# Iron Deficiency Anaemia > Iron deficiency anaemia for FMGE: ferritin-led diagnosis, Mentzer index, oral iron rules, hookworm causes and Anemia Mukt Bharat programme points. - Canonical URL: https://prepelephant.com/topics/fmge/medicine/iron-deficiency-anaemia - Exam / course: FMGE · Subject: Medicine - Publisher: PrepElephant (https://prepelephant.com) — Prepared and reviewed by the PrepElephant Academic Review Team - First published: 2026-10-02 - Last updated: 2026-10-02 - How to cite: "Iron Deficiency Anaemia", PrepElephant, https://prepelephant.com/topics/fmge/medicine/iron-deficiency-anaemia ## Direct answer Iron deficiency anaemia, India's commonest anaemia, presents with fatigue, breathlessness, pallor and, when long-standing, koilonychia and glossitis, and is confirmed by a microcytic hypochromic picture with low ferritin. Treatment is oral iron — roughly 100 to 200 mg of elemental iron daily — continued for about three months after haemoglobin normalises to refill stores, with the cause (dietary lack, menstrual blood loss, pregnancy, hookworm or malaria) sought and corrected alongside. The Anemia Mukt Bharat programme supplements iron and folic acid across children, adolescents and women of reproductive age to attack this burden at population scale. ## What you must remember - Diagnostic signature: low haemoglobin with microcytosis and hypochromia, low serum ferritin (the best single marker), raised transferrin or total iron-binding capacity, and transferrin saturation below about 16 per cent, with a high red-cell distribution width. - Causes in India: heavy menstrual bleeding, pregnancy demand, hookworm and other gastrointestinal loss, and diets low in bioavailable iron — always deworm and treat the source. - Separate it from thalassaemia trait, the other common Indian microcytosis: a Mentzer index (MCV divided by red-cell count) below 13 favours iron deficiency, above 13 favours thalassaemia trait, which is confirmed by haemoglobin electrophoresis showing raised HbA2. - Oral iron: 100–200 mg elemental iron daily on an empty stomach with a vitamin C source; reticulocytes rise within 7–10 days and haemoglobin climbs about 1–2 g per dL monthly. - Continue therapy for about three months after haemoglobin normalises to replenish stores; non-response means poor adherence, ongoing blood loss, malabsorption or a wrong diagnosis — re-investigate rather than escalate the dose. - Parenteral iron is reserved for intolerance, malabsorption or late-pregnancy need; transfusion is for severe decompensated anaemia alone. - Anemia Mukt Bharat delivers iron with folic acid supplementation, deworming, and testing through schools, anganwadis and health facilities; the standard prophylactic tablet for women contains 100 mg elemental iron with 500 micrograms of folic acid. ## Common confusion Candidates treat every microcytosis as iron deficiency without ferritin, missing thalassaemia trait — lifelong iron therapy does nothing for it and is a classic exam trap. A second confusion is response monitoring: the earliest marker is the reticulocyte count within a week, not the haemoglobin, and failure to respond is an indication to review adherence and repeat the search for blood loss. Finally, anaemia of chronic disease mimics iron deficiency but shows normal or high ferritin with low transferrin — the inflammatory state flips the pattern. ## Exam-focused takeaway FMGE iron deficiency anaemia questions are pattern questions: the tired woman with heavy periods, a low MCV and low ferritin is iron deficiency; oral iron with monthly follow-up is the management; and the Mentzer index or electrophoresis settles the thalassaemia distractor. Learn the timeline — reticulocytes at 7–10 days, haemoglobin up 1–2 g per dL monthly, three months of therapy after normalisation — and the Anemia Mukt Bharat pairing of iron with folic acid and deworming. Hookworm in the stem should make deworming part of every answer alongside iron. ## Frequently asked questions ### Which test best confirms iron deficiency anaemia? Serum ferritin, low in iron deficiency; since ferritin rises with inflammation, a trial of iron helps when it is ambiguous. ### How is iron deficiency distinguished from thalassaemia trait? By ferritin and iron studies plus the Mentzer index, with haemoglobin electrophoresis (raised HbA2) confirming beta thalassaemia trait. ### What is the oral iron dose and duration? About 100–200 mg of elemental iron daily, taken on an empty stomach, continued for roughly three months after haemoglobin normalises to refill stores. ### Why is deworming part of Indian anaemia management? Because hookworm and other soil-transmitted helminths cause chronic intestinal blood loss, and Anemia Mukt Bharat couples iron supplementation with periodic deworming.