Iron deficiency anemia medical therapy: Difference between revisions

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==References==
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[[Category:Hematology]]
[[Category:Hematology]]
[[Category:Gastroenterology]]
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[[Category:Primary care]]
[[Category:Endocrinology]]
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Latest revision as of 22:25, 29 July 2020

Iron deficiency anemia Microchapters

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Patient Information

Overview

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Causes

Differentiating Iron deficiency anemia from other Diseases

Epidemiology and Demographics

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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.
  • 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:
Template:Col-2
Selected Food Sources of Heme Iron
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

Template:Col-2

Selected Food Sources of Nonheme Iron
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

  1. 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.
  2. 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.
  3. 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.
  4. 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
  5. 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.

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