Kabtafer Plus Medical Team · Last reviewed: 11 October 2026
Sources: BSG guideline (Gut 2021), JAMA 2025 review, AAFP 2025, NIH Office of Dietary Supplements, StatPearls and Stoffel et al. (Lancet Haematology 2017).
The short answer
Iron deficiency anemia happens when the body runs out of stored iron and can no longer make enough haemoglobin. It is diagnosed with a blood count plus iron studies, usually a ferritin below 30 ng/mL or transferrin saturation below 20%. Doctors treat it with oral iron (often one tablet daily or on alternate days) or IV iron when tablets are unsuitable. Just as important is finding why iron ran low, whether heavy periods, poor absorption or bleeding from the gut.
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Key points
- Iron deficiency is the most common cause of anemia worldwide.
- Heavy menstrual bleeding accounts for about 33–41% of iron-deficiency anemia in women of reproductive age (NIH ODS).
- Ferritin below 30 ng/mL or transferrin saturation below 20% points to iron deficiency (JAMA 2025).
- Alternate-day oral iron can improve absorption and tolerability.
- A haemoglobin rise of about 2 g/dL by roughly 4 weeks is an adequate response (BSG).
- Men and post-menopausal women with iron deficiency anemia need checks of the gut.
What is iron deficiency anemia?
Iron is needed to build haemoglobin, the oxygen-carrying protein in red blood cells. When intake or absorption does not keep up with losses and needs, the body first uses up its iron stores (measured by ferritin). Only once stores are empty does haemoglobin start to fall. This is why you can be iron deficient without being anemic: the JAMA 2025 review estimates that in high-income countries around 38% of non-pregnant women of reproductive age have iron deficiency without anemia, and around 13% have iron-deficiency anemia.
What causes iron deficiency anemia?
According to StatPearls, the causes fall into four groups.
| Cause | Examples | Key figure |
|---|---|---|
| Blood loss | Heavy periods; bleeding from ulcers, IBD or tumours in the gut | Heavy periods: about 33–41% of cases in reproductive-age women (NIH ODS); 25–35% of regular blood donors become iron deficient |
| Poor absorption | Coeliac disease, H. pylori, atrophic gastritis, bariatric surgery, proton pump inhibitors | Coeliac disease in 3–5% of cases (BSG); up to 30% iron deficient 5 years after gastric bypass (AAFP 2025) |
| Increased need | Pregnancy, infancy, adolescence | — |
| Low intake | Restrictive or vegetarian diets | Vegetarian diet iron bioavailability about 5–12% vs 14–18% for mixed diets (NIH ODS) |
Many women in the UAE will recognise more than one of these at once, for example heavy periods plus tea with meals or long-term acid-reducing tablets.
How is it diagnosed?
A full blood count shows low haemoglobin and, usually, small red cells (MCV below about 80 fL). Iron studies then confirm whether iron is the problem. Our blood test guide explains each value.
| Source | Ferritin cut-off | Meaning |
|---|---|---|
| WHO 2020 (healthy people aged 5+) | <15 µg/L | Iron deficiency |
| NIH ODS | <30 mcg/L | Suggests iron deficiency |
| JAMA 2025 | <30 ng/mL or TSAT <20% | Iron deficiency |
| BSG 2021 | <15 / <30 / >150 | Absent stores / low stores / absolute deficiency unlikely |
Ferritin also rises with inflammation, so a “normal” ferritin does not always rule out iron deficiency. WHO suggests a threshold of 70 µg/L when infection or inflammation is present. Small red cells with normal iron studies should prompt testing for thalassaemia trait, which is common in the UAE.
How do doctors treat it?
Oral iron
The British Society of Gastroenterology recommends one tablet daily of ferrous sulphate, fumarate or gluconate, providing roughly 50–100 mg of elemental iron. If side effects are a problem, taking it on alternate days is an accepted option. Your doctor or pharmacist in the UAE will choose the product and dose.
Why alternate days can work better
In a randomised study in iron-depleted women, Stoffel et al. (2017) found fractional iron absorption of 21.8% with alternate-day dosing versus 16.3% with consecutive-day dosing. A follow-up study in iron-deficient anemic women (Stoffel 2020) found alternate-day absorption was 40–50% higher. See when to take an iron supplement for timing tips.
What response to expect
The BSG notes that a haemoglobin rise of at least 1 g/dL within 2 weeks strongly suggests iron deficiency was the cause, and a rise of about 2 g/dL by around 4 weeks is an adequate response. Treatment usually continues for about 3 months after haemoglobin returns to normal, to refill stores. Read more in how long iron supplements take to work.
When is IV iron used?
The BSG advises IV iron when oral iron is contraindicated, not tolerated, not working, or when a rapid response is needed. The JAMA 2025 review lists further situations: malabsorption (coeliac disease, bariatric surgery), chronic kidney disease, heart failure, inflammatory bowel disease, cancer, ongoing bleeding, and the second or third trimester of pregnancy.
Why finding the cause matters
Treating the iron without treating the cause means the anemia is likely to come back. The BSG advises that men and post-menopausal women with iron deficiency anemia should have the gut investigated, because bleeding there may be silent. The AAFP recommends testing for H. pylori and coeliac disease. If you have Crohn’s disease or ulcerative colitis, see iron deficiency in IBD.
How can you get more iron from food?
According to the NIH ODS, vitamin C and meat, fish or poultry help the body absorb plant (non-heme) iron, while tea, coffee and phytates reduce it; calcium may also reduce it. In practice:
- Pair iron-rich meals with vitamin C foods — see vitamin C and iron.
- Keep karak, tea and coffee away from iron-rich meals — see coffee, tea and iron.
- Choose from local iron-rich foods and read our iron absorption guide.
- In pregnancy, see iron absorption in pregnancy.
Where Kabtafer Plus fits
Kabtafer Plus is an iron-free food supplement that supports absorption of iron from food. It has been studied in two small trials. In a placebo-controlled study of 49 women of childbearing age with iron deficiency (Rondanelli 2006), serum iron rose significantly versus placebo at 30 and 60 days in women with low baseline levels. An open-label pilot in 25 IBD patients with iron-deficiency anemia, 18 of whom completed 4 months, reported modest rises in serum iron, ferritin and haemoglobin, with no control group (Belluzzi 2007). It is not a treatment for anemia and does not replace prescribed iron. It is not for thalassaemia carriers without iron deficiency. See the studies and speak to your doctor.
Frequently asked questions
Can I have iron deficiency with normal haemoglobin?
Yes. Ferritin falls before haemoglobin does, so low iron stores often come before anemia. Symptoms such as tiredness or hair shedding can appear at this stage.
How long will I need to take iron?
The BSG suggests continuing for about 3 months after haemoglobin returns to normal, so that stores are refilled. Your doctor will guide you with repeat blood tests.
Why did my doctor refer me for a stomach or bowel test?
For men and post-menopausal women, iron deficiency anemia can be a sign of hidden bleeding in the gut. Guidelines recommend checking, even if you feel well.
Is IV iron safer than tablets?
Neither is “better” for everyone. IV iron is used in specific situations such as intolerance, malabsorption, IBD or later pregnancy; your doctor will decide.
Does fasting in Ramadan affect iron tablets?
Timing changes when you eat only at suhoor and iftar. Ask your doctor or pharmacist how to fit your dose around meals, and keep tea and coffee apart from it.
Sources
- Snook J, et al. British Society of Gastroenterology guidelines for the management of iron deficiency anaemia in adults. Gut 2021;70:2030–2051. gut.bmj.com
- Auerbach M, DeLoughery TG, Tirnauer JS. Iron deficiency in adults: a review. JAMA 2025;333(20):1813–1823. PMID 40159291
- Latimer K, et al. Iron deficiency anemia. Am Fam Physician 2025;112(5):538–545. aafp.org
- NIH Office of Dietary Supplements. Iron: Fact Sheet for Health Professionals. ods.od.nih.gov
- StatPearls. Iron Deficiency Anemia. StatPearls Publishing. NCBI Bookshelf
- World Health Organization. WHO guideline on use of ferritin concentrations to assess iron status in individuals and populations. 2020. NCBI Bookshelf
- Stoffel NU, et al. Iron absorption from oral iron supplements given on consecutive versus alternate days and as single morning doses versus twice-daily split dosing in iron-depleted women. Lancet Haematol 2017;4(11):e524–e533. doi:10.1016/S2352-3026(17)30182-5
- Stoffel NU, et al. [Alternate- vs consecutive-day iron supplementation in iron-deficient anaemic women]. Haematologica 2020;105(5):1232–1239.
- Rondanelli M, Opizzi A, Andreoni L, Trotti R. [Randomised placebo-controlled trial of the Captafer formulation in women of childbearing age with iron deficiency; in Italian]. Minerva Med 2006;97(5):385–390. PMID 17146419
- Belluzzi A, Roda G, Tonon F, et al. [Open-label pilot of the Captafer formulation in IBD patients with iron-deficiency anaemia]. World J Gastroenterol 2007;13(10):1575–1578. doi:10.3748/wjg.v13.i10.1575
This article is for general education and does not replace advice from your doctor or pharmacist.