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Anaemia, iron deficiency - Treating iron deficiency anaemia

NHS Choices Medical Reference

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Treatment for iron deficiency anaemia usually involves taking iron supplements to replace missing iron and making necessary changes to address the underlying cause.

Iron supplements

Your GP will prescribe an iron supplement to restore iron missing from your body. The most commonly prescribed supplement is ferrous sulphate, taken orally (by mouth) two or three times a day.

Some people can experience side effects when taking iron supplements including:

  • nausea (feeling sick)
  • sickness
  • abdominal (tummy) pain
  • heartburn
  • constipation
  • diarrhoea 
  • black stools (faeces)

These side effects should settle down over time. Taking ferrous sulphate with food or shortly after eating may help minimise side effects. Your GP may also recommend you only take one or two tablets a day, instead of three, if you are finding side effects difficult to cope with. 

If ferrous sulphate is not suitable because of side effects, you may be prescribed a different iron supplement called ferrous gluconate. This supplement should cause fewer side effects because it contains a less concentrated dose of iron. However, it may take longer for iron levels in your body to be restored.

Storing iron supplements

If you have young children, it is important to store iron supplements out of their reach. This is because an overdose of iron supplements in a young child can be fatal.

Dietary advice

If a lack of iron in your diet is thought to contribute to your iron deficiency anaemia, your GP will advise on how to include more iron in your diet.

Iron-rich foods include:

  • dark-green leafy vegetables, such as watercress and curly kale
  • iron-fortified cereals
  • wholegrains, such as brown rice 
  • beans
  • nuts
  • meat
  • apricots
  • prunes
  • raisins

To ensure a healthy, well-balanced diet, include foods from all major food groups in your diet. If you have iron deficiency anaemia, eat plenty of iron-rich foods, such as those listed above.

However, some foods and medicines can make it harder for your body to absorb iron. These may include:

  • tea and coffee
  • calcium, found in dairy products such as milk
  • antacids (medication to help relieve indigestion)
  • proton pump inhibitors (PPIs), which affect the production of acid in your stomach
  • wholegrain cereals - although wholegrains are a good source of iron themselves, they contain phytic acid which can interfere with how your body absorbs iron from other foods and pills

If you are finding it difficult to include iron in your diet, you may be referred to a dietitian (a health professional who specialises in nutrition). They can give you detailed, personalised guidance about how you can change your diet.

Underlying causes

Your GP will also need to ensure the underlying cause of your anaemia is treated so anaemia does not become a recurrent problem.

For example, if non-steroidal anti-inflammatory drugs (NSAIDs) are causing bleeding in your stomach, your GP may prescribe an alternative type of medicine to help minimise the risk of stomach bleeding.

Heavy periods (menorrhagia) can also be treated in a number of different ways, using both medicines and special internal devices.

Read the full list of Health A-Z topics for more information if you have been diagnosed with another condition as well as iron deficiency anaemia.

Monitoring

Your GP will ask you to return for a check-up two to four weeks after you have started taking iron supplements to assess how well you have responded to the treatment. Your haemoglobin levels will be checked in a blood test.

If the result of the blood test shows an improvement, you will be asked to return in two to four months for a further blood test.

Once your haemoglobin levels and red blood cells are normal, your GP will usually recommend you continue taking iron supplements for three months to help replenish the iron stores in your body.

After this, depending on the cause of your iron deficiency anaemia, you should be able to stop taking the supplements. Your condition will then be monitored every three months for one year.

Continuing treatment

In some people, after iron stores in the body have been replenished, they start to fall again. This could happen if:

  • you do not eat an iron-rich diet
  • you are pregnant
  • you have heavy periods (menorrhagia)

In these circumstances, you may be prescribed an ongoing iron supplement. This will usually be one tablet a day. This will stop your anaemia returning. 

If treatment fails

If your iron levels do not improve, your GP will ask how regularly you have been taking your iron supplements. Some people are put off taking the medication because of the side effects (see above). However, your conditions will not improve if you do not take the supplements.

If you have been taking the supplements as prescribed and your iron levels have still not improved, your GP may refer you for an assessment with a specialist.

Medical Review: May 01, 2012
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