Talking With Your Doctor About Treatment of Iron-Deficiency Anemia

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Female doctor discussing with a patient

If you have iron-deficiency anemia, it means your red blood cells are not carrying enough oxygen. Iron deficiency can cause this problem, because you need iron to make hemoglobin. Hemoglobin is the protein that carries oxygen in your blood.

Treatment depends on what is causing your iron deficiency. This is the first of several important conversations with your doctor about your anemia. Ask your doctor if your iron deficiency could be from blood loss, not getting enough iron, or an increased demand for iron by your body. Your doctor will look for common causes of iron deficiency and treat these, while also working to restore iron to your system.

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What to Know About Iron Replacement

Ask your doctor if the cause of your iron deficiency can be treated. For example, if blood loss is the cause, your doctor will treat the source of bleeding. You may have a digestive problem that keeps you from absorbing iron. If you are pregnant, ask your doctor if you may need more iron than you can get from your diet.

Regardless of the cause, once you are diagnosed with iron-deficiency anemia, diet and over-the-counter vitamins may not be enough to get your iron levels back to a safe level. Talk to your doctor about iron replacement pills. The average dosage of iron necessary to correct iron deficiency in an adult is between 150 to 200 milligrams (mg) per day.

Your doctor will start you on iron replacement and check your blood levels in about a month. You may need to take iron replacement for another three months to build up an iron reserve supply in your liver. If you can’t get enough iron from pills, your doctor may give you iron intravenously. In very severe cases of iron-deficiency anemia, you may need a blood transfusion.

The Side Effects of Iron Pills

Iron pills can be tough on your digestive system. One reason that some people need to get intravenous iron is that they just can’t tolerate the pills. Side effects of iron pills include nausea, belly pain, diarrhea and constipation. Talk to your doctor about how to reduce these side effects. Suggestions may include:

  • Taking your iron pills with food
  • Starting slowly and building up your dosage over several days
  • Avoiding iron pills at bedtime
  • Adding fiber to your diet (this causes iron to be absorbed more slowly)
  • Switching to a different type of iron pill (different pills have different forms of iron)

If you take antacids, your doctor may suggest taking iron pills either two hours before or four hours after your antacid medication. This is because antacids and acid-lowering medications can block your absorption of iron. You doctor may also suggest taking a vitamin C supplement. Vitamin C increases iron absorption.

Talk to Your Doctor About Getting More Iron from Your Diet

Iron from food alone may not be enough to reverse iron-deficiency anemia, but it helps. Increasing dietary iron may also help prevent future anemia. Your doctor may suggest adding:

  • Red meats, especially liver
  • Poultry, especially livers and dark meat
  • Fish, especially shellfish, anchovies or sardines
  • Leafy green vegetables, especially broccoli, kale and collard greens
  • Peas and beans
  • Iron-enriched foods, like some cereals, pastas, rice and breads. Check the label to find out if the food is enriched.
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Sep 11

  1. Iron-Deficiency Anemia. American Society of Hematology.

  2. Anemia.

  3. Iron Deficiency Anemia: Evaluation and Management. American Family Physician.

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