why is it often difficult to determine an effective course of treatment for iron deficiency anemia?

by Gladys Daugherty 8 min read

Most of the time, people have iron-deficiency anemia because they’re losing blood or they’re not absorbing iron in their diet. Healthcare providers treat iron-deficiency anemia by diagnosing and, if possible, treating the underlying cause while treating the iron deficiency.

Full Answer

What are the additional studies for the treatment of iron deficiency anemia?

Additional studies, including repeat upper and lower endoscopy and often investigation of the small intestine may thus be required. Although oral iron is inexpensive and usually effective, there are many gastrointestinal conditions that warrant treatment of iron deficiency with intravenous iron.

What questions should I ask my doctor about iron deficiency anemia?

For iron deficiency anemia, some basic questions to ask your doctor include: What's the most likely cause of my symptoms? Are there other possible causes for my symptoms? Is my condition likely temporary or long lasting?

What is iron deficiency anemia?

Iron deficiency anemia is diminished red blood cell production due to low iron stores in the body.

Is iron deficiency anemia a risk factor for cerebrovascular events?

Pediatrics. 2007;120(5):1053–1057. [PubMed] [Google Scholar] 37. Azab SF, Abdelsalam SM, Saleh SH et al. Iron deficiency anemia as a risk factor for cerebrovascular events in early childhood: a case-control study.

Is iron deficiency anemia difficult to diagnose?

Sometimes it is difficult to diagnose the cause of iron deficiency, or your doctor may be concerned that there is a problem other than iron deficiency causing the anemia.

Which type of anemia is the most difficult to treat?

Aplastic anemia can be short-lived, or it can become chronic. It can be severe and even fatal.

What could be the possible reason for her failure to respond to the oral iron medication?

Adverse effects such as constipation, dysgeusia and nausea reduce adherence,12 and hence effectiveness, particularly when the recommended duration of therapy is 3–6 months. Poor adherence is a common cause for failure to respond to oral iron therapy, however other causes should also be considered (Table 4).

What is the course of treatment for anemia?

Treatment varies, depending on the type, but it may include iron or vitamin supplements, medications, blood transfusions, and bone marrow transplants. However, for some people with anemia, dietary changes can resolve the issue.

What causes iron deficiency anemia?

Iron-deficiency anemia is the most common type of anemia. It occurs when your body doesn't have enough iron. Potential causes include not eating enough iron-rich foods, blood loss due to menstruation, and inability to absorb iron. If you suspect you have an iron deficiency, see a doctor.

What happens if anemia is not treated?

Anemia if not treated for a long period can lead to serious complications. These include heart failure, severe weakness and poor immunity. Anemia is a medical condition in which the person does not have enough red blood cells or RBCs. The RBCs in the blood carry iron a specialized protein called hemoglobin.

Why would iron infusions not work?

Reasons why a patient may not respond to iron therapy include: Iron supplementation is too low. Once you develop iron deficiency anemia, you need more than the amount most people require daily in their diet.

What is a side effect associated with oral iron therapy?

Gastrointestinal side-effects are the most commonly reported adverse effects associated with oral iron treatment and include nausea, flatulence, abdominal pain, diarrhoea, constipation, and black or tarry stools [11,12,13,14,15].

How long does it take an iron infusion to take effect?

How long after my iron infusion will I start to feel better? Your iron levels will be restored directly right after the infusion, however, it can take up to two weeks before you start to notice a difference and feel better.

Which of the following is the best nursing intervention regarding iron deficiency anemia?

Oral ferrous iron salts are the most economical and effective medication for the treatment of iron deficiency anemia; of the various iron salts available, ferrous sulfate is the one most commonly used.

What is the objective of managing anemia?

The goal of treatment is to increase the amount of oxygen that your blood can carry. This is done by raising the red blood cell count and/or hemoglobin level. (Hemoglobin is the iron-rich protein in red blood cells that carries oxygen to the body.) Another goal is to treat the underlying cause of the anemia.

What causes iron deficiency without anemia?

Iron deficiency can occur secondary to inadequate dietary intake, increased requirements (e.g. pregnancy and breastfeeding), impaired absorption (e.g. coeliac disease, bariatric surgery), or blood loss (e.g. menstrual, blood donation, gastrointestinal).

How long does iron infusion take?

In 2015, the FDA added a boxed warning that extended the minimum recommended infusion time, from 17 seconds to 15 minutes, which has greatly minimized the potential for side effects.

Who said hair stands up when bariatric patients get oral iron?

Dr. Auerbach, who also is Clinical Professor of Medicine at Georgetown University School of Medicine in Washington, D.C., agreed, saying, “My hair stands up when bariatric patients get oral iron. These people so desperately need to be iron sufficient to maintain the energy that they need for ongoing exercise.”.

How many injections of iron dextran?

These formulations are considered as safe and effective as LMW iron dextran but are given in a series of four or five injections. The amount of time a patient needs to sit in the chair at the infusion center is shorter, but they need to return to the office repeatedly.

How many IV irons are there?

IV Iron Options and Indications. There are currently five formulations of IV iron on the market. They vary in dose and the speed at which they can be administered. Some can be taken all at once over the course of several hours, others require multiple shorter visits.

When was IV iron dextran removed from the market?

For example, one formulation of IV iron, high-molecular weight iron dextran, was approved by the FDA in 1996; after reports of serious AEs associated with the drug, including anaphylaxis, it was removed from the market in 2009. The damage was done, though, according ...

Is iron dextran the least expensive drug?

Iron dextran is the least expensive drug on its own, but, she said, that does not account for the cost of “chair time” at the infusion center. The longer a patient remains at the center, the more expensive the treatment becomes because of facility and labor fees.

Is Ferumoxytol approved for chronic kidney disease?

However, when it was approved at this dose and rate, the drug was not issued a broad approval , but was indicated for the treatment of iron-deficiency anemia in a limited population of individuals with chronic kidney disease. Ferumoxytol is currently approved for treatment of iron deficiency anemia in all populations of individuals.

What causes anemia in cancer patients?

Cancer — There are numerous causes of anemia in patients with cancer, including chronic inflammation, impaired absorption of nutrients, hemolysis, and iron deficiency, often caused by bleeding. (See "Causes of anemia in patients with cancer" .)

What is the best way to restore iron balance?

Oral iron. Uses for oral iron Oral iron provides an inexpensive and effective means of restoring iron balance in a patient with iron deficiency without complicating comorbid conditions. Uses for oral iron supplements include the following: ● Treatment of iron deficiency anemia.

How much of the world's population is anemic?

More than a quarter of the world's population is anemic, with about one-half of the burden from iron deficiency. The prevention and treatment of iron deficiency is a major public health goal, especially in women, children, and individuals in low-income countries.

Can you use intravenous iron with oral iron?

In circumstances where intravenous iron therapy may not be an immediate option ( patient preference for a trial of oral therapy, third-party payor issues) oral iron may be used with the recognition that intravenous iron may ultimately be required if oral iron is poorly tolerated or ineffective.

Can older people become iron deficient?

Older adults — Older individuals may become iron deficient for a number of reasons. As noted above, a search for the cause of new onset iron deficiency is mandatory for all older individuals for whom a new underlying lesion would be treated. (See 'Source of deficiency/blood loss' above.)

Is iron rare in adults?

For adults in resource-rich countries, dietary iron deficiency is exceedingly rare because of iron availability in many meats (as heme iron) and vegetables (as non-heme iron), along with routine supplementation of grains with iron. (See "Iron deficiency in infants and children <12 years: Screening, prevention, clinical manifestations, ...

Can you have anemia without iron?

Iron deficiency without anemia — Some individuals with reduced or absent iron stores who have not yet developed anemia may have symptoms such as fatigue or reduced exercise tolerance. The approach to therapy is individualized according to etiology and severity of iron deficiency.

Physical Examination

Your doctor will do a physical exam to look for signs that you might have IDA. They may look at your skin, gums, and nailbeds to see if they are pale. 1 They may also listen to your heart for rapid and irregular heartbeats and your lungs for rapid or uneven breaths.

Labs and Tests

Iron deficiency anemia is diagnosed using lab work. Your doctor will request a complete blood count (CBC) to see if your red blood cell counts, hemoglobin, hematocrit, or mean corpuscular volume (MCV) could suggest anemia. 1

Differential Diagnoses

There are many different forms of anemia, often identified by their causes. The signs and symptoms of anemia might be similar, although different underlying causes might cause different symptoms.

Summary

Iron deficiency anemia is diagnosed by reported symptoms, physical examination, and laboratory testing. It must be distinguished from other forms of anemia. Your healthcare professional will also look for underlying conditions that could lead to iron deficiency anemia.

A Word From Verywell

You should make an appointment to see your doctor if you are experiencing high levels of fatigue and don’t know why. Fatigue has many causes, and iron deficiency anemia is only one.