What is the recommended treatment for a 12-year-old male patient with iron deficiency anemia, characterized by low hemoglobin, erythrocyte count, hematocrit, blood iron level, and ferritin level?

Treatment of Iron Deficiency Anemia in a 12-Year-Old Male

For a 12-year-old male with laboratory values confirming iron deficiency anemia, the recommended treatment is one 60-mg iron tablet daily along with dietary counseling to increase iron intake. 1

Diagnosis Confirmation

The patient's laboratory values indicate iron deficiency anemia:

• Hemoglobin of 12 g/dL (borderline low for age)
• Low hematocrit (34.9%)
• Low ferritin (53 μg/L)
• Low blood iron level (88)
• Low transferrin saturation (30%)

These values confirm iron deficiency, as:

• Serum ferritin is the single most useful marker of iron deficiency 1
• Transferrin saturation below normal range supports the diagnosis 1

Treatment Protocol

First-Line Therapy

• Prescribe one 60-mg iron tablet daily for this adolescent boy 1
• Administer iron between meals to maximize absorption 1
• Counsel the patient and family about dietary sources of iron to correct underlying low iron intake 1
• Consider adding ascorbic acid (vitamin C) to enhance iron absorption if response is poor 1

Monitoring Response

• Repeat hemoglobin measurement after 4 weeks of therapy 1
• A good response is defined as an increase in hemoglobin concentration ≥1 g/dL (10 g/L) within this timeframe 1
• A good response to iron therapy confirms the diagnosis of iron deficiency anemia 1

Duration of Treatment

• If iron deficiency anemia is confirmed by response to treatment, continue iron therapy for an additional 2 months (total of 3 months) 1
• This extended treatment ensures not only correction of anemia but also replenishment of iron stores 1
• Reassess hemoglobin approximately 6 months after successful treatment 1

Follow-Up Considerations

• If there is no response to oral iron despite compliance after 4 weeks, further evaluate with additional laboratory tests including MCV, RDW, and repeat serum ferritin 1
• Consider alternative oral preparations if the initial treatment is not tolerated 1
• Monitor hemoglobin and red cell indices at three-month intervals for one year after normalization, and then after a further year 1
• Provide additional iron if hemoglobin or MCV falls below normal during follow-up 1

Common Pitfalls and Caveats

• Failure to continue treatment for sufficient duration (3 months) may lead to recurrence of anemia due to inadequate replenishment of iron stores 1, 2
• Poor compliance, particularly in adolescents, is common with supplements and requires patient education about the importance of treatment 1
• Gastrointestinal side effects may reduce compliance; if not tolerated, consider:
  • Reduced dosing (every other day)
  • Alternative oral preparations
  • Taking with food (though this may reduce absorption) 1, 3
• If anemia persists despite appropriate oral iron therapy, consider evaluation for ongoing blood loss or malabsorption 1, 4