The use of iron supplementation in a patient with normal peripheral iron stores is anathema to the hematologist. But there is increasing data pointing to a role of LOCAL BRAIN iron deficiency in patients with RLS, even in those with perfectly normal serum ferritin, TSAT and Hb.
Moreover, studies have shown some benefit of oral or IV iron therapy in patients with RLS and serum ferritins as high as 300 ug/L.
It is hard to ignore these findings, and it forces hematologists to consider a paradigm shift in which the usual markers for iron stores in RBCs, macrophages and liver are not necessarily representative of iron stores in other tissues.
