- Royal College of pathologists of Australasia definition of iron deficiency is serum ferritin level of < 30 for an adult
Who gets iron deficiency?
- Basically everyone
- Pre-menopausal and pregnant women are at higher risk
- Vegetarian with a balanced diet should not have iron deficiency
What causes iron deficiency?
- 2 major categories
- Not taking in enough iron such as coeliac disease, poor diet etc
- Loosing iron such as blood loss
What are the clinical features of iron deficiency?
- No clinical features in many cases and found out from routine blood test
- Clinical features include: fatigue
How is it diagnosed?
- It is diagnosed via iron studies, not as straight forward as it sounds
- Ferritin is the most reliable indicator of iron level but it elevates with acute inflammation so a CRP is recommended to order with ferritin together
- Transferrin saturation levels reflecting transport iron, if it is less than 20% indicate an iron supply that is insufficient to support normal erythropoiesis
- Total iron binding capacity increases in iron deficiency in an attempt to increase iron uptake
What is the treatment for iron deficency?
- Dietary modification is inadequate to treat iron deficiency, only enough to prevent
- treatment is around 100 - 200 mg elemental iron daily in divided doses
- Over the counter product only contains very small amount of iron content
- If iron replenish is required urgently (prior to operation or pre-obstetric delivery), IV iron can be used. (Usually ferronjet 1000 mg can be given over 15 minutes)
- There are quite many iron oral formulas available: Here
What is the outcome?
- Variable depends on the cause
- takes 3 to 4 weeks to have a clinical significant impact
- Hb level should increase by approximately 20 g/L every 3 weeks
References:
- RACGP check program 2016 Blood disorder
- South Australia health. Blood safe iron deficiency anaemia resources
No comments:
Post a Comment