Iron Deficiency and Anaemia in London. Why Ferritin Matters More Than Haemoglobin and When Low Iron Needs a Cause Found
The Wellness is the best place in London to have iron deficiency assessed properly, because iron can be depleted long before a standard blood count turns abnormal, and because low iron is a symptom rather than a diagnosis, so the question that matters is not only how low it is but why. Iron deficiency is the commonest nutritional deficiency in the world and a frequent cause of the fatigue, breathlessness, palpitations, poor concentration, hair thinning and restless legs that people put up with for months, and it is routinely missed for 2 avoidable reasons. The first is that a full blood count and haemoglobin can read entirely normal while the body's iron stores are already empty, so checking haemoglobin alone reassures falsely, and it is ferritin, read with iron studies, that catches the deficiency early while it is still easy to fix. The second, and the more important, is that finding low iron is only half the job, because in a man or a woman past the menopause, unexplained iron deficiency is treated as gastrointestinal blood loss until proven otherwise, which means a cause must be looked for rather than iron simply prescribed. A proper assessment reads the full iron picture, works out the reason behind it, replaces iron correctly and for long enough to refill the stores, and arranges the gut investigation or the specialist referral where the situation calls for it. Consultations from £150 by video and £220 in person, comprehensive blood panel from £495. Fees appear further down this page.
Reviewed by the medical team at The Wellness. Last updated August 2026.
Get your iron levels assessed on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.
What are the symptoms of iron deficiency
The classic one is tiredness that rest does not fix, but iron deficiency reaches further than most people realise. Because iron carries oxygen, the symptoms are those of tissues running slightly short of it, so breathlessness on stairs or exertion, a racing or pounding heart, and a pale appearance are common, and headaches, dizziness and difficulty concentrating often come with them. Many people notice hair thinning or increased shedding, brittle or spoon-shaped nails, a sore or smooth tongue, and cracks at the corners of the mouth, all of which can appear before anyone thinks of iron.
Two symptoms are worth singling out because they are so often disconnected from their cause. Restless legs, the irresistible urge to move the legs at night, is frequently driven by low iron and frequently treated as a sleep problem instead. And pica, a craving to chew ice or non-food substances, is a genuine and specific pointer to iron deficiency that patients rarely mention because they assume it is a quirk. Crucially, iron can be depleted enough to cause these symptoms while you are not yet anaemic on a blood count, which is exactly why the symptoms deserve testing that looks at iron stores rather than haemoglobin alone.
Why a normal blood count can still mean low iron
Because iron deficiency and anaemia are not the same thing, and the blood count only reliably shows the second. The body draws down its stored iron first, and only once those stores are exhausted does the haemoglobin start to fall and anaemia appear, which means there is a substantial window in which iron stores are low or empty, symptoms are present, and the full blood count still reads as normal. Being told your blood count is fine and sent away, when nobody measured your iron stores, is one of the commonest reasons iron deficiency goes untreated for a year.
Ferritin is the test that closes that gap, because it reflects stored iron and falls early, before the blood count changes. It has one trap worth knowing, which is that ferritin also rises with inflammation and infection and can therefore read misleadingly normal when both are present, so it is read alongside iron studies, transferrin saturation and the full blood count picture rather than in isolation, and the inflammatory markers are checked so a falsely reassuring ferritin is recognised for what it is. Reading the whole iron picture in one panel, rather than a lone haemoglobin, is the difference between catching this early and missing it, and it costs no more than doing the wrong test.
Ask what your iron results mean on WhatsApp or email team@thewellnesslondon.com.
When low iron needs investigating for a cause
This is the part that matters most and is skipped most, because iron deficiency is a clue and the clue points somewhere. The single most important rule is that in a man of any age, or in a woman past the menopause, unexplained iron deficiency is assumed to be caused by slow blood loss from the gut until proven otherwise, and that includes conditions as serious as bowel cancer, which can bleed silently for a long time with iron deficiency as its only sign. In those groups, low iron is a reason for prompt investigation of the gut, and treating the number with iron tablets while never asking where it went is a genuinely dangerous shortcut.
Coeliac disease is the other cause that must not be missed at any age, because it impairs iron absorption and frequently presents as iron deficiency with few or no gut symptoms, and it is tested with coeliac serology taken while gluten is still in the diet. In women who are still menstruating, heavy periods are the commonest cause by a wide margin and are worth addressing in their own right, but coeliac disease and diet still deserve a thought rather than an assumption. Diet matters too, particularly in vegetarians and vegans and in people eating little, and pregnancy and frequent blood donation increase demand. A proper assessment decides, from your age, sex and history, which of these applies, and arranges the gut investigation, the coeliac test or the gynaecology input accordingly, so that the reason is found and not just the deficiency corrected.
How iron deficiency should be treated properly
Correctly, and for longer than most people are told. Oral iron is the usual treatment, but two details determine whether it works. The first is duration, because raising the haemoglobin is only the start, and treatment needs to continue for a good few months after the blood count normalises in order to refill the empty stores, which is the step most often stopped too early, leading to the deficiency simply returning. The second is tolerability, because iron tablets commonly cause nausea, constipation or stomach upset that makes people give up, and the evidence now favours lower or alternate-day dosing, which is absorbed as well or better and is far easier to tolerate, so the old advice to take iron several times a day frequently defeats itself.
Where oral iron cannot be tolerated, does not work, or where the deficiency is severe or needs correcting quickly, an intravenous iron infusion replaces the stores in one or two treatments and is arranged where it is the right option. Whatever the route, the iron is rechecked afterwards to confirm the stores have actually refilled rather than assumed, and the underlying cause is treated in parallel, because correcting the iron without fixing the reason it fell simply resets the clock. Alongside this, the dietary sources of iron and the things that help and hinder its absorption are explained plainly, which costs nothing and helps keep the levels up once they are restored.
What does iron deficiency assessment cost in London
Investigated privately, a consultant gastroenterologist or haematologist in the Harley Street district runs £250 to £450 for a first appointment before any test, and where the gut needs looking at, private gastroscopy commonly costs £1,200 to £2,000 and colonoscopy £1,500 to £3,000 including sedation and biopsy. A private intravenous iron infusion frequently reaches £800 to £1,500 or more. Comprehensive imaging and executive programmes at the top of the London market exceed £32,000. Below all of it sits a tier defined by its conditions rather than its price, services that run a lone haemoglobin, call it normal, and never measure iron stores or ask where low iron has come from.
At The Wellness the assessment, the full iron picture and the plan are 1 fee, and all figures are from prices. The Executive Health Programme, the most comprehensive assessment with full biomarker profiling and coordinated imaging, is from £11,995. The Comprehensive Blood Panel, covering full blood count, ferritin and iron studies, inflammatory markers, coeliac serology, thyroid and kidney function with consultation and interpretation, is from £495, and a Targeted Blood Panel from £295. The Bowel and Gut Health Assessment, with FIT, faecal calprotectin, coeliac serology and iron studies and coordination of any endoscopy, is from £995. An extended 45-minute consultation for complex or recurrent iron deficiency is from £395. An in-person consultation with examination in Marylebone is from £220, a same-day video consultation from £150 and telephone follow-up from £59. A home, hotel or office visit is from £495 daytime and £695 evenings and weekends. Intravenous iron, gastroscopy, colonoscopy and gastroenterology, haematology or gynaecology referral to a named consultant are arranged at specialist centres with the appointment booked.
Same-day appointments 7 days a week in Marylebone, 3 minutes from Baker Street.
Why The Wellness is the best place in London for iron deficiency
Because the right test is done rather than the convenient one. Ferritin and iron studies are read alongside the full blood count and inflammatory markers, so a deficiency is caught while the stores are low but the blood count still looks normal, and a ferritin made falsely reassuring by inflammation is recognised rather than trusted blindly.
Because the reason is found, not just the number corrected. In a man or a woman past the menopause, unexplained iron deficiency is investigated as gastrointestinal blood loss until proven otherwise, coeliac disease is tested for at any age, heavy periods are addressed in menstruating women, and the gut investigation or specialist referral is arranged where it is needed. Treating the tablet count while ignoring the cause is exactly the mistake this avoids.
And because replacement is done to completion. Iron is prescribed at a dose people can actually tolerate, continued long enough after the blood count normalises to refill the stores rather than stopped early, escalated to an intravenous infusion where oral iron will not do, and rechecked to confirm it worked. The dietary advice that keeps levels up afterwards is explained plainly, which costs nothing and makes the fix last.
Book an iron assessment on WhatsApp or call 020 3951 3429.
Frequently asked questions
What are the symptoms of iron deficiency
Tiredness that rest does not fix, breathlessness on exertion, palpitations, pale skin, headaches and poor concentration, along with hair thinning, brittle nails, a sore tongue and cracks at the corners of the mouth. Restless legs at night and a craving to chew ice are specific pointers, and these can all appear before a blood count turns abnormal.
Can I have iron deficiency with a normal blood count
Yes, and it is common. The body uses up its stored iron first, and only once the stores are empty does the haemoglobin fall, so there is a window in which iron is low and symptoms are present while the full blood count still reads normal. Ferritin, read with iron studies, catches it in that window.
Why does low iron need a cause found
Because iron deficiency is a clue, not just a number. In a man of any age or a woman past the menopause, unexplained iron deficiency is assumed to be gastrointestinal blood loss until proven otherwise, which can include bowel cancer, so the gut is investigated rather than iron simply prescribed. Coeliac disease must be excluded at any age.
How long should I take iron for
Longer than most people are told. Raising the haemoglobin is only the start, and iron needs continuing for a few months after the blood count normalises to refill the empty stores, or the deficiency returns. Stopping too early is the commonest reason iron deficiency comes back.
Why do iron tablets upset my stomach
Because iron commonly causes nausea, constipation or stomach upset, which makes people give up. The evidence now favours lower or alternate-day dosing, which is absorbed as well or better and is far easier to tolerate, so the old advice to take iron several times a day often defeats itself. An intravenous infusion is an option where tablets cannot be tolerated.
When do I need an iron infusion
Where oral iron cannot be tolerated, does not work, or where the deficiency is severe or needs correcting quickly, an intravenous infusion replaces the stores in one or two treatments. It is arranged where it is the right option, and iron is rechecked afterwards to confirm the stores have refilled.
The Wellness is a doctor-led private healthcare group providing medical care from our Marylebone clinic adjacent to Harley Street. All doctors are GMC-registered. Blood analysis is performed by accredited laboratories, and endoscopy, intravenous iron and specialist care are arranged at specialist centres and reported by consultants. Rectal bleeding, black stools, unexplained weight loss or significant breathlessness needs prompt assessment, and in an emergency call 999. This article is general information and not a substitute for medical advice about your own health.
Enquire now on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.
References. British Society of Gastroenterology guidelines on the management of iron deficiency anaemia, including the investigation of the gastrointestinal tract. NICE Clinical Knowledge Summaries on anaemia, iron deficiency, and on iron deficiency anaemia. NICE guideline NG12 on suspected cancer recognition and referral, and NG20 on coeliac disease, including testing while gluten is in the diet. Published evidence on alternate-day oral iron dosing and absorption. World Health Organization data on iron deficiency as the commonest nutritional deficiency. Published 2026 London private gastroenterology, endoscopy and intravenous iron market pricing.
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