From the Guidelines
I strongly recommend starting iron supplementation immediately due to your very low ferritin level of 5.7, which indicates significant iron deficiency. You should take ferrous sulfate 325mg once or twice daily (providing 65mg elemental iron per tablet), preferably on an empty stomach with vitamin C (like orange juice) to enhance absorption, as suggested by recent guidelines 1. Take it at least 2 hours apart from calcium supplements, dairy products, coffee, tea, or antacids which can reduce absorption. Common side effects include constipation, nausea, and dark stools - taking it with food can reduce stomach upset if needed, though this may decrease absorption.
We should recheck your ferritin levels after 3 months of supplementation, as recommended by expert consensus guidelines 1. This low ferritin level explains symptoms you may be experiencing like fatigue, weakness, headaches, or shortness of breath, as ferritin is your body's iron storage protein. Iron is essential for producing hemoglobin that carries oxygen throughout your body. We should also investigate potential causes of your iron deficiency, such as blood loss (heavy menstrual periods, gastrointestinal bleeding), poor dietary iron intake, or absorption issues, as outlined in the AGA clinical practice update 1.
Some key points to consider:
- The goal ferritin level is 50 ng/mL, regardless of sex at birth, as stated in the expert consensus guidelines 1.
- Laboratory evaluation following iron supplementation should include a complete blood count and iron parameters (ferritin, percent transferrin saturation) 4 to 8 weeks after the last infusion, as recommended by the American Journal of Hematology 1.
- We should monitor your hemoglobin concentrations and adjust the iron supplementation as needed to achieve a hemoglobin level of at least 12 g/dL, as suggested by the European Crohn's and Colitis Organization guidelines 1.
Overall, starting iron supplementation immediately and monitoring your ferritin levels and symptoms closely is crucial to improve your quality of life and decrease the risk of complications related to anemia, as emphasized by the Clinical Gastroenterology and Hepatology journal 1.
From the Research
Patient Information
- A ferritin level of 5.7 is considered low, indicating iron deficiency.
- Iron deficiency can cause a range of symptoms, including fatigue, weakness, and shortness of breath.
Treatment Options
- Oral iron supplementation is often the first line of treatment for iron deficiency, with ferrous sulfate being a common medication 2.
- However, oral iron supplementation can cause gastrointestinal side effects, such as nausea, diarrhea, and constipation 3.
- Intravenous iron therapy may be recommended for patients who are intolerant or unresponsive to oral iron, or who require rapid correction of iron deficiency 4, 5.
Dosage and Administration
- The optimal dosage and frequency of oral iron supplementation are still being researched, but studies suggest that taking 60-120 mg of iron as a ferrous salt on alternate days may be an effective regimen 6.
- Intravenous iron formulations, such as ferric carboxymaltose and iron isomaltoside 1000, can be administered in high doses, but may be associated with a risk of infusion reactions and hypophosphatemia 4, 5.
Benefits and Risks
- Iron supplementation has been shown to effectively reduce the prevalence of anemia and iron deficiency, improve exercise performance, and reduce symptomatic fatigue 3.
- However, iron supplementation can also cause gastrointestinal side effects, and high doses of intravenous iron may be associated with more serious complications, such as hypophosphatemia and osteomalacia 5.