Treatment Options for Iron Deficiency Anemia
Treatment for Iron Deficiency Anemia
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When considering treatment options for iron deficiency anemia, you first need to determine if you are really anemic, if the anemia is due to iron deficiency or something else and if it is iron deficiency anemia, is it due to low iron intake, either from poor diet or absorption, or is it from chronic bleeding? The answers to these questions will help your doctor to determine the proper course of treatment. Some of these treatments may include hormone pills (birth control) to control monthly menstruation, surgery, medical procedures or medication to correct or manage digestive system problems, or various iron therapy.
Typically with iron deficiency anemia iron is used as treatment itself or in conjunction to other treatments. The goal is to get your iron levels back within normal range so that your body can function properly. The first thing your doctor will look at is your diet and most likely recommend adding or increasing iron rich foods daily. Although this is helpful to increase iron levels, it is generally not more than a change to help maintain iron levels as iron deficiency requires higher doses of iron to correct as quickly as possible. It is important to get iron levels within normal ranges quickly because severe, long term iron deficiency anemia can cause long term damage to organs. Therefore, your doctor will most likely recommend an iron supplement.
There are two forms of iron supplements, multivitamins with iron and high dose iron supplements. Multivitamins with iron are best for maintaining iron levels. They are best for people who are not anemic (or have recently corrected anemia) such as women of child bearing age to compensate for monthly blood loss or pregnant or lactating women because normal dietary intake is unable to meet the iron needs of the body during these times. Generally the dosage of multivitamins with iron is 10-20mg of ferrous sulfate which will give your body 1-2mg of iron a day.
The second form of iron supplements are the high dose category. In significant anemia higher doses are necessary to maximize absorption. There are many types available and most without a prescription. The following are examples:
Generic Ferrous Sulfate - Most common and widely prescribed by doctors. Typical dose is 325mg and delivers about 65mg of elemental iron. Cheap and effective, although many report stomach discomforts and irritations.
Feosol - Comes in capsules, tablets and elixer. Capsules contain about 45mg of pure elemental iron. Tablets contain about 65mg elemental iron, the same as 325mg of ferrous sulfate. Elixer, doesn't taste all that bad and provides 45mg elemental iron in 1 teaspoon.
SlowFe - This is ferrous sulfate packaged in a wax matrix to slow the release of the iron. This slow release may help minimize gastric side effects. Each tablet contains about 160mg of dried ferrous sulfate and provides 50mg of elemental iron.
How you take your supplements is important. Depending on the severity of your anemia and how well you tolerate the supplements, your doctor will recommend from 1 - 3 doses a day. Iron seems to be best absorbed on an empty stomach, 1 - 2 hours prior to eating, However, most people can't tolerate iron on an empty stomach and take it with or after a meal to help ease side effects such as upset stomach, diarrhea, constipation, nausea, abdominal distress and abdominal pain. The iron will be absorbed at a lower rate if taken with or after meals.
Vitamin C helps the body absorb iron. You should always make sure you are getting the daily recommended amount or check with your doctor to determine how much you should be taking. Some things, such as milk and antacids will interfere with the absorption of iron and should not be taken within two hours of taking iron. Iron itself may interfere with the absorption of other drugs and should be taken two hours before or after certain medications. Some of these are the antiparkinsonian drug Levodopa (aka: Atamet, Sinemet, Larodopa, Dopar) used to treat Parkinson's disease, RLS (restless leg syndrome) and herpes zoster (shingles), Tetracycline antibiotics used to treat various infections (some brand names are Achromycin and Topicycline, but there are many others) and the antibiotic Norfloxacin (Noroxin and Chibroxin). Since the absorption of these drugs can be reduced up to 90% when taken with iron, it is very important to take them at least two hours apart from iron. Tell your doctor when he is prescribing meds if you are taking iron supplements.
Iron Shots - If a patient doesn't tolerate oral iron supplements well, their doctor may decide an alternate form of iron is necessary. INFeD is an iron shot that is available. Over the course of several weeks 5 - 10 shots are given, depending on the severity of the deficiency and the patients progress in absorbing the iron shots. These shots are very expensive, can be quite painful and cause a permanent brown stain in the skin where the iron was injected. There is also a small, but serious, risk for an allergic reaction. Because of these reasons, Iron shots are not given often except in unusual cases where other methods have failed.
IV Iron Therapy - There are two effective approaches to IV iron therapy. The first is periodic iron repletion. This is a series of iron doses administered when iron levels decrease to replenish them. Continuous maintenance treatment is the second approach. This is when smaller doses of iron are administered on a regular schedule, determined by the doctor monitoring the patient, to maintain iron levels. Venefor is an iron sucrose injection used for both of these approaches and is very effective and safe. It also seems to be well tolerated. The cost is high, but typically patient insurance will cover this. If the patient doesn't have insurance and requires this method to control iron deficiency anemia, there is a patient assistance and reimbursement program available. You can find out more about this by going to the Venefor website.
Blood Transfusions - There are cases in which iron deficiency can become so severe that it is life threatening and blood count needs to be raised immediately. In such cases the patient may be admitted to the hospital for a blood transfusion. Typically a doctor will prescribe blood transfusions for patients who have a hemoglobin level of 8 or below (normal levels are 12-14) or if the patient has a history of heart disease, trouble breathing or is at risk for a stroke. With any blood transfusion there is a risk of blood reactions or the transmission of infectious diseases such as HIV or AIDS. Blood banks do screen to minimize these risks, but the risk is still there to a small degree. Blood transfusions are only administered if the anemia is life threatening, and in that case, the benefit of receiving the transfusions seems to outweigh the risks.
Before starting any Iron treatment you should discuss your anemia and the cause with your doctor. He can prescribe a treatment plan or refer you to a specialist if necessary. High doses of iron can be toxic and deadly so it is very important to never take iron without first consulting your doctor!
© Anglfire693, 2009
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