From the Research
The patient's lab values indicate iron deficiency anemia, and the recommended course of action is to start iron supplementation, as supported by the most recent study 1. The iron saturation of 10% is significantly below the normal range of 20-50%, and the serum iron level of 51 μg/dL is also low. The elevated transferrin level of 402 mg/dL further supports this diagnosis, as it indicates the body's attempt to increase iron absorption. According to the study 1, a low baseline transferrin saturation (TSAT) is a reliable indicator of the effect of intravenous iron to reduce major heart failure events, and the use of a serum ferritin level <100 μg/L alone as a diagnostic criterion should be discarded. The recommended treatment is to start oral ferrous sulfate, with a standard dose of 325 mg (65 mg elemental iron) taken 2-3 times daily between meals, as suggested by the study 2. This regimen should be continued for at least 3 months after the hemoglobin normalizes to replenish iron stores. To enhance absorption, iron supplements should be taken with vitamin C (such as a glass of orange juice) and avoided within 2 hours of calcium-rich foods, tea, coffee, or antacids, as recommended by the study 3. Patients should be advised that iron supplements may cause gastrointestinal side effects like constipation or dark stools. It's essential to investigate the underlying cause of the iron deficiency, which could include chronic blood loss (e.g., heavy menstrual periods, gastrointestinal bleeding), malabsorption disorders, or dietary insufficiency, as mentioned in the study 4. A follow-up appointment should be scheduled in 4-6 weeks to reassess iron studies and hemoglobin levels to monitor treatment response. Some key points to consider when treating iron deficiency anemia include:
- Investigating the underlying cause of the iron deficiency
- Monitoring iron studies and hemoglobin levels regularly
- Adjusting the treatment regimen as needed to achieve optimal iron levels
- Considering the use of intravenous iron in cases where oral iron supplementation is not effective or practical, as suggested by the study 1.