Anemia, even low grade, should never be dismissed no matter the primary complaint because it affects the ability of every cell in the body to do its job. Iron deficiency has numerous causes. This fascinating paper recently published in Acta Hæmatologica describes the fairly common phenomenon of iron deficiency anemia (IDA) that does not respond to iron supplementation. The authors state: “Recent studies indicate that 20-27% of patients with unexplained IDA have autoimmune gastritis, about 50% have evidence of active H. pylori infection, and 4-6% have celiac disease. The implications for abnormal iron absorption of celiac disease or autoimmune gastritis are obvious.” [Helicobacter is an extremely common stomach infection and the cause of most gastric ulcers.]

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