Health Questions and Answers

QUESTION: In the treatment of Iron Deficiency Anemia, how much iron should be administered, in what form, and for how long?

Answer:
Iron
is best given as ferrous sulfate in a formulation that does not include enteric coating. Typically, patients take 325mg PO TID until the anemia corrects and for several months thereafter. This provides 60mg of elemental iron per tablet, or 180mg per day. Of this, 18-36mg can be absorbed and utilized by an otherwise unimpaired marrow. When a low serum ferritin value is used to make the diagnosis of iron deficiency, the ferritin can be checked to verify that iron stores have increased with therapy. In some instances patients improve but do not fully correct their anemia. If the ferritin has normalized, another cause of anemia (eg. coexistent thalassemia minor) should be sought. A useful guide to success is the occurrence of reticulocytosis about 10 days after initiation of iron therapy.

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