Anemia, Iron Deficiency

Deborah R. Erlich, MD, MmedEd, FAAFP Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Low serum iron associated with low hemoglobin (Hgb) or microcytic, hypochromic red blood cells (RBCs)

  • Because normal Hgb varies with age and sex, anemia is defined as Hgb level 2 stan...

DIAGNOSIS

HISTORY

  • Asymptomatic in most cases

  • Weakness, fatigue, and/or malaise

  • Exertional dyspnea

  • Angina with coronary artery disease

  • Headaches or inability to concentrate

  • Melena

  • Pica

PHYSICAL EXAM

  • Pallor (ski...

TREATMENT

GENERAL MEASURES

  • Search for underlying cause and correct.

  • Avoid transfusions, except in rare cases.

MEDICATION

  • Elemental iron 100 to 200 mg/day for adults (whether pregnant or not) (3,5)[C]

  • Eleme...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Patient Monitoring

  • Monitor patients every 3 months after Hgb normalizes for a year and then yearly (1)[C].

  • Hgb increases 1 g/dL every 3 to 4 weeks.

  • Iron stores may t...

REFERENCES

1 Short MW, Domagalski JE. Iron deficiency anemia: evaluation and management. Am Fam Physician.  2013;87(2):98–104.  [View Abstract]
2 Culleton BF, Manns BJ, Zhang J, et al. Impact o...

ADDITIONAL READING

  • Chertow GM, Mason PD, Vaage-Nilsen O, et al. On the relative safety of parenteral iron formulations. Nephrol Dial Transplant.  2004;19(6):1571–1575.

  • de Benoist B, McLean E, Egli...

SEE ALSO

Algorithm: Anemia 

CODES

ICD10

  • D50.9 Iron deficiency anemia, unspecified

  • D62 Acute posthemorrhagic anemia

  • D50.0 Iron deficiency anemia secondary to blood loss (chronic)

  • D50.8 Other iron deficiency anemias

ICD9

  • 280.9 Iron defi...

CLINICAL PEARLS

  • IDA due to poor dietary iron intake is the most common anemia.

  • Blood loss and reduced iron stores due to malabsorption or poor utilization are major risk factors for IDA.

  • Premenopausal w...

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