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Iron deficiency anaemia is commonly associated with thrombocytosis, however cases of thrombocytopenia have been reported. Recurrent cases of iron deficiency with thrombocytopenia are even more unusual; therefore, we present a patient with recurrent thrombocytopenia in the setting of intermittent iron deficiency anaemia. The mechanism of platelet count variation in response to iron remains poorly understood. There are multiple possible explanations, including but not limited to the diphasic response of platelets to erythropoietin and the dual function of iron in platelet production. This case highlights the importance of an iron replacement trial for the individuals with documented iron deficiency and thrombocytopenia. An iron treatment trial could spare the patients with iron responsive thrombocytopenia from more invasive diagnostic modalities looking for primary bone marrow disorders.