2026 Volume 2 Issue 1 Pages 303-313
Background:Non-anemic iron deficiency (NAID) is common among adolescent females due to gro wth and menstrual blood loss and may be associated with mood instability and irritability. Ferritin measurement is often overlooked when hemoglobin levels are within the reference range.
Case:A 17-year-old female presented with mood swings, irritability, apathy, headache, difficulty a wakening, and academic decline. Hemoglobin was 13.8 g/dL, while ferritin was markedly low at 11.1 ng/mL. Oral iron supplementation was attempted but discontinued because of gastrointestinal i ntolerance. Intravenous ferric carboxymaltose (500 mg ×2) increased ferritin to 365.2 ng/mL, acco mpanied by marked improvement in mood and daily functioning. Upon ferritin decline to 28.9 ng/ mL, ferric derisomaltose (total 750 mg) was administered, resulting in ferritin elevation to 184.7 n g/mL and rapid symptomatic improvement. Dietary counseling emphasizing animal protein intake was provided throughout follow-up.
Conclusion:In symptomatic NAID without anemia, intravenous iron supplementation may be an eff ective option when oral therapy is poorly tolerated. Monitoring ferritin dynamics may be essential in nutritional psychiatry.
