What happens if a patient's headache worsens after starting anemia treatment?

From the Research

If a patient's headache worsens after starting anemia treatment, they should contact their healthcare provider immediately as this could indicate a serious complication, such as polycythemia or cerebral hyperperfusion syndrome, as suggested by the most recent study on the bidirectional relationship between iron deficiency anemia and chronic headache disorders 1. This symptom may represent an adverse reaction to the treatment, and the provider may need to adjust the treatment regimen by reducing medication dosages, slowing the rate of hemoglobin correction, or temporarily suspending therapy. Some key points to consider include:

• Common anemia treatments include oral iron supplements, injectable iron, or erythropoiesis-stimulating agents, and the choice of treatment may impact the risk of worsening headaches.
• Worsening headaches can occur due to rapid correction of anemia, which can cause blood viscosity changes and altered cerebral blood flow, potentially leading to increased intracranial pressure, as noted in a study on the emergency medicine evaluation and management of anemia 2.
• Other concerning symptoms that should prompt immediate medical attention include visual disturbances, confusion, seizures, or severe hypertension.
• Patients should never discontinue treatment without medical consultation, as untreated anemia carries its own risks, and the benefits of treatment should be weighed against the potential risks, as discussed in a study on the treatment of mild non-chemotherapy-induced iron deficiency anemia in cancer patients 3.
• The most recent and highest quality study on the comparison of the effect of ferrous sulfate and ferrous gluconate on prophylaxis of iron deficiency in toddlers suggests that both supplements are effective, but ferrous gluconate may be more effective in improving iron status 4. However, the specific treatment regimen and potential risks and benefits should be individualized based on the patient's condition and medical history, and the healthcare provider's guidance should be followed.