Features of iron deficiency-related alopecia:
(1) The patient (often a premonopausal woman) has thinning of the hair or alopecia.
(2) The patient has a reduction in total body iron stores, typically associated with a low serum ferritin.
(3) The iron deficiency may be associated with deficiencies in other essential nutrients such as l-lysine.
(4) There are no other diagnoses that can explain the alopecia better.
(5) The alopecia corrects with replacement of iron and other nutritional deficiencies.
Problems in the diagnosis of iron deficiency-related alopecia,:
(1) Many patients with iron deficiency do not develop alopecia.
(2) Serum ferritin is an acute phase reactant and may not always accurately reflect total body iron stores. Rushton (2002) used a serum ferritin < 70 micrograms per L with normal ESR to identify a patient to investigate.
