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Dr. Andrew Rynne

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What causes iron deficiency anemia?

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Dr. Venkat Sivayogi

Internal Medicine Specialist

Practicing since :2007

Answered : 454 Questions

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Posted on Mon, 11 Aug 2014 in Medicines and Side Effects
Question: I just got my blood work done. I am 37 F with DM 2. My HBA1c = 7. LFTs, KFT and Lipid profile cam back normal. But I got a strange report about my blood work, reporting irregular parameters : Platelets 424000 / microlitre ( normal 150 -400K ), Total RBC = 4.44, Hb = 8.3, Hematocrit (PCV) =31.5% ( Normal 36 -36%), MCH = 18.7pq ( Normal = 27 - 32 ), MCHC = 26.3 g/dl ( Normal = 31.5 - 34.5 ), RDW - SD = 50.6 fL ( Normal ( 39-46), RDW - CV = 20.1% ( Normal = 39 - 46 ) with remarks RBCs = Marked anisocytosis moderate poikilocytosis. Predominantly microcytic hypochromic cells with ovalocytes & elliptocytes. Serum Fe = 20.1 microg/dl ( Normal = 60 -180 ), TIBC = 418.5 microg/dl, %Transferrin saturation= 4.8 ( Normal Range is 13 - 45 ). Please suggest dosage for my Iron supplement. I have been declared anemic with iron deficiency and was tested for celiac dieses antibodies which was negative and also for Thelissemia which was also negative. My weight is 75 Kgs an I am 5'3". Thanks in advance.
doctor
Answered by Dr. Venkat Sivayogi 6 hours later
Brief Answer:
i have outlined the treatment..

Detailed Answer:
Hello,
Welcome to Healthcare Magic,

As per the given lab reports, Its evident that you are having - Iron deficiency Anaemia. Iron deficiency can be seen in following situations:-

1. In adequate food intake
2.Any intestinal worm infestations
3.Chronic blood loss due to Menstrual issues or Haemorrhoids
4.Malabsorption
5.Alcoholics

Now, coming to the treatment in your case,
Your Hb is - I will take it 8 grams
Your weight -75 kgs

Total amount of Intravenous Iron required is = 2.4X(Desired Hb-Present Hb)Xweight in kgs = 2.4*6*75 = 1080 mg

Each vial of 5 ml Iron sucrose comes in 200 mg . So approx. you may require 5-6 inj of iron sucrose weekly once.




Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Venkat Sivayogi 6 hours later
Dear Doctor,

1) Do you mean 1 injection of 5 ml Fe Sucrose contains 200 mg of Elemental Fe ?
2) You recommend 1 injection per week or 1 injection daily for 5 days ?

1) Please advice, whether tablets like livogen or haem up won't help ?
2) I have had Fe deficiency for long now, so will I need to keep a regular intake of Iron with tablets like alternate week or alternate month ??
doctor
Answered by Dr. Venkat Sivayogi 20 hours later
Brief Answer:
choice of therapy depends on patient condition..

Detailed Answer:
Hello,
Welcome back,

From the laboratory data, you are having severe Iron deficiency . The treatment option depends upon the severity of the problem, Clinical symptoms of the patient and mainly the patient acceptance of oral iron therapy.

But there is a difference between the oral iron therapy like Livogen,Haemup tablets and the Inj. therapy.
Oral iron therapy requires daily usage of pills for atleast 4-6months to get the target haemoglobin. While most of the patients complain about gastric issues like constipation,abdominal cramps, diarrhea, bloating ,black stools .Some patients even they dont like the smell or taste also. In this situation doctor will discuss with the patient for appropriate choice.

Another thing that should be considered in treating patients with Iron deficiency is thru oral iron therapy only 20 to 30% of iron is absorbed thru the gut and rest will be passed on to stools. so those who want immediate results and those who can not tolerate the oral therapy are best for inj.

For oral iron therapy , there will be no calculation required, just you have to use the pills regularly for 6 months and then check ur Hb
But for Inj therapy, I have provided the total elemental iron required for your body weight, its approx 1100mg. okay Iron inj. come in different sterngths in different countries. I have calculated with 200 mg of elemental iron per inj. some brands supply with 100 mg of elemtal iron only. in that case you may require 10 inj. What you have to consider is total elemtal iron required thats it.






Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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