Anemia in Adolescents: Iron Deficiency and Normal Ranges

Results of the health examination?

Hello, doctor.
I have a question.
I was diagnosed with anemia in middle school, and I still have it in high school, but over these three years, my values have significantly increased, even though I still qualify as anemic.
I would like to know if this is iron deficiency anemia.
What are the normal ranges for MCV and Hb, as well as the thresholds for mild, moderate, and severe anemia? Thank you.

Xiao Hei, 10~19 year old female. Ask Date: 2015/11/24

Dr. Xiao Kaiwen reply Pediatrics

A 15-year-old female.
MCV less than 80 is abnormal (microcytic), and Hb less than 12.5 indicates anemia.
It is necessary to visit a major hospital's hematology department for in-depth testing, diagnosis, and treatment to determine if it is iron deficiency anemia.
Hemoglobin levels between 7 and 10 indicate moderate anemia, while levels above and below this range indicate mild and severe anemia, respectively.

Reply Date: 2015/11/24

More Info

Anemia, particularly iron deficiency anemia, is a common concern among adolescents, especially during periods of rapid growth and development. In your case, it appears that you have been diagnosed with anemia since middle school, and while your values have shown improvement over the past three years, you still fall within the anemic range.
To determine whether you have iron deficiency anemia, we need to look at several key laboratory values, including hemoglobin (Hb), mean corpuscular volume (MCV), and ferritin levels. Normal ranges for these values can vary slightly depending on the laboratory, but generally, the following ranges are accepted:
1. Hemoglobin (Hb):
- Normal for adolescent females: 12.0 - 15.5 g/dL
- Normal for adolescent males: 13.0 - 16.0 g/dL
2. Mean Corpuscular Volume (MCV):
- Normal range: 80 - 100 fL
- Values below 80 fL indicate microcytic anemia, which is often associated with iron deficiency.

3. Ferritin:
- Normal range: 15 - 200 ng/mL (varies by age and sex)
- Low ferritin levels (below 15 ng/mL) indicate depleted iron stores, which is a hallmark of iron deficiency anemia.

In terms of classification:
- Mild Anemia: Hb levels are slightly below normal (e.g., 11.0 - 12.0 g/dL for females, 11.0 - 13.0 g/dL for males).

- Moderate Anemia: Hb levels are more significantly low (e.g., 8.0 - 10.9 g/dL).

- Severe Anemia: Hb levels are critically low (e.g., below 8.0 g/dL).

Given that you have mentioned your hemoglobin levels are still below the normal range, it is likely that you are experiencing some degree of iron deficiency anemia. The fact that your values have improved over time is encouraging, but it is essential to continue monitoring them, especially if you are still experiencing symptoms such as fatigue, weakness, or pallor.

It is also important to consider the underlying causes of your anemia. In adolescents, common causes include inadequate dietary intake of iron, increased iron requirements during growth spurts, and potential blood loss (though less common in this age group). If the cause of your anemia is not clear, further investigation may be warranted, such as dietary assessments or gastrointestinal evaluations to rule out hidden sources of blood loss.

In summary, based on your description, it seems you may still have iron deficiency anemia, albeit with improving values. Regular follow-ups with your healthcare provider are crucial to monitor your hemoglobin and ferritin levels, adjust any iron supplementation as needed, and ensure that you are on the right track to recovery. Additionally, maintaining a balanced diet rich in iron (such as lean meats, beans, lentils, and fortified cereals) and vitamin C (which enhances iron absorption) can be beneficial in managing your condition.

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