Iron deficiency anemia

Abstract

Awareness of subtle symptoms of mild iron deficiency is increasing, but unsuspected iron deficiency is a persistent problem, especially among certain groups, such as menstruating women and milk-fed infants. The diagnosis must be clearly established through appropriate testing, and an underlying cause should always be sought. Useful tests include determination of serum ferritin and iron levels and of iron-binding capacity. A nomogram is available that correlates the serum ferritin value with the degree of inflammation present, but in some patients, bone marrow aspiration and iron staining is still required. When oral iron therapy is undertaken, an appropriate non-enteric-coated, non-sustained-release preparation should be chosen. Gradually increasing the amount of iron supplementation and taking the tablets with meals help limit side effects and ensure patient compliance. Iron therapy should be continued for 6 months after the hemoglobin level returns to normal so that total iron stores are replaced. Follow-up to ensure that iron deficiency anemia has not recurred and that the diagnosis was correct is required.