disorders of nutrition
Iron Deficiency
Treatment of Iron Deficiency
Control of bleeding Iron supplements by mouth Rarely iron given by injection Because the most common cause of iron deficiency in adults is excessive bleeding, doctors first look for a source of bleeding. If the source is excessive menstrual bleeding, drugs, such as oral contraceptives (birth control pills), may be needed to control it. Surgery may be needed to repair a bleeding ulcer or remove a polyp in the colon. A Overview of Blood Transfusion may be necessary if the anemia is severe. Normal dietary intake of iron may not be sufficient to replace lost iron (because less than 20% of iron in a typical diet is absorbed into the body). Thus, most people with iron deficiency need to take iron supplements by mouth usually once or twice a day. Iron in supplements is absorbed best when taken on an empty stomach, 30 minutes before meals or 2 hours after meals, particularly if the meals include foods that reduce the absorption of iron, such as vegetable fibers, foods that contain phytates (including whole-grain bread, bran, beans, soybeans, and nuts), coffee, and tea. However, taking iron supplements on an empty stomach can cause indigestion and constipation. So some people must take the supplements with meals. Antacids and calcium supplements can also reduce iron absorption. Consuming vitamin C in juices or taking it as a supplement enhances iron absorption, as does eating small amounts of meat, which contains the more easily absorbed form of iron (heme iron). Iron supplements can turn stools black—a harmless side effect. Rarely, iron is given by injection. Injections are necessary for people who cannot tolerate tablets or for the few people who cannot absorb enough iron from the digestive tract. Correcting iron deficiency anemia usually takes several weeks up to about 2 months, even after the bleeding has stopped. After the anemia is corrected, an iron supplement should be taken for 6 months to replenish the body’s reserves. Blood tests are usually done periodically to determine whether people are receiving enough iron and to check for continued bleeding. Women who are not menstruating and men should not take iron supplements or multiple vitamins with iron unless they are specifically instructed to do so by a doctor. Taking such supplements can make diagnosing bleeding from the intestine difficult. Such bleeding may be due to serious disorders, including colon cancer. Because a developing fetus requires iron, iron supplements are recommended for most pregnant women. Most babies, particularly those who are premature or who have a low birth weight, need an iron supplement. It is given as an iron-fortified formula or, to breastfed babies, as a separate liquid supplement. 