Iron deficiency anemia medical therapy: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Iron deficiency anemia}} | {{Iron deficiency anemia}} | ||
{{CMG}}; {{AE}} | {{CMG}}; {{AE}} {{JSS}} | ||
{{PleaseHelp}} | {{PleaseHelp}} | ||
==Overview== | ==Overview== | ||
Treatment of iron deficiency anemia includes iron supplementation and treating the cause of the iron deficiency. Treatment is given according to the severity of anemia. | |||
==Medical Therapy== | ==Medical Therapy== | ||
* Iron supplementation is recommended among patients with iron deficiency anemia<ref name="pmid27913463">{{cite journal| author=Auerbach M, Deloughery T| title=Single-dose intravenous iron for iron deficiency: a new paradigm. | journal=Hematology Am Soc Hematol Educ Program | year= 2016 | volume= 2016 | issue= 1 | pages= 57-66 | pmid=27913463 | doi=10.1182/asheducation-2016.1.57 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27913463 }} </ref><ref name="pmid21705493">{{cite journal| author=Krayenbuehl PA, Battegay E, Breymann C, Furrer J, Schulthess G| title=Intravenous iron for the treatment of fatigue in nonanemic, premenopausal women with low serum ferritin concentration. | journal=Blood | year= 2011 | volume= 118 | issue= 12 | pages= 3222-7 | pmid=21705493 | doi=10.1182/blood-2011-04-346304 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21705493 }} </ref><ref name="pmid11506061">{{cite journal| author=Patterson AJ, Brown WJ, Roberts DC| title=Dietary and supplement treatment of iron deficiency results in improvements in general health and fatigue in Australian women of childbearing age. | journal=J Am Coll Nutr | year= 2001 | volume= 20 | issue= 4 | pages= 337-42 | pmid=11506061 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11506061 }} </ref><ref name="pmid12763985">{{cite journal| author=Verdon F, Burnand B, Stubi CL, Bonard C, Graff M, Michaud A et al.| title=Iron supplementation for unexplained fatigue in non-anaemic women: double blind randomised placebo controlled trial. | journal=BMJ | year= 2003 | volume= 326 | issue= 7399 | pages= 1124 | pmid=12763985 | doi=10.1136/bmj.326.7399.1124 | pmc=156009 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12763985 }} [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=&cmd=prlinks&id=15122863 Review in: ACP J Club. 2004 Mar-Apr;140(2):43] </ref><ref name="pmid28034892">{{cite journal| author=Achebe MM, Gafter-Gvili A| title=How I treat anemia in pregnancy: iron, cobalamin, and folate. | journal=Blood | year= 2017 | volume= 129 | issue= 8 | pages= 940-949 | pmid=28034892 | doi=10.1182/blood-2016-08-672246 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28034892 }} </ref>. | |||
* Pharmacologic medical therapies for iron deficiency anemia include (either) oral iron supplements, parenteral iron supplements, erythropoetin and blood transfusion. | |||
=== Iron deficiency anemia === | |||
* '''1. Mild anemia''' | |||
** '''1.1 Adults- (Hb -11.0-11.9 g/dL in women and 11.0-12.9 g/dL in men''') | |||
*** Ferrous sulfate/ferrous gluconate/ferrous fumarate PO 100mg per day for 4 weeks. | |||
** 1.2 Pediatrics- (Hb <9g/dl) | |||
*** Ferrous sulfate 3mg/kg PO for 8-12 weeks. | |||
* 2. Moderate anemia | |||
** 2.1- Adults( Hb 7-11g/dL) | |||
*** Ferric carboxymaltose in a dose of 750mg ( 50mg/ml/min) IV once a week for 2-4 weeks. | |||
** 2.2 Paediatrics- (Hb 5-9g/dl) | |||
*** Iron sucrose in a dose of 200mg (30mg/ml/min) IV once a week for 2-4 weeks. | |||
* 3. Severe anemia | |||
** 3.1 Adults (Hb <7g/dl in individuals without co morbidities and <8g/dl in patients with heart diseases) | |||
*** Blood transfusion- units of packed red blood cellsdepending on the Hb level | |||
*** 2 units of blood increase 1 g/dl of Hb. | |||
** 3.2 Paediatrics (Hb <5g/dl) | |||
*** Blood transfusion- Units of packed red blood cells depending on the Hb level. | |||
*** 1 unit given over 3-4 hours. | |||
* Intravenous formulations of iron include ferric carboxymaltose, iron dextran, and iron sucrose. | |||
* Iron deficient individuals need to consume iron rich diet. | |||
* Source of iron rich foods is mentioned below: | |||
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==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
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[[Category:Hematology]] | [[Category:Hematology]] | ||
[[Category:Gastroenterology]] | [[Category:Gastroenterology]] | ||
[[Category:Endocrinology]] | [[Category:Endocrinology]] | ||
Latest revision as of 22:25, 29 July 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Jogeet Singh Sekhon, M.D. [2]
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Overview
Treatment of iron deficiency anemia includes iron supplementation and treating the cause of the iron deficiency. Treatment is given according to the severity of anemia.
Medical Therapy
- Iron supplementation is recommended among patients with iron deficiency anemia[1][2][3][4][5].
- Pharmacologic medical therapies for iron deficiency anemia include (either) oral iron supplements, parenteral iron supplements, erythropoetin and blood transfusion.
Iron deficiency anemia
- 1. Mild anemia
- 1.1 Adults- (Hb -11.0-11.9 g/dL in women and 11.0-12.9 g/dL in men)
- Ferrous sulfate/ferrous gluconate/ferrous fumarate PO 100mg per day for 4 weeks.
- 1.2 Pediatrics- (Hb <9g/dl)
- Ferrous sulfate 3mg/kg PO for 8-12 weeks.
- 1.1 Adults- (Hb -11.0-11.9 g/dL in women and 11.0-12.9 g/dL in men)
- 2. Moderate anemia
- 2.1- Adults( Hb 7-11g/dL)
- Ferric carboxymaltose in a dose of 750mg ( 50mg/ml/min) IV once a week for 2-4 weeks.
- 2.2 Paediatrics- (Hb 5-9g/dl)
- Iron sucrose in a dose of 200mg (30mg/ml/min) IV once a week for 2-4 weeks.
- 2.1- Adults( Hb 7-11g/dL)
- 3. Severe anemia
- 3.1 Adults (Hb <7g/dl in individuals without co morbidities and <8g/dl in patients with heart diseases)
- Blood transfusion- units of packed red blood cellsdepending on the Hb level
- 2 units of blood increase 1 g/dl of Hb.
- 3.2 Paediatrics (Hb <5g/dl)
- Blood transfusion- Units of packed red blood cells depending on the Hb level.
- 1 unit given over 3-4 hours.
- 3.1 Adults (Hb <7g/dl in individuals without co morbidities and <8g/dl in patients with heart diseases)
- Intravenous formulations of iron include ferric carboxymaltose, iron dextran, and iron sucrose.
- Iron deficient individuals need to consume iron rich diet.
- Source of iron rich foods is mentioned below:
Template:Col-2
| Food | Serving size |
Miligrams per serving |
% DV* |
|---|---|---|---|
| Chicken liver (cooked) | 3˝ ounces | 12.8 | 70 |
| Oysters(breaded and fried) | 6 pieces | 4.5 | 25 |
| Beef, chuck (lean, braised) | 3 ounces | 3.2 | 20 |
| Clams (breaded, fried) | 1 cup | 3.0 | 15 |
| Beef tenderloin (roasted) | 3 ounces | 3.0 | 15 |
| Turkey ( dark meat, roasted) | 3˝ ounces | 2.3 | 10 |
| Beef, eye of round (roasted) | 3 ounces | 2.2 | 10 |
| Turkey, light meat (roasted) | 3˝ ounces | 1.6 | 8 |
| Chicken, leg, meat only (roasted) | 3˝ ounces | 1.3 | 6 |
| Tuna, fresh bluefin (cooked) | 3 ounces | 1.1 | 6 |
| Chicken breast (roasted) | 3 ounces | 1.1 | 6 |
| Halibut (cooked) | 3 ounces | 0.9 | 6 |
| Blue crab (cooked) | 3 ounces | 0.8 | 4 |
| Pork loin (broiled) | 3 ounces | 0.8 | 4 |
| Tuna white (canned in water) | 3 ounces | 0.8 | 4 |
| Shrimp (mixed species, cooked) | 4 large | 0.7 | 4 |
| Food | Serving size |
Miligrams per serving |
% DV* |
|---|---|---|---|
| Ready-to-eat cereal (100% iron fortified | cup | 18.0 | 100 |
| Oatmeal, instant, fortified (prepared with water | 1 cup | 10.0 | 60 |
| Soybeans, mature (boiled) | 1 cup | 8.8 | 50 |
| Lentils (boiled) | 1 cup | 6.6 | 35 |
| Kidney beans mature (boiled) | 1 cup | 5.2 | 25 |
| Lima beans large, mature (boiled) | 1 cup | 4.5 | 25 |
| Navy beans mature (boiled) | 1 cup | 4.5 | 25 |
| Ready-to-eat cereal (25% iron fortified) | 1 cup | 4.5 | 25 |
| Black beans mature (boiled) | 1 cup | 3.6 | 20 |
| Pinto beans mature (boiled) | 1 cup | 3.6 | 20 |
| Molasses (blackstrap) | 1 tablespoon | 3.5 | 20 |
| Tofu (raw, firm) | ˝ cup | 3.4 | 20 |
| Spinach (boiled, drained) | ˝ cup | 3.2 | 20 |
| Spinach (canned, drained solids) | ˝ cup | 2.5 | 10 |
| Black-eyed peas (cowpeas) (boiled) | ˝ cup | 1.8 | 10 |
| Spinach (frozen, chopped, boiled) | ˝ cup | 1.9 | 10 |
| Grits (white, enriched | 1 cup | 1.5 | 8 |
| Raisins (seedless, packed) | ˝ cup | 1.5 | 8 |
| Whole wheat bread | 1 slice | 0.9 | 6 |
| White bread (enriched) | 1 slice | 0.9 | 6 |
References
- ↑ Auerbach M, Deloughery T (2016). "Single-dose intravenous iron for iron deficiency: a new paradigm". Hematology Am Soc Hematol Educ Program. 2016 (1): 57–66. doi:10.1182/asheducation-2016.1.57. PMID 27913463.
- ↑ Krayenbuehl PA, Battegay E, Breymann C, Furrer J, Schulthess G (2011). "Intravenous iron for the treatment of fatigue in nonanemic, premenopausal women with low serum ferritin concentration". Blood. 118 (12): 3222–7. doi:10.1182/blood-2011-04-346304. PMID 21705493.
- ↑ Patterson AJ, Brown WJ, Roberts DC (2001). "Dietary and supplement treatment of iron deficiency results in improvements in general health and fatigue in Australian women of childbearing age". J Am Coll Nutr. 20 (4): 337–42. PMID 11506061.
- ↑ Verdon F, Burnand B, Stubi CL, Bonard C, Graff M, Michaud A; et al. (2003). "Iron supplementation for unexplained fatigue in non-anaemic women: double blind randomised placebo controlled trial". BMJ. 326 (7399): 1124. doi:10.1136/bmj.326.7399.1124. PMC 156009. PMID 12763985. Review in: ACP J Club. 2004 Mar-Apr;140(2):43
- ↑ Achebe MM, Gafter-Gvili A (2017). "How I treat anemia in pregnancy: iron, cobalamin, and folate". Blood. 129 (8): 940–949. doi:10.1182/blood-2016-08-672246. PMID 28034892.