Athlete with persistent f...

A 19-year-old female student and competitive athlete presented with C/O persistent fatigue, weakness, and shortness of breath during physical activity. She also experiences difficulty concentrating during lectures and occasional light-headedness. No history of blood in stools, jaundice, and menorrhagia. Despite her rigorous training regimen, her athletic performance has been declining. On examination, she appears pale and fatigued, with pale conjunctiva and brittle nails. Her BMI was within the normal range. Laboratory findings revealed hemoglobin levels of 7.5 g/dL (12-15.5 g/dL) and a low MCV of 68 fL (80-100 fL). Other blood parameters included RBC-3.8 x 10^6/μL (4.2-5.4 x 10^6/μL), serum iron-20 μg/dL (60-170 μg/dL), ferritin-10 ng/mL (12-150 ng/mL), total iron-binding capacity-400 μg/dL (240-450 μg/dL) and blood hepcidin levels are 216 mcg/dl (50 to 170 mcg/dL).