Figure 1 29 shows a suggested diagnostic algorithm to determine if a patient has IDA. This algorithm is adapted from a clinical guideline, with the primary modification that serum iron, total iron-binding capacity, and transferrin saturation are recommended as follow-up tests in patients with an intermediate ferritin level as a strategy to reduce the need for bone marrow biopsy. 29 If these blood tests are indeterminate, an elevated serum transferrin receptor level is recommended to distinguish IDA from anemia of chronic disease. The choice of a ferritin level of less than 45 ng per mL (45 mcg per L) is to allow for a higher sensitivity, despite the fact that most laboratories' normal range for ferritin includes 45 ng per mL.
Today’s human economies are designed with little attention to the residuals of production and consumption. Among the most visible unintended byproducts of the current economic system are environmental problems like air and water pollution and landscape degradation. Nearly all the world’s ecosystems are shrinking to make way for humans and their homes, farms, malls, and factories. WWF’s Living Planet Index, which measures the health of forests, oceans, freshwater, and other natural systems, shows a 35 percent decline in Earth’s ecological health since 1970.