Treatment of iron deficiency anemia has two goals:
- to remove the cause of blood loss if possible (if this is the cause of the anemia)
- to cure the anemia by correcting iron deficiency
Both of these goals should be addressed at the same time, and treatment can start before the exact cause of the iron deficiency anemia is known.
Iron deficiency anemia often can't be treated by diet alone. In many cases, it wouldn't be possible for a person to eat enough iron-rich food in order to get the amount of iron needed. To help with bringing the iron levels back to normal, oral iron supplements are often prescribed. Injections are only necessary in severe cases, or when oral supplementation is not suitable for the underlying problem (such as malabsorption that often occurs after bariatric or gastric bypass procedures). It's still important, of course, for those on iron supplements to eat a proper, well-balanced diet.
Although expensive forms of iron supplements are available, iron replacement therapy generally doesn't cost more than a few dollars a month. Even though enteric-coated or prolonged-release iron supplements are available, iron pills shouldn't be enteric-coated or taken with meals or antacids, as this can reduce the amount of iron absorbed. Take iron pills between meals, and do not take them with milk, calcium, tea, or coffee, as this may also decrease absorption. Taking them with vitamin C can help absorption, but check with your doctor before trying this.
Seniors may respond more slowly to iron replacement therapy, and young people more rapidly. It's best to continue taking iron supplements for an additional 6 months after the cause is treated. If only the anemia is treated, it's likely to come back. For this reason, it's important to find and treat the cause of the anemia.
All good oral iron preparations will cause stools to appear black. This is normal and doesn't mean there's blood loss. Although it's rare for iron supplements to cause problems, a few people may get abdominal discomfort, constipation, or loose stools from taking oral iron medications. Those whose symptoms continue may have to switch to a different form of iron (e.g., from ferrous sulfate to ferrous fumarate), reduce the dose of iron, or reduce the number of pills they take for a few days.
Blood transfusions are rarely performed to treat iron deficiency, except possibly in elderly persons with brain, heart, or kidney problems. Treatment of the underlying reason for the iron deficiency will be necessary for the iron to work. Otherwise, the iron is being lost as it is being replaced.
The key to prevention of iron deficiency anemia that's not due to disease or blood loss is proper nutrition. Plenty of iron-rich and easily absorbed foods such as meats (especially liver), fish, poultry, eggs, legumes (peas and beans), potatoes, and rice should be eaten. Iron is also absorbed more easily by the body if iron supplements and iron-rich foods are taken with citrus juice. Good eating habits are especially important for children, pregnant women, and women who are still menstruating. People who are strict vegetarians or on low-calorie diets should be aware of the symptoms of iron deficiency, as they may not be getting enough iron in their diets.
It's extremely important that breast-fed babies start receiving iron supplement drops or iron-fortified cereal after they are 6 months old.
Iron supplements can be helpful during growth spurts in children and in pregnancy. Too much iron, however, can cause liver damage and cirrhosis.
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