Table 1: Potential role of iron therapy in management of anemia [12].

ConditionExpected hepcidin levelsIron parametersIron therapy strategiesPotential hepcidin therapy

Absolute iron deficiency anemia (IDA)LowLow TSAT and ferritinPO or IV if poorly tolerated or malabsorbedNo

Functional iron deficiency (ESA therapy, CKD)Variable, depending on ±CKDLow TSAT, variable ferritinIVAntagonist (if hepcidin levels are not low)

Iron sequestration (anemia of inflammation (AI))HighLow TSAT, normal-to-elevated ferritinIVAntagonist

Mixed anemia (AI/IDA or AI/functional iron deficiency) VariableLow TSAT, low-to-normal ferritinIVAntagonist
(if hepcidin levels are not low)

TSAT = transferrin saturation; PO = oral; IV = intravenous; CKD = chronic kidney disease; ESA = erythropoiesis-stimulating agent.
Mixed anemia is a diagnosis of exclusion without a therapeutic trial of iron.
From [12].