why deeper testing matters and which blood markers can reveal the real picture behind ongoing fatigue and dizziness.
Dr Karan Rajan a UK surgeon and widely followed medical content creator explains that storage iron is usually the first to decline. This means many people are reassured too early by standard reports. According to him persistent exhaustion forgetfulness low mood or dizziness despite normal results should prompt a closer look at specific iron-related markers rather than relying only on basic panels.
He advises checking ferritin first as it reflects iron stores and drops early before anaemia develops. Transferrin saturation should also be reviewed as it shows how much iron is actively available for use in the body. Total iron binding capacity helps indicate whether the body is trying to compensate for low iron by increasing its carrying capacity. CRP an inflammation marker is important because inflammation can falsely raise ferritin levels and mask deficiency. Lastly haemoglobin and MCV are considered late indicators and often remain normal until iron deficiency becomes advanced.
Dr Rajan also cautions against self-prescribing iron supplements without confirmation since excess iron can be harmful. Instead he suggests improving absorption naturally by pairing iron-rich foods with vitamin C reducing tea and coffee intake around meals cooking in cast iron cookware checking for gut-related absorption issues and timing supplements carefully if prescribed. He emphasises that low iron exists on a spectrum and symptoms often appear long before classic anaemia is diagnosed.