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Yes, a low ferritin is worrisome for blood loss. The serum ferritin is a reflection of iron stores, and iron stores can get low before the hemoglobin gets low. So, someone that is getting progressively more iron deficient will get a low ferritin before they get a low hemoglobin, but decreasing body iron levels is worrisome for blood loss in either case.
In practical scenarios, we usually do not routinely check ferritin levels until we find a low hemoglobin, so it usually true that a person has both a low hemoglobin and a low ferritin. It is also important to note that there is a long list of conditions that can cause a falsely elevated ferritin, which one of the reasons that it is usually not done as an initial test.
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No. There is a concern that there could be malignancy. However, any condition that causes chronic blood loss can cause iron deficiency and a low ferritin. Some are benign, such as peptic ulcers or abnormal blood vessel formation. Since malignancy is the most worrisome, that is the reason that the tests are being done, and usually done as quickly as possible, but the tests will also look for the benign conditions that can cause blood loss.
Progressive lowering of the hemoglobin is likely due to worsening iron deficiency.
It is only a modest drop, but in the context of a low ferritin, further evaluation is indicated.
It is virtually impossible for an adult to become iron deficient solely because of poor iron intake, which is why iron deficiency indicates loss of iron somewhere, and in a post-menopausal woman or an adult male of any age, that usually means blood loss in the gut.
Yes - as I said above, decreasing body iron levels is worrisome for blood loss in either case.
I am sorry for the delay, but I had to step away from the computer.
There is a moderate chance that cancer or a pre-cancer is present.
Yes, although your original question was asking about the significance of the ferritin level.
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I answered that above.