Iron deficiency anemia medical therapy
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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)
- 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.