A well-balanced diet is essential and there is proof that iron supplementation during times of increased demand such as pregnancy and weaning are vital for the prevention of iron deficiency. Treating the underlying cause of iron deficiency will prevent the development of anaemia or the continuation of anaemia after treatment.
Iron deficiency responds very well to oral iron sulphate tablets such as ferrous sulphate, taken in a dose of 300 mg three times a day in an adult. A dose of 300 mg once or twice a day may be effective for prophylaxis or mild iron deficiency. In children the dose is dependent on the child’s weight, and it is best for a doctor or pharmacist to advise on this.
The tablets should be taken between meals, as iron is absorbed better on an empty stomach. However, this form of iron has side effects such as bloating, fullness and sometimes stomach pain, and taking the tablets with meals may help to alleviate these side effects. Iron may result in constipation and black stools.
Ferrous gluconate or ferrous lactate may have fewer side effects. Vitamin C may be used to aid absorption of the iron tablets. Iron tablets should not be taken with tea, as this inhibits or decreases the absorption of the iron.
Iron-containing cocktails of vitamins should not be used alone to treat iron deficiency, as they contain insufficient amounts of iron. They can be used as a part of routine supplementation. Once iron deficiency occurs, specific iron supplements are required to provide sufficient iron for replacement. Drugs that reduce acid production by the stomach such as cimetidine (Tagamet) may inhibit iron absorption and these tablets should not be taken with iron supplements.
It is necessary to continue iron therapy for four to six months to correct anaemia and replenish stores.
If iron is not being absorbed in the gut, it may be given by injection into the vein. This is required in certain cases where there is insufficient absorption of iron due to problems with the gastro-intestinal tract, or where iron supplements are not tolerated. Intravenous iron should be used when a sufficient trial of oral iron has been given, and should be done with the guidance of a physician. There is a small possibility of reactions to the intravenous preparation and its should be administered with the necessary care, preferably in a hospital, doctor’s rooms or a clinic.
Iron deficiency anaemia responds well to treatment with iron tablets and a change in diet.
When to see your doctor
- If you have heavy and prolonged menstrual periods and show symptoms of iron deficiency anaemia.
- If you develop strange food cravings, along with symptoms of tiredness and weakness.
- If your stool becomes black and foul-smelling.
- If you notice growth faltering or a fall-off in growth on the “road to health card” of your child.
Previously reviewed by Dr Betsie Lombard, MBChB (Pret), Mmed (Haem Path) (Stell)
Reviewed by Dr Yasmin Goga MBBCH (Wits), DCH (SA), FCPaeds (SA), Cert Clin Haem Paeds (SA), June 2011