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Suggest Treatment For Iron Deficiency In A Child

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Posted on Mon, 20 Jun 2016
Question: Hello,
My 8 year old daughter is iron deficient. 3 months ago her Ferritin was 15 and her iron was 43. For the last 3 months she has been taking 60 mg of iron a day. We have cut down dairy and increased vitamin C for absorption. We just retested have levels and the Ferritin is at 19 but the iron is at 38. Our doctor says we were not aggressive enough and to go to 180 mg of iron a day. This seems like a lot to give a child. I also don't understand why the iron went down. We were giving her more iron than she has ever gotten on a daily basis, shouldn't her levels have stayed the same or a least gone up a smidge? It doesn't make sense to me that the levels go down with additional iron unless something is depleting it. I did ask the doctor to check her for Celiac Disease because I know that can hinder iron absorption and she has adrenal hormonal imbalances (which can also be caused by Celiac). This last blood test she also had high Neutrophils (Auto count) 9.9 K/ul, high white blood cells 15.2 K/ul, high red blood cells 5.39 M/ul, and high platelets 410 K/ul and then slightly low MCV 76 fl. All of the high tests, could point to Celiac as well. The doctor dismissed the Celiac Disease and dismissed my concern with the other blood tests. What are you thoughts? I am especially interested in whether or not the 180 mg seems high for an 8 year old (90 lbs), whether or not you think there could be a connection to Celiac and if you think something is hindering the iron absorption (other than us not being "aggressive" enough).
Thank you for your assistance. XXXXXXX XXXXXXX
doctor
Answered by Dr. Shailja Puri (22 minutes later)
Brief Answer:
Celiac disease can be the cause of iron deficiency despite iron supplements

Detailed Answer:
Hello,
Thanks for posting your query on HealthcareMagic.
The MCV of 76 fl suggests microcytic red blood cells or small sized red cells.
Most common cause if microcytic blood cells is iron deficiency.
It is surprising that the iron levels did not increase despite 60 mg iron for 3 months.
There is a possibility of malabsorption which is interfering with absorption of iron from gastrointestinal tract.
Celiac disease can be a cause of absence of iron absorption as suspected by you.
I would recommend you to get blood test for celiac disease - tTGA Ig A.

Please get back to me with the test results so I could help you further.

Thanks and take care
Dr Shailja Puri
Above answer was peer-reviewed by : Dr. Naveen Kumar
doctor
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Follow up: Dr. Shailja Puri (56 minutes later)
Thank you Dr. Shailja Puri. I have asked that they order the Celiac testing. I will let you know how it turns out. What do you think about the dosage of 180 mg of iron daily for my daughter? Do you think it is too much?
doctor
Answered by Dr. Shailja Puri (1 minute later)
Brief Answer:
60 mg iron is sufficient for iron deficiency.

Detailed Answer:
Hello and welcome again,
60 mg iron is sufficient for 3 months for iron deficiency.

Thanks and take care
Dr Shailja Puri
Note: Do you have more questions on diagnosis or treatment of blood disorders? Ask An Expert/ Specialist Now

Above answer was peer-reviewed by : Dr. Naveen Kumar
doctor
Answered by
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Dr. Shailja Puri

Pathologist and Microbiologist

Practicing since :2006

Answered : 9705 Questions

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Suggest Treatment For Iron Deficiency In A Child

Brief Answer: Celiac disease can be the cause of iron deficiency despite iron supplements Detailed Answer: Hello, Thanks for posting your query on HealthcareMagic. The MCV of 76 fl suggests microcytic red blood cells or small sized red cells. Most common cause if microcytic blood cells is iron deficiency. It is surprising that the iron levels did not increase despite 60 mg iron for 3 months. There is a possibility of malabsorption which is interfering with absorption of iron from gastrointestinal tract. Celiac disease can be a cause of absence of iron absorption as suspected by you. I would recommend you to get blood test for celiac disease - tTGA Ig A. Please get back to me with the test results so I could help you further. Thanks and take care Dr Shailja Puri