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At the cellular level, Xu et al

Understanding the Science Behind Muscle Contractions Muscle cramps are sudden, involuntary contractions of one or more muscles that cause intense pain and temporary disability

Nature 607 , 585592 (2022)

Total body depletion of iron (absolute or true iron deficiency) will eventually result in a microcytic hypochromic anemia and hypochromasia (decreased rim of hemoglobin resulting in increased central pallor) will be evident in red blood cells on blood smear examination (see image on the right and images below)

Monoclonal antibody therapy has been shown to help reduce symptoms and hospitalizations.