From the Guidelines
Iron deficiency anemia should be treated with oral iron supplements as the first line of treatment, with intravenous iron formulations considered for severe cases or when oral therapy fails, according to the most recent guidelines 1. The treatment of iron deficiency anemia typically involves oral iron supplements, such as ferrous sulfate 325 mg taken 1-3 times daily between meals with vitamin C to enhance absorption.
Key Considerations
- Treatment should continue for 3-6 months after hemoglobin normalizes to replenish iron stores.
- For patients who cannot tolerate oral iron due to gastrointestinal side effects, alternatives include ferrous gluconate or ferrous fumarate.
- Intravenous iron formulations like iron sucrose or ferric carboxymaltose can be administered for severe cases or when oral therapy fails.
- The underlying cause of iron deficiency must also be identified and addressed, whether it's blood loss, poor dietary intake, or malabsorption.
- Dietary changes to include iron-rich foods are recommended as supplementary measures. Some key points to consider when treating iron deficiency anemia include:
- Improvement in hemoglobin levels typically begins within 1-2 weeks of starting treatment, with complete resolution usually occurring within 2 months, though iron stores take longer to replenish 1.
- In patients with celiac disease, ensuring adherence to a gluten-free diet can improve iron absorption, and oral iron supplementation or intravenous iron therapy may be considered based on the severity of iron deficiency and patient tolerance 1.
- For patients with inflammatory bowel diseases, intravenous iron should be considered as first-line treatment in certain situations, such as clinically active disease, previous intolerance to oral iron, or hemoglobin below 10 g/dL 1.
From the FDA Drug Label
WARNINGS Do not exceed recommended dosage. The treatment of any anemic condition should be under the advice and supervision of a doctor. Uses Iron Supplement Purpose Iron Supplement
The treatment of iron deficiency anemia should be under the advice and supervision of a doctor. Iron polysaccharide (PO) can be used as an iron supplement for this purpose 2, 2, 2.
- Key points:
- Do not exceed the recommended dosage.
- Take with meals to minimize gastrointestinal discomfort.
- Be aware of potential drug interactions, such as with tetracycline antibiotics.
From the Research
Treatment Options for Iron Deficiency and Anemia
- Oral iron supplementation is the first line of treatment for iron-deficiency anemia and pre-anemic iron deficiency, with ferrous sulfate being the most commonly prescribed drug 3
- Other oral iron supplements, such as ferrous salts and ferric complexes, are also available, as well as novel formulations like ferric maltol and nanoparticle encapsulated sucrosomial iron 3
- Intravenous iron therapy is an alternative for patients who cannot tolerate oral iron or have poor absorption, and can rapidly achieve therapeutic targets without gastrointestinal complications 3, 4, 5
Indications for Intravenous Iron Therapy
- Intravenous iron is indicated for patients with oral iron intolerance, poor absorption, chronic inflammatory conditions, ongoing blood loss, and during the second and third trimesters of pregnancy 4, 5, 6
- It is also used for patients with severe, symptomatic iron-deficiency anemia with hemodynamic instability 5
Diagnosis and Screening
- Iron deficiency is diagnosed by low serum ferritin (<30 ng/mL) in individuals without inflammatory conditions or by transferrin saturation (<20%) 6
- Testing for iron deficiency is indicated for patients with anemia and/or symptoms of iron deficiency, and should be considered for those with risk factors such as heavy menstrual bleeding, pregnancy, or inflammatory bowel disease 6
Quality of Life Improvement
- Correction of anemia with iron treatment is associated with a relevant improvement in patients' quality of life, as measured by the shortened CCVEII-9 questionnaire 7
- Oral iron treatment is effective and well tolerated in most patients with inflammatory bowel disease, and does not exacerbate the symptoms of the underlying disease 7