Iron Deficiency Anemia

Question 1

Describe iron deficiency anemia and list its usual causes.

Answer 1

Description: microcytic hypochromic

Usual cause:
Blood loss via:
- GYN
- GI

Question 2

What are the signs and symptoms of IDA (iron deficiency anemia) by age group for young/middle adults and older adults?

Answer 2

Usually asymptomatic until H/H </= 30/10

Young/middle adults:
- fatigue
- weakness
- headache
- irritability
- exercise intolerance

Older adults:
- exacerbation of comorbid conditions

Question 3

What is the treatment for IDA?

Answer 3

4 - 6 months of 150 - 200mg of elemental iron daily

Question 4

What are the the equivalents of 325mg elemental iron for iron fumerate, iron sulfate, and iron gluconate? Which is usually best tolerated?

Answer 4

325 mg elemental iron =

Iron fumerate: 106 mg, x 2/day (most expensive)
Iron sulfate: 65 mg, x 3/day
Iron gluconate: 33 mg, x 6/day (cheapest)

Iron sulfate is usually best tolerated

Question 5

What are foods rich in iron?

Answer 5

Spinach
Clams
Liver
Lentil soup
Oysters
Red beans
Rice

Question 6

What labs are typically included in an iron panel and what are their definitions?

Answer 6

Serum Fe (iron): iron in circulation
Serum Ferritin: iron in storage
TIBC (Total Iron Binding Capacity): number of available iron-binding sites

Question 7

What is the relationship between serum Fe, serum ferritin, and TIBC?

Answer 7

Serum Fe and serum ferritin have a reciprocal relationship with TIBC

Question 8

What is the order of normalization of labs following iron supplementation?

Answer 8

1: RBCs increase

#2: H/H increases
#3: Serum Fe increases
#4: TIBC decreases
#5: Ferritin increases