From the Guidelines
Based on your lab results, you have low iron levels and low iron saturation, which suggests iron deficiency, and I strongly recommend starting an oral iron supplement to replenish your iron stores. According to the British Society of Gastroenterology guidelines for the management of iron deficiency anaemia in adults 1, iron deficiency should be confirmed by iron studies prior to investigation, and serum ferritin is the single most useful marker of IDA. Although your serum ferritin levels are not provided, your low iron and iron saturation levels are indicative of iron deficiency.
To manage your iron deficiency, I recommend starting an oral iron supplement such as ferrous sulfate 325 mg once or twice daily, taken on an empty stomach with vitamin C (like orange juice) to enhance absorption, as suggested by the guidelines 1. It is essential to take this supplement for at least 3 months to replenish your iron stores, then repeat your blood tests to monitor improvement.
Some key points to consider when taking iron supplements include:
- Avoid taking iron with calcium, dairy products, coffee, tea, or antacids as these can reduce absorption
- Common side effects include constipation and stomach upset, which can be managed by starting with a lower dose and gradually increasing, or by switching to a gentler formulation like ferrous gluconate
- Iron deficiency can cause fatigue, weakness, and reduced exercise tolerance, so supplementation should help improve these symptoms
- Your TIBC (Total Iron Binding Capacity) is normal, which indicates your body has adequate capacity to bind and transport iron, but your current iron levels are insufficient to meet your body's needs. A good response to iron therapy, as defined by the guidelines 1, is a haemoglobin rise ≥10 g/L within a 2-week timeframe, which would confirm the diagnosis of absolute iron deficiency.
From the Research
Iron Deficiency Anemia
- The provided lab results show low iron levels (52 mcg/dL) and low iron saturation (14%) in the patient's blood, indicating iron deficiency anemia 2, 3.
- The patient's Total Iron-Binding Capacity (TIBC) is within the normal range (371 mcg/dL), which suggests that the patient's body is able to bind iron, but the iron levels are still low 4.
Treatment Options
- Oral iron-replacement therapy is the mainstay of treatment for iron-deficiency anemia, but it is often poorly tolerated or ineffective 2.
- Ferrous sulfate is a commonly used iron supplement, but it can cause gastrointestinal side effects 3, 5.
- Lactoferrin supplementation has been shown to have better effects on serum iron and hemoglobin levels compared to ferrous sulfate, with fewer side effects 3.
- Sucrosomial iron supplementation has been shown to be effective in patients with celiac disease who are intolerant to oral ferrous sulfate 4.
- Intravenous iron sucrose has been shown to be effective in correcting peripartum anemia, although oral iron can also be effective 6.
Response to Treatment
- A ≥1.0-g/dL increase in hemoglobin at day 14 of oral iron therapy can predict a satisfactory overall hemoglobin response to oral iron 2.
- Hemoglobin responses <1.0 g/dL at day 14 of oral iron identify patients who should be transitioned to intravenous iron supplementation 2.
- Iron-replacement therapy can improve quality of life and reduce fatigue in patients with iron-deficiency anemia 2, 4.