History

A 32 year-old woman is referred to your clinic for evaluation of abnormal iron indices. She recently presented to her PCP with generalized fatigue. Her PCP ordered a complete blood count and iron indices, which revealed a normal Hb (13.1 g/dL) and an elevated transferrin saturation TSAT of 68%. The patient reports that she was found to have “elevated blood iron” when she was in college. She denies shortness of breath on exertion, headache or chest pain. However, she complains of a several-month history of brittle nails, alopecia and restless leg syndrome, all new within the past 6 months. She suffers from polycystic ovary syndrome (PCOS), for which she is taking oral contraceptive pill (OCP). Her periods are irregular and not particularly heavy. There are no other bleeding symptoms. She has no other medical problems. Her family history is negative for hereditary hemochromatosis or other hematological disorders. Her medications include OCP and lorazepam. She has no known drug allergies.