From the Guidelines
For a 35-year-old male with iron deficiency anemia in the UK, the initial treatment should be with one tablet per day of ferrous sulphate, fumarate or gluconate, as recommended by the British Society of Gastroenterology guidelines 1. The management of iron deficiency anaemia (IDA) in this patient involves oral iron supplementation as the first-line treatment.
- The recommended oral iron preparations include ferrous sulphate, fumarate, or gluconate, with a dosage of one tablet per day 1.
- If the patient is unable to tolerate the standard dose, a reduced dose of one tablet every other day, alternative oral preparations, or parenteral iron should be considered, as stated in the guidelines 1.
- It is essential to investigate the underlying cause of iron deficiency, particularly in adult males, where gastrointestinal blood loss is a common cause, potentially requiring endoscopic evaluation.
- Regular monitoring of hemoglobin levels is necessary, with follow-up at 2-4 weeks to assess response to treatment.
- The treatment should continue for a sufficient duration to replenish iron stores, which may be several months after hemoglobin normalization.
- Common side effects of oral iron supplements include constipation, nausea, and black stools, and patients should be advised to take the supplements on an empty stomach, ideally 1 hour before meals, to maximize absorption, or with food if gastrointestinal side effects occur.
- Additionally, patients should be informed that vitamin C can enhance iron absorption, while tea, coffee, and calcium supplements should be avoided within 2 hours of iron intake as they inhibit absorption.
From the Research
Management of Iron Deficiency Anaemia (IDA)
According to the available evidence, the management of IDA in a 35-year-old male involves:
- Oral iron supplementation as the first line of treatment 2, 3, 4, 5
- The use of ferrous sulfate as the simplest, least expensive, and most commonly prescribed drug 2, 4, 5
- Other ferrous salts and ferric complexes with polysaccharides or succinylated milk proteins as alternative options 2
- Novel iron formulations such as ferric maltol, or nanoparticle encapsulated sucrosomial® iron as alternative options 2, 3
- Intravenous iron therapy as an alternative when oral iron supplementation is contraindicated 2, 3, 6
Treatment Goals
The goals of treatment are to:
- Replenish iron stores 2, 6
- Return the haemoglobin to a normal level 6
- Improve quality of life, morbidity, prognosis in chronic disease and outcomes in pregnancy 6
Considerations
When managing IDA, it is essential to consider the underlying cause of the condition, such as gastrointestinal bleeding, decreased dietary iron, or decreased iron absorption 6. Additionally, the choice of iron formulation and route of administration should be individualized based on patient tolerance, compliance, and clinical response 2, 3, 4, 5.