Iron Deficiency Anaemia (1)

Question 1

What is the most common cause of this?

What are the other causes?

Answer 1

➊ Dietary insufficiency

➋ • Inadequate absorption e.g. Crohn’s or Coeliac
• Blood loss e.g. in menstruation

Question 2

Iron Absorption:
Where is Iron absorbed?
→ Therefore, what can interfere here?

What else is required for iron absorption?
→ Therefore, what can interfere here?

Answer 2

➊ Duodenum and jejunum
→ Conditions like Coeliac and Crohn’s

➋ Acid from the stomach as it keeps the iron in its soluble form (Fe2+)
→ PPIs

Question 3

Ferritin:
What is it? Where is it stored?

When is it released?

Why is a high ferritin difficult to interpret?
→ What can give the wrong impression of this?

What can a normal ferritin level mask?

Answer 3

N.B. Most useful test for Iron – When low, it’s highly suggestive of iron deficiency

➊ The form Iron takes when its being stored
• Liver stores lots of Ferritin

➋ With inflammation

➌ Likely to be due to inflammation rather than iron overload
→ Iron supplementation and Acute liver failure

➍ IDA if there’s also inflammation

Question 4

How is it managed?

Answer 4

• Treat underlying cause, which is usually by dietary supplementation e.g. more red meat and nuts
• Ferrous sulphate 200mg