From the Guidelines
I strongly recommend continuing with oral iron supplements rather than pursuing an iron transfusion at this point, as your ferritin level has shown improvement and you have never been anemic. Your ferritin level has increased from 10 to 16 over three months, indicating that the supplements are working, albeit slowly. Since the cause of your iron deficiency has been identified as dysfunctional uterine bleeding (DUB) for 70 days, addressing the underlying bleeding issue while continuing supplementation is the most appropriate approach, as suggested by the expert review in Clinical Gastroenterology and Hepatology 1. Key points to consider include:
- Oral iron supplements such as ferrous sulfate 325mg once or twice daily, ferrous gluconate 300mg daily, or ferrous fumarate 200mg daily are typically effective for gradually replenishing iron stores.
- Take these with vitamin C (like orange juice) to enhance absorption, and avoid taking with calcium, dairy, coffee, tea, or antacids which can reduce absorption.
- Iron transfusions are generally reserved for cases with severe anemia, malabsorption issues, or when oral supplements aren't tolerated, as outlined in the clinical practice update on management of iron deficiency anemia 1.
- Your improving ferritin levels suggest your body is responding to oral supplementation, making transfusion unnecessary at this time. However, it's crucial to work with your healthcare provider to address the underlying DUB causing your iron loss, as controlling this bleeding will be vital for maintaining your iron levels long-term.
From the Research
Iron Supplementation and Transfusion Considerations
- The user's ferritin level has increased from 10 to 16 after three months of iron supplementation, indicating a positive response to treatment 2.
- The cause of iron deficiency is known to be due to dub bleeding for 70 days, which has been addressed through iron supplementation.
- According to studies, oral iron supplementation is typically the first-line therapy for iron deficiency, and it can be effective in increasing ferritin levels and improving iron stores 3, 4.
- The user has not been anemic, but iron deficiency can still cause symptoms such as fatigue, irritability, and difficulty concentrating 4.
Considerations for Continuing Supplements or Transfusion
- Intravenous iron therapy is usually reserved for patients with intolerance or unresponsiveness to oral iron, or those who require rapid correction of iron deficit 5.
- The user's ferritin level has increased, but it is still below the normal range, suggesting that continued supplementation may be necessary to achieve optimal iron stores.
- Studies suggest that oral iron supplementation can be continued for several months to build up iron stores and prevent complications of iron deficiency 6.
- The decision to continue supplements or consider transfusion should be based on individual factors, such as the user's overall health, symptoms, and response to treatment, as well as guidance from a healthcare professional.