дефицита железа явного у нее нет, но если у нее есть атрофический гастрит, то у нее может быть комбинированный б12 и железо-дефицит, на субклин. дефицит в12 может указывать билирубин более 20, железо внутрь при атрофическом гастрите не усваивается у 2/3 пациентов
between 83 subjects presenting with iron deficiency anemia (IDA), 48 with normocytic indices, and 29 with macrocytic anemia. Compared with macrocytic patients, patients with IDA were 21 years younger (41 ± 15 years versus 62 ± 15 years) and mostly women... Stratification by age cohorts from younger than 20 years to older than 60 years showed a regular and progressive increase in mean corpuscular volume (MCV) from 68 ± 9 to 95 ± 16 fl, serum ferritin levels from 4 ± 2 to 37 ± 41 μg/L, gastrin level from 166 ± 118 to 382 ± 299 pM/L (349 ± 247 to 800 ± 627 pg/mL), and a decrease in cobalamin level from 392 ± 179 to 108 ± 65 pg/mL. // Variable hematologic presentation of autoimmune gastritis: age-related progression from iron deficiency to cobalamin depletion
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