10/14/2026
“Your labs are normal.” But what if you still don’t feel like yourself?
As a physician, one of the most important things I want women to understand is that normal laboratory values do not always tell the whole story.
Take iron deficiency, for example. Many women associate iron deficiency with anemia. However, iron stores can become depleted long before hemoglobin levels begin to fall.
This is where ferritin becomes particularly important.
Ferritin is a protein that reflects your body's iron reserves. When those reserves are low, you may begin experiencing symptoms such as:
✨ Persistent fatigue, even after adequate sleep
✨ Difficulty concentrating or brain fog
✨ Hair shedding or thinning
✨ Reduced exercise tolerance
✨ Heart palpitations or shortness of breath
✨ Feeling physically and mentally exhausted
And here's something important: You can have iron deficiency without having anemia.
A normal hemoglobin level does not necessarily rule out depleted iron stores.
But the conversation shouldn't end with prescribing iron supplements, either.
As physicians, we need to ask WHY.
Why are your iron stores low? Is it related to heavy menstrual bleeding? Inadequate dietary intake? Poor absorption? Gastrointestinal blood loss? Or another underlying medical condition?
Identifying the cause is just as important as correcting the deficiency.
And this principle extends beyond iron.
Hormonal changes, thyroid disorders, nutritional deficiencies, sleep disturbances, and other medical conditions can produce overlapping symptoms. Sometimes, the appropriate next step isn't more testing, but a more comprehensive evaluation of your history, symptoms, and existing results.
The goal of medicine should never be simply to make laboratory numbers look better. The goal is to improve your health, your daily functioning, and your quality of life.
You deserve to be heard, understood, and cared for as a whole person. 🤍
— Dr. Xyomara Rivas, MD
